# Warfarin - and beyond ......



## KeithChesterfield (Mar 12, 2010)

After having a Pacemaker fitted (now able to pick up BT Sport and be a Wifi Hotspot) I've been told by the Hospital that I also need to have a blood thinning drug such as Warfarin to keep me going for a few years more.

I've heard there are other alternatives to Warfarin such as Pradaxa, Xarelto, Eliquis and Lixiana but that each one has it's own pros and cons.

Until I have a chat with the Doctor, who is to advise me which is the most suitable, could I ask if anyone on these forums has had experience of one or the other of the alternatives to Warfarin ? 

I will, obviously, take the Doctors advice (which may be that I don't have another choice) but I'd like to hear of any opinions from you gentlemen on the options available to me.

One reason for wanting an alternative is that we like to go on holiday abroad for at least a few weeks at a time and I believe Warfarin requires regular check-ups and the others not so frequently.

Any help appreciated.


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## TheAleMan (Apr 21, 2017)

I am on Warfarin and have no knowledge of any of the other drugs that you named. However, once Warfarin checks are consistent for a few weeks on the spin, then you shouldn't need to be checked for five or six weeks, I have gone as long as a few months between checks before now after consistently hitting my range. Only when they are struggling to get your dose right will you be going back and forth to be tested.


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## jiwawa (Jun 22, 2007)

KeithChesterfield said:


> I will, obviously, take the Doctors advice (which may be that I don't have another choice) but I'd like to hear of any opinions *from you gentlemen* on the options available to me.


I'm not trying to be sexist here but is it only men go on warfarin? The only other person I know was on it was my brother-in-law.


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## Drew (May 30, 2005)

Hi Keith, After having a stent inserted a few years ago I was prescribed TICAGRELOR to be taken with an Aspirin every morning for a year.


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## JanHank (Mar 29, 2015)

Hans has taken pradaxa for years probably 6 years, he did have Eliquis for a short time, but he bruised very easily so back to pradaxa. Hans has 2 Stents and uneven heart rhythm (can't think of what it is called in English)😕


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## emjaiuk (Jun 3, 2005)

Hi Keith, after 5/6 years on warfarin due to heart problems, I've recently bean moved to Edoxaban. My understanding is that there is not a lot of difference between the new drugs and warfarin, they've all got potential side effects, but then most medication does. 
I had to have a couple of blood tests done whilst away in France last year, INR tests are fully understood in France, and the process isn't that complicated, more inconvenient. If you . do end up on warfarin, I've got a couple of pdf translations. One which asks a pharmacy where the nearest blood lab is, and one for the blood lab which explains what is required. A friend of mine's sister is a pharmacist in France and she did them. You or anyone else is welcome to copies.


Malcolm


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## HermanHymer (Dec 5, 2008)

janhank said:


> hans has taken pradaxa for years probably 6 years, he did have eliquis for a short time, but he bruised very easily so back to pradaxa. Hans has 2 stents and uneven heart rhythm (can't think of what it is called in english)😕


arrhythmia


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## 747 (Oct 2, 2009)

HermanHymer said:


> arrhythmia


Gazundheit. :laugh:


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## listerdiesel (Aug 3, 2012)

I am currently on Rivaroxaban, it wasn't fully licenced for post-op use but now it is, so you should be able to ask for it instead of Warfarin.

I had Warfarin for some time after my heart valve op, then again after the breast cancer surgery, but currently I'm on Rivaroxaban, one tablet a day and no blood tests, which was what made Warfarin such a PITA.

I take it for Attrial Fibrillation which is almost the same as Arrhythmia.

Peter


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## JanHank (Mar 29, 2015)

:smile2: in German herzrhythmusstoerung.


