Posted on 09/08/2020 9:27:12 AM PDT by ConservativeMind
New atrial fibrillation drugs possess significant advantages over warfarin for reducing the risk of embolic events such as a stroke or peripheral embolism.
Patients with AFib have an especially high risk of blood clots that can lead to stroke. Warfarin (Coumadin) has been the gold standard for stroke prevention in patients with AFib for the past 50 years. But to be effective, warfarin requires careful monitoring.
Within the last several years, the FDA has approved several new anticoagulants as alternatives to warfarin: dabigatran (Pradaxa), a direct thrombin inhibitor; rivaroxaban (Xarelto), a factor Xa inhibitor; and apixaban (Eliquis), also a factor Xa inhibitor.
In testing these drugs’ efficacy against warfarin’s performance, the newer drugs showed some significant advantages. All were studied in large clinical trials of between 14,000 and 19,000 subjects—and all showed that these drugs were equal to warfarin or superior in reducing the risk of embolic events such as a stroke or peripheral embolism.
“By a significant percentage—30% to 40%—there was a reduction in stroke or systemic embolism,” Sheikh says. “And all of these drugs did it with at least equivalent safety or, in some cases, even greater safety.”
Additionally, there are dietary restrictions associated with warfarin that aren’t necessary with the new anticoagulants. Warfarin works against vitamin K, which the liver uses to make blood-clotting proteins, reducing the liver’s ability to use vitamin K to produce these proteins. So if a patient on warfarin eats too many foods with high levels of vitamin K, such as leafy greens or liver, it can affect warfarin’s metabolism. “It could either get very high or very low and increase the risk of bleeding or stroke,” Sheikh says. “But with these new drugs you don’t have to worry about these types of food interactions. People can eat what they want.”
(Excerpt) Read more at todaysgeriatricmedicine.com ...
Eliquis must be astronomically expensive to afford all those TV commercials. On the other hand a ninety day prescription for Warfarin is less than $20.
True, $500 for A MONTH’S SUPPLY.
But with warfarin you have to have blood work done constantly................
If you don’t have drug insurance beware. Spouse had to say no to Eliquis at nearly $600 per 30 days, twice a day pill.
Paroxysmal A-Fib my problem, heart structural sound, veins and arteries clear...damn wiring messed up.
Lay off the caffeine?................
I had a couple arterial stents plugged in 2 months ago and they put me on Plavix which gave me brain fog and vivid nightmares. It is also contraindicated for use with Esomeprazole which I have been taking for 20 years for acid reflux - so, back to aspirin for now.
“let’s shoot for zero cholesterol.”
zero?
cell membranes are made from cholesterol
the brain is mostly made of cholesterol
cholesterol is a precursor to all male and female sex hormones ...
anyone whose cholesterol went to zero would die ...
Are you a candidate for cryo-ablation?
Had it performed last summer, and I have been cleared to go off all prescription drugs in a month.
Bristol-Meyer-Squib has a foundation that may be able help you if your overall financial situation falls within their qualifiers. Surprised your cardio didn’t mention it.
Will send you info in FR if you like.
I get INR tested every six weeks.
My husband has A-Fib/ had an ablation about ten years ago, and is on Eliquis. Loves it. He has NO fibs to speak of. No dietary restrictions. We walk and hike/ camp at altitude. NP. Western medicine is amazing these days.
best bet is to get it fixed permanently and forget the drugs ...
go to Wilbur Su in Phoenix, AZ and have him perform cryoablation on your pulmonary vein openings in the left atrium ...
That was Covenantor’s diagnosis, not mine. I’m okay AFAIK. Although I have had two Cardioversions. One before and one after the by-pass.................
When I was in the hospital, I was getting it every day!.......They ran out of places to get blood!............
WellRX shows Eliquis at $473.89 for 60, 5 mg pills (Costco).
GoodRX at $472 (Costco).
Those are still expensive, without a doubt, though.
Coming on two years with Eliquis. With blood draws I sometimes get good size bruising, though it seems dependant on skill of blood tech. Then there was the one time the IV port was removed and compression bandage was a tad late...clean up in aisle, got pretty good altitude that time.
90 day supply = $0
Blood test every 6 weeks = $0
Doc and I haven’t been able to isolate any triggers yet. Zio monitors haven’t caught an episode, so its like a thief in the night, arrives without warning and by the time I get to ER it leaves without a trace but for high pulse rate.
Additionally, there are dietary restrictions associated with warfarin that aren’t necessary with the new anticoagulants. Warfarin works against vitamin K, which the liver uses to make blood-clotting proteins, reducing the liver’s ability to use vitamin K to produce these proteins. So if a patient on warfarin eats too many foods with high levels of vitamin K, such as leafy greens or liver, it can affect warfarin’s metabolism. “It could either get very high or very low and increase the risk of bleeding or stroke,” Sheikh says. “But with these new drugs you don’t have to worry about these types of food interactions. People can eat what they want.”
...
An advantage of this relationship is that vitamin K is an effective and cheap antidote for Coumadin overdoses.
Any scar tissue? Like from an operation or heart attack?..............
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