An Alternative to Coumadin Therapy
Coumadin (Coumadin, Jantoven) is an anticoagulant medication which works to prevent dangerous blood clots from forming and reduce risk for stroke, heart attack, deep vein thrombosis, and pulmonary embolism. To do this effectively it requires regular “INR” blood tests as well as restrictions on what patients can eat and drinks.
Pradaxa (dabigatran) and Eliquis (apixaban) are two new oral medications that do not require regular testing or dietary restrictions, yet effectively decrease the risk of blood clots while simultaneously increasing bleeding risks. Both can directly inhibit an important clotting factor to decrease risks without increasing bleeding risks.
Warfarin
Warfarin is one of the most frequently prescribed blood thinners, and is used to prevent brain blood clots in those suffering from atrial fibrillation (AF). This condition involves irregular quivering in the upper chambers of the heart that leads to pooled blood in these chambers – potentially increasing risk for stroke. Warfarin acts by interfering with an enzyme involved in creating blood clots as well as inhibiting certain proteins responsible for their formation – both processes helping ensure no new clots form!
Regular blood tests must be performed to ensure patients are receiving an appropriate dosage, and aren’t over or under medicated. Each drug has a narrow therapeutic window where its strength must be sufficient to inhibit clot formation while not leading to dangerous bleeding; while genetic tests have been promoted as ways of helping predict an optimal dose, they have not proven useful yet in day-to-day practice.
Persons on warfarin must avoid activities that may lead to injuries, including contact sports such as boxing, karate and rugby. If one does sustain an injury while taking warfarin it is essential that immediate medical attention be sought in order to reduce risks of serious bleeding. For added peace of mind when taking their medications it is also recommended that individuals wear medical alert bracelets.
At times, doctors may recommend switching an individual from warfarin to another anticoagulant due to injury risks or intolerance of warfarin. Two such alternatives are dabigatran and apixaban; dabigatran was approved in 2010 as an interference with blood clotting proteins that has proven as effective as warfarin for atrial fibrillation prevention with reduced bleeding risks; however it may increase your risk for kidney disease known as calciphylaxis.
As this drug may interact with various other medications, those taking it must notify their healthcare team of all prescription and nonprescription drugs they are taking, whether prescription or over-the-counter drugs; and pregnancy/breastfeeding status; plus any supplements or herbal products being utilized.
Eliquis
Eliquis is a blood thinner designed to prevent DVT and PE as well as stop new blood clots from forming in veins, by inhibiting certain enzymes that contribute to clotting processes. Taken orally in tablet form, dosage will depend upon individual circumstances. Aspirin should be taken for several months following a DVT or PE, and also used to help prevent DVT/PE from returning following surgery, usually for approximately one month post hip or knee replacement and several weeks to a month post surgery to treat DVT or PE in arms and legs. In addition, those at risk due to atrial fibrillation who could potentially experience blood clots or stroke can take this drug twice daily for as long as your physician recommends (usually 2.5 mg).
Bleeding is a potentially life-threatening side effect of taking Eliquis, especially among people who have a history of stomach ulcers or bleeding disorders. People taking anticoagulants, NSAIDs, or antidepressant medicines that increase bleeding risk (SSRI or SNRI antidepressants for example) should notify their physician. Bleeding may also increase with use. People at higher risk include those who already suffer from ulcers or bleeding disorders in general and individuals taking medications like Eliquis. It is also important that users inform their physician of any medications they take that increase bleeding risk such as anticoagulants, NSAIDs or antidepressant antidepressants that increase bleeding risk such as anticoagulants SSRI/SNRI antidepressants etc that increase the risks – either way this medication increases bleeding risks further – and to let him/her/her know.
Anemia, caused by the depletion of red blood cells, is another potential side effect of medication use. Symptoms may include dizziness, fatigue, and an irregular heartbeat; your doctor can often identify this problem through blood tests or examination.
