Warfarin v new anti coagulant drugs

Coley, no experience of new anti-coagulants but, like you, have had PAF for 3 years and have been taking Flecainide and Warfarin for that time. Shortly after my first period of 'calm' I was told by my cardiologist that I could stop taking Warfarin and promptly suffered another short PAF episode. I'm now reconciled to taking the drugs though haven't had an episode since Jan 2013! I don't experience any side effects with either.

I'd try the new drug - if they've recommended it grab it as it costs abou 50x as much as warfarin! Apixaban is

the newest and I would try that one. It has a much shorter half life than warfarin so although there is no

antidote you are less likely to bleed out. I wish I'd only had one episode of AF in 3yrs! Mine are every few months and I hate them.

The message that they do not require any monitoring is misleading - patients still need to be monitored for signs of side effects as well as efficacy. With warfarin this is easily done by checking the INR value as part of a blood test. If the INR is within a pre-specified target range you are protected from stroke. If it is too high you are at an increased risk of bleeding but this can be managed by reducing the dose or taking vitamin K, which reverses warfarin's effect. If a patient came in to hospital on one of the newer drugs, there is currently no way of determining whether they are sufficiently protected. A blood level of the drug concentration is meaningless. The newer drugs are being promoted as not needed these periodic blood tests, having fewer drug interactions (although there are still plenty to watch for) and providing a fixed dose. But is regular monitoring that bad ? This is a discussion that you need to have with your cardiologist. Apologies cannot tell if you are female or male - if the former your age puts you at increased risk.

Tarun (hospital pharmacist)

To Tarun

What amazes me is the drug companies released these drugs and got NICE and the FDA to approve them without any sort of antidote being available!

Personally I quite like being monitored regularly for INR. Tho I hate warfarin (it's given me rosacea) I'd rather take it than have a stroke.

Interesting article on anti coagulation in the on-line BMJ.

http://www.bmj.com/content/342/bmj.d3653

Bit too technical for me!

I have just started ( 2 weeks ) a course of Bisopropol and Clopidogrel, the latter being the blood thinning agent. The doctor advised me that their was not an antidote available but it was not as strong as warfarin. Side effects, I have not suffered any, if you require to see the possible side effects just Google it and check on the NHS site.

Thank you all for your comments. I am going to talk to my GP this week.