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## fatbuddha (Aug 7, 2006)

having recently had a minor stroke as a result of an (at the time) undiagnosed atrial fibrillation (awaiting correction) I am now on apixaban (Eliquis) which is now the anticoagulant of choice in my local NHS Trust. 

the upside of the newer anticoags is that you don't need monitoring to ensure the plasma levels are fine (as you do with warfarin) but the downside is that there is no "antidote" if you have a heavy bleed. with warfarin an injection of vitamin K will neutralise the drug so your clot mechanism works fully again - there is no such equivalent for apixaban and similar drugs such as rivaroxaban, betrixaban etc (they are all Factor Xa inhibitors so will interrupt the clotting mechanism). recipients of these newer drugs should carry a Medical Alert card in case of injury - I've had a dogtag made so it's on me at all times. 

so yes, there are pros and cons to warfarin alternatives so you need to discuss these with your specialist.

as an example, I should no longer take part in "high risk" sports such as skiing in case of a fall resulting in a heavy bleed - it's a risk I am prepared to accept as a long term skier (who rarely falls!). I'm probably more at risk using powertools frankly having nearly ruined my inner right thigh with a belt sander last year!!!


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## JanHank (Mar 29, 2015)

All true what fats has said.
*1st, Jan- 2015*
This was the day when Hans had his first ever machining accident, he caught the tops of his finger in a bench router (a biscuit cutter attachment).
Luckily I came through the door seconds after it happened after taking the dogs for a walk, the blood spurted like fountain. I drove as fast as I dare to the hospital 17 km away, he had to wait about an hour before the doctor/surgeon arrived to stitch him up, it was new years day not many staff on duty.
Hans loves horses, but he was told to keep out of the stables in case one decided to kick out and he was in the way.


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## listerdiesel (Aug 3, 2012)

I haven't had any problems with wounds or surgery bleeding excessively on Rivaroxaban, can't comment on the others.

Peter


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## JanHank (Mar 29, 2015)

The big concern is blunt injuries causing internal bleeding both with warferin and alternative drugs.
Our village Major was on warferin, he fell from a tree, died in hospital because they couldn't stop the internal bleeding, so whatever you take there's risk, but not as great as not taking anything at all.


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## TheAleMan (Apr 21, 2017)

I have had internal bleeding on Warfarin just walking down the street. Don't just need a bang to set off a bleed. My INR wasn't high at the time either. :surprise:


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## KeithChesterfield (Mar 12, 2010)

Many thanks for all the helpful replies.

I went to have my Pacemaker checked earlier this week and then to see the Cardiologist who informed me that I needed a blood thinner but wouldn't know the options until I'd had a blood test.

Now I've had the blood test and await the results. 

Apparently I have an abnormal heart rhythm and, as there are around 70 possible conditions trying to find the one I have it's beyond my expertise, I'll let the medical experts oblige me by diagnosing which one fairly quickly.

I'm trying to get some idea on my options, as and when, so that at least I have some idea of what route to take and your input is a great help.

Thanks again.


:grin2: :grin2: :grin2: :grin2:


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## KeithChesterfield (Mar 12, 2010)

Things are moving on.

It's now over three months since having the Pacemaker fitted and the other week I started on the anticoagulant Rivaroxaban.

I've tried to avoid cutting myself and can't comment on what would happen if I did but at the moment there doesn't seem to be any new problems caused by the anticoagulant.

When I left Hospital back in November they reduced my Ramipril from 10mg a day to 2.5mg a day and stopped my Bisoprolol completely.

Now I'm back on 5mg Ramipril a day (slowly building back up 10mg) and 2.5mg Bisoprolol.

For the last few days I've been going for a decent long walk, taking in gradients as well as the flat, without a pause and I've felt completely reinvigorated by the time I come to my destinations.

A couple of hours later my legs have ached but that's hardly surprising as it's the most I've walked at a reasonable speed for many months.

Having the Pacemaker fitted has improved my life enormously and I feel now that I really have a new lease of life and for that I'm extremely grateful.


:grin2: :grin2: :grin2: :grin2:


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## JanHank (Mar 29, 2015)

I am very pleased for you Kieth.


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## jiwawa (Jun 22, 2007)

Excellent Keith - onwards and upwards ?


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## patp (Apr 30, 2007)

Wonderful news Keith


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