DOACs (direct-acting oral anticoagulants), like Apixaban, are direct-acting oral anticoagulants and shouldn’t be taken during pregnancy as the increased risk of bleeding can increase risks during labor and delivery. DOACs differ from warfarin by not requiring frequent blood testing and having less interactions with other drugs; additionally they’re cheaper; patients can often obtain it with coupons or free trial offers for less than $10 per refill – although pregnant women should avoid this drug due to increased bleeding risks for both mother and newborn alike. Apixaban should not be taken during gestation as it increases risks during delivery as it increases risks associated with bleeding during labor. It should also not recommended due to increased risks during gestation & delivery during delivery of their newborn after delivery of their baby after delivery has taken.
Pradaxa
Pradaxa (dabigatran etexilate) is an anticoagulant drug that operates differently from warfarin and other blood thinners; it prevents blood clot formation by blocking an inhibitory factor, making a regular dose one or two capsules daily recommended by your healthcare provider based on your unique situation.
Pradaxa belongs to a new class of medications known as direct thrombin inhibitors, designed to replace older blood thinners such as warfarin. They work by directly blocking the enzyme thrombin which plays an essential part in blood clotting processes and have significantly fewer side effects and interactions than their older counterparts, as well as require less monitoring than previous medications.
Pradaxa’s primary use is to reduce the risk of blood clots and stroke among those diagnosed with nonvalvular atrial fibrillation, often caused by defective heart valves but possibly other sources. People living with nonvalvular atrial fibrillation have an increased chance of lung or brain clots that could result in stroke.
Your doctor may suggest Pradaxa to prevent blood clots after surgery. It’s especially useful in those undergoing hip replacement or who have had previous DVT/PE, which involve large veins in their legs or lungs becoming blocked with blood clots. In addition, it could help stop an aorta clot, the main artery connecting blood from the body to the heart.
If you are taking Pradaxa and suffer from an ulcer, notify your physician immediately as it could make matters worse. Avoid eating or drinking anything acidic (e.g. vinegar) during treatment to ensure maximum efficacy.
Do not take this medication if you have serious kidney or liver disease. Additionally, do not combine this anticoagulant medicine with another anticoagulant medication such as Heparin. Be sure to inform your healthcare provider of all medicines or supplements you are taking along with any medical conditions you have such as allergies, pregnancy or breast-feeding.
Injections
If a patient needs long-term anticoagulation, such as COUMADIN to inhibit vitamin K-dependent clotting factors and prevent blood clots from forming and treat certain thromboembolic conditions like venous thrombosis and pulmonary embolism, blood thinners may be prescribed in order to lower their risk. Since COUMADIN’s therapeutic range is quite narrow it’s essential that INR levels be closely monitored so as to prevent bleeding complications.
Medication injection can take place in various parts of the body depending on its desired effect and location. Intravenous (IV) administration provides quick onset; intramuscular (IM) injections offer less immediate effects but still yield results quickly.
Necrosis and gangrene of skin or other tissues is an uncommon but serious side effect of drug treatment, often manifested within days after beginning medication and usually affecting legs or arms but also possibly other parts of the body. Necrosis often arises as a result of blocked bloodflow to tissues which leads to necrosis and eventually necrosis leading to gangrene, necrosis in extreme cases can even result in necrosis necrosis leading to an amputation of affected tissue.
COUMADIN can interact with other medications, including heparins, through both pharmacodynamic and pharmacokinetic mechanisms, leading to increased levels of vitamin K in the blood and thus diminishing its effectiveness. As such, patients must eat a diet rich in essential vitamins like K while taking their medication, in addition to avoiding sudden shifts or drastic changes in eating habits or food items high in Vitamin K content.
Before beginning treatment with COUMADIN, it is wise to consult a physician. The drug interacts with various foods and supplements as well as being contraindicated during pregnancy due to risks of fetal injury. As alternatives, Xarelto or Eliquis may be better choices since they do not interact with food sources nor require regular monitoring of INR levels.