I've been on warfarin for just over a year and have to be on it for life but want to change to Rivaroxaban as there is no regular INR checks. My GP said that it can't be done as no-one has ever been on Rivaroxaban long term. Can anybody tell me if this is correct? or have I been fobbed off.
There are tests being carried out at the moment to ascertain the suitability of rivoroxaban long-term; it isn't recommend for this now. One reason is that some problems with bleeding have arisen, and they are trying to see if a lower dose can still have the desired anticoagulant effect. So no, you're not being fobbed off. But it's true that rivoroxaban is more expensive than Warfarin.....
Thanks for your reply Lucy, I just thought my GP was trying it on. Do you know if any of the other anticoagulants are ok for long term? Apixaban perhaps?
Hi Rob. I have just started on Apixaban which is a new anticoagulant along with Rivoroxaban. I did not want to go on Warfarin for the same reason that you want to come off it. I know this is a new drug, but the problem with internal bleeding is no different to being on Warfarin. I was recommended to go on this new drug by my Cardiac Rehabilitation Nurse and also a doctor friend of mine has been on it for the past six months! I think you will find that it does all come down to expense but I was also told that Apixaban is gentler on the stomach. Good luck.
I wanted to come off Warfarin but my doctor actually said there was no antidote for the particular drug I was requesting now whether this applies to Rivaroxaban also I`m not sure. So I have come to terms with being on Warfarin and if I have to go each week to have my INR checked so be it at least they have got my back!!
Hi Marion, yes you are quite right about warfarin having an antedote which is Vitamin K. I really don't think we need to worry about there not being an antidote for these other tablets yet. I have been told by my medical doctor friend who is on Apixaban that really there is no real cause for concern because you would just stop taking the tablets and then the blood would clot. He really thinks it all comes down to cost!!!
This would rather depend on how quickly the body can eliminate these other anticoagulants. Vitamin K can be administered in an emergency to activate clotting while Warfarin is still in the body.
If you have had a replacement heart valve the new anticoagulants are contra indicated.
Hi Rob....that is very interesting. Seems simple enogh to just stop taking the tablets....never thought of that...makes sense though.
Hi Rob,
Rivaroxaban is one of the new NOAC's and what you say is correct but is only half the story. There is also no antidote at this stage. So in an emergency - with Warfarin the effects can be reversed, these new NOAC's cannot. To the best of my knowledge they are usually prescribed to those patients who have big problems with Warfarin, i.e. a history of unstable INR readings, etc. etc. NOAC's are also considerably more expensive than Warfarin and therefore some GP's and CCG's will not prescribe them unless they have to. If you haven't already done so I suggest you read NICE Guidelines on NOAC's.
John
in an emergency whereby you injure yourself in an accident or you happen to bleed internally due to an adverse drug interaction then the effects of Warfarin can be reversed quickly whereas they cant with Rivaroxaban. The only option currently with Rivaroxaban is to let your body get rid it it naturally - the usual daily dose (20mg) has a half life of ~12 hours so potentially up to 24 hours before your blood regains its ability to clot naturally.
I am on Rivaroxaban to treat a PE and I had an adverse effect after taking it for 5 days after which I started peeing blood (haematuria) - it cleared up after 3 days and I have had no recurrence for nearly 6 weeks now. I underwent a number of tests etc which have all been clear and suggests that it was due to an adverse effect /interaction to the Rivaroxaban. Internal bleeding is relatively common with Rivaoxaban and it can affect up to 1 in 10 people taking it.
You are being fobbed off. I have been on it for 4 weeks ...have a kidney blood test every 6 months on it for life. Hope this helps x
Hi Lucy only just been put on Riveroaxaban but I can tell you and the doctors swore by it that it's far better than warfarin. I'm only on it for 6 months but I hate tablets or medicine, but I have to take it to get better. I have had no side effects.
Thank you for responding ...have a great day
Glad the Riveroxaban is working well for you. I'm on anti-coagulants for life, have not had any problems with Warfarin, my INR is stable and has been almost from the time I started taking it, no side effects, INR test every couple of months. I'd be interested to know in what way Riveroxaban is 'far better than Warfarin', aside from not having to be regularly monitored.
Less incidence of bleeding on the brain .which as you know is very serious. That's it really the only differences . Hope this as helped.
I have been on Rivaroxaban for 1 year and will be on it for life. I had multiple extensive PE's with no reason as to why I suffered from them.
My haematologist told me I needed to have a blood test once a year to check my kidneys and liver.
It is true there is no antidote to the drug but it has a half life of 24 hours. If a patient was on the drug and was bleeding extensively there are did that can be given to stop the bleeding so I wouldn't worry about it.
I was put onto the drug by my haematologist who suggested it was more convenient for me.
Hope this helps
i have AF and am on Warfarin - i have blood tests almost every week which is very inconvenient - she told me that giving me dagabran would be cheaper for them as they would not have to keep paying for the INR tests - i think i looked up the cost on the internet for this drug - it is around £46 per month compared to pennies for warfarin. do you also know that GP's get a payment from the government for putting us on these drugs!!
I have always been told that warfarin is the cheaper option and that surgeries get around £10 per INR test and most patients don't need them every week. In some areas pharmacies are now doing the tests instead of GP's. The surgery I go has around 300 patients on Warfarin.
my GP is reluctant to take me off warfarin and give me Rivaroxaban - i think she is waiting for consultant to recommend rather than diagnose herself. although this drug is around £48 per month compared to pennies for warfarin if you need regular INR checks my consultant says it comes in cheaper in the long run