rivaroxaban or warfrin

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Just had to make the decision of these drugs to be taken for life

Warfarin takes forever to regulate lots injections to find right level. However they can give vit d if you have a life threatening bleed.

Rivaroxaban which I have been on for 6 months no side effects really but there is nothing they can give to reverse it if you have a bleed.

Blimey what a choice I went with Rivaroxaban thinking more risk getting another clot than bleed but I keep worrying about accidents. It's all new cause only knew today I have more PE . Apparently told that within a couple of years they should have something they can give to reverse thinning and it has a shorter shelf life which means if I have elective surgery etc I don't have to be off it for long

Seems a really unfair decision to make. What a day

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8 Replies

  • Posted

    Be carefull when taking Warfarin. Check on any other medication. I was Taking Tramadol for back pain and after doing a search online regarding side effects of certain drugs I found out that Tramadol can affect warfarin levels. Stopped Tramadol and hey presto Warfarin levels stabilised !
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  • Posted

    Tina,

    I have experience of both, so may be able to shed a bit of light....

    Rivaroxaban - Fairly new drug. Really convenient as no testing required. No antidote yet, but it has a very short half-life (useful when you need to stop for an op or procedure). Suits some very well, not all (usually very clear if it doesn't suit you). No INR testing possible, but not supposed to be required.

    Warfarin. Very old drug. Easy to take, but needs testing on a regular basis. Has antidote, which is just as well, as it has a VERY long half life (days). Does not suit everyone, usually through difficulty keeping a stable level. Can be tested, but can be a nuisance depending on frequency. A lot of prejudice, as it is also a poison. Interacts with many many other drugs, so can be troublesome (drug interations are well documented though). Supposed to restrict certain foods, but a lot of that is actually a bit of an urban myth.

    I was on Rivaroxaban, but didn't get on with it after a short while. Switched to Warfarin and problems went. Many have gone the other way. My friend is on RRB and has no side effects at all.

    If it were me and I had had 6 months on RRB with no problems, I would stick with it. 

    HTH

    Peter

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    • Posted

      p.s. Warfarin testing does not require injections, just a pin prick. Very quick and easy. It's the trip to the doctors or hospital for the test that's a pain. I am lucky, as I live 5 mins away from the doc. If I lived further away, I would buy an INR tester and do it at home.
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  • Posted

    Hi Tina, Warfarin is a Vitamin K antagonist so they can inject vit K to neutralise. Some people stabilise easily and need checking infrequently. Yes possible to check using own machine. Any other meds mould need to be checked for interaction with both. Good luck with your decision. 
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  • Posted

    Hi,

    I'm surprised rivaroxaban was offered as a "for life" treatment. My consultants didn't recommend me switching to it as it's a new drug and long term effects of it are not yet known as opposed to tried and tested warfarin. They did mention the possibility of the body becoming immune to it long term.

    I've been on warfarin for last 20 years since I was 18. I bought a home testing kit many years ago and set up an email agreement between surgery and clinic as the official means of communication, thus no yellow book etc. Admittedly there have been a few bumps in the road, generally when a new member of staff at the clinic encounters this, but in general it works pretty well and means warfarin has a pretty minimal impact on my life.

    Food wise, I eat a healthy balanced diet. There are a lot foods which some people say you shouldn't eat, namely those in rich in vitamin k. However, it's about balance, if you eat them little but often then this will in effect be naturally reflected into your INR. Problems only occur when you don't normally consume those foods, and say for example you suddenly went on a health food kick and had lots of super green kale juices then it would impact your INR, your dose would be adjusted accordingly, then say you stopped drinking them again your INR would go high again etc.

    Basic rule of thumb foods rich in vitamin k don't need to dropped completely just consumed consistently.

    The only thing I have cut out completely is alcohol, buts that's a personal choice.

    Injection wise I have a stock of clexane in case my INR falls below a certain level but that is generally case specific. Other than that it's just a small pin prick on the finger and that's it.

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  • Posted

    Hiya I went for rivaroxeban on the basis that it's less faffing about etc etc , it seems a bit unknown compared to warfarin, but I would be personally crap at monitoring dosages and having to go to appointments etc .

    The only side effect I have so far is being dog tired after a few hours working , really hard to keep my eyes open some days !

    I am too a bit worried about accidents etc as I am a klutz , but I suppose it's pro and con of any choice of any medications

    I hope as time goes on we can all share any side effects and experiences in the absence of long term info so far

    James

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  • Posted

    Hey Tina :-)

       I take Apixaban. Another new one like Rivaroxaban. No reversal agent for bleeding and still relatively new on the market.

      I am in no doubt that these new ones are right for me! I found warfarin so life impacting and half the time my INR wasn't between 2 and 3 so I wasn't even protected from PEs on those days!

       It sounds scary to have no antedote but as others have said the half life is short. In that time I have been reassurred that blood products are normally enough to sustain life if severely bleeding unless you're stuck in the middle of nowhere but if that were the case then vitamin k wouldn't be handy either!

       Good luck :-)

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  • Posted

    Hi Tina

    I have been on Warafin for years.   I have had surguries, and dental surgury's  and only had to be off the warafin for a very short time time  and as soon as the surgury was over I immediatly went back on the wrafin and found no problem on that score.  I think the big question is wether one particular drug gives you any negative side effects

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