Warfarin- To Take Or Not To Take That Is The Question

[gordie1]

Hi there it has been suggested that I go on warfarin as I am having random episdodes of atrial fibrillation lasting up to 2 hours at a time. GP says it would be less risky of stroke if I was in permanent AF. He wants me to go on warfarin but what if I want to go away on holiday in the UK is that still ok and what other limitations are there on life> I know a stroke would be very limiting but my practice wont prescribe pradaxa as there is a cost issue but he says it is not only that there is more known about warfarin than the other drug. Anyone on here on warfarin or know about it? Also Im only 41 is warfarin not for older people

[bednobs]

i am 38 and have been on it for around 5 years, so age not a barrier. You can't go on drinking binges (you can actually drink as much as you like as ling as it's regular)

[coffeeboy]

I have been on warfarin for the past 12yrs
and I'm 67 yrs old, i'v been on holiday
Abroad with no problem, but you have to
Be careful not to eat cranberries or
Grapefruit as this conteracts the warfarin.

[Buenchico]

Warfarin was developed as a rat poison (honestly!) so that, through a lack of clotting, rats would bleed to death internally. However someone suddenly realised that (in much smaller doses) it could be used as an anti-coagulant in humans. It's now widely used and is probably at least as safe as aspirin.

For detailed information, click through the links ('considerations', 'side effects', etc) here:
http://www.nhs.uk/conditions/Anticoagulants-warfarin-/Pages/Introduction.aspx

[SeaJayPea]

My, you are going through it, aren't you?

Chris's link is as good as you'll find. I've been on it twice now, after a pulmonary embolism in 2010 and a DVT last year. It's no problem at all. you go for a blood test every so often, wait an hour while they do the test, then get told if you need to vary the dose. Initially, you'll go every week, then once they've got it under control, that'll extend to once a fortnight or even longer.

As coffeeeboy says, there are food restrictions, cranberries and grapefruit are two, but they also suggest that leafy green vegetables should be avoided.

There's no problem with travel, either. Just make sure you carry your pills with you and that you also take the documentation you're given as well. You can easily go abroad, just make sure you tell your insurers that you are on the stuff or they may refuse to pay out in the event of a claim.

Good luck with it.

[SeaJayPea]

Incidentally, has your GP suggested investigating why you get the AF? They can do various things to deal with that, you know.

Just a thought.

[LazyGun]

Warfarin has been used for a long time and is in widespread clinical use around the globe. Millions of patients, so the medical profession has had lots of experience and lots of exposure to the benefits and the risks.

If your GP is recommending anticoagulant therapy because you have a background condition of AF, I would take his advice.

There are some restrictions on lifestyle with warfarin - you do have to be careful around alcohol, since it can have a synergistic interaction with the warfarin. There are certain foods to avoid also - food that are rich in Vitamin K, such as Kale, or Spinach. I do not believe though that such restrictions would offer and serious material detrimental impact on lifestyle.

Warfarin can sometimes be tricky to get to the recommended level for each individual, and might require quite a lot of adjustment, at least initially. Because of its mode of action, anyone on warfarin therapy needs to be monitored via a blood test regularly, usually 1/month, which can be something of a pain i guess.

Dabigatran and other, similar drugs, are very new, but do have a different mode of action. They control coagulation in a slightly different manner, but at the moment they are only considered to be of use in very specific circumstances. Warfarin remains the "gold standard" for now.

Don't make the mistake of thinking that Dabigatran is a superior drug and they are denying you that drug because of costs. It is true that coagulation therapy using dabigatran is signicantly more expensive at the moment ( about £100 or so per year for warfarin, around £2,500 a year for dabigatran) ; Dabigatran has its own side effects and adverse reactions too.