Top Ten Reasons I’m Glad I’m on Warfarin
Warfarin is an excellent anticoagulant/blood thinner that helps prevent blood clots from forming where they can be dangerous and are not wanted. Here are the top ten reasons to be glad you’re on warfarin for the management of potential blood clots:
1. Blood levels can be monitored (INR).
It is a good idea to monitor the effectiveness of any anticoagulant and warfarin is the only anticoagulant on the market that can be monitored to see if the dose should be increased or decreased. When warfarin is monitored, a prothrombin time is measured which has been changed to be called an INR test, also called the International Normalized Ratio, a measure how “thin” the blood is. You need only give a small amount of blood approximately once a month in order to be assured that the warfarin is working effectively for you.
2. There is a good reversal agent in case too much is given.
Unlike other anticoagulants, warfarin has a built in reversal agent if you accidentally take too much and need to normalize your clotting ability. Doctors can give you vitamin K, which counteracts the warfarin and lets your body clot normally. The vitamin K works quickly so, within hours, your risk of abnormal bleeding goes way down. This benefit only works with warfarin and not with the newer agents that act as anticoagulants.
3. It has been tested and tried for years.
Doctors have used warfarin for about 60 years. They understand the pros of using warfarin and are generally quite good at initial dosing and adjusting the dose by following the INR. There are hundreds of articles and studies involving the use of warfarin and scientists are well aware of its benefits. Research studies on warfarin are generally nonbiased so they can be trusted as valuable resources on the ways warfarin can work for you.
4. Doctors and other providers are comfortable using it.
Doctors do best when they are familiar with a medication and how to use it. Warfarin is no exception. Almost all general practice and internal medicine doctors have patients on warfarin and they have learned how to manage these types of medications with ease. When a doctor is comfortable with a medication like warfarin, they make fewer mistakes in dosing the medication and know how to make adjustments in the dose of warfarin each patient needs for the most effective blood thinning ability.
5. It is easy to titrate it to the proper levels. Warfarin is a medication that can be titrated. What this means is that the blood testing of the prothrombin time and INR can help the doctor increase or decrease the dose if necessary. It means that you always take the proper amount of warfarin. Like other medications, the effectiveness of warfarin depends on things like your diet. This is why doctors prefer to err on the side of caution by checking the prothrombin time and calculating the INR on a regular basis.
6. It has been shown to prevent strokes.
Warfarin is considered the gold standard in stroke prevention, especially in people who suffer from a heart arrhythmia called atrial fibrillation. It can also be used in the management and prevention of deep vein thrombosis or blood clots, usually in the deep veins of the leg. There have been hundreds of studies on warfarin and the prevention of strokes and other blood clotting conditions. This is good news for the thousands of people who are preventing life-threatening and debilitating strokes by taking warfarin.
7. It is much cheaper than the newer anticoagulants.
There is no comparison when looking at the difference in price between warfarin and the newer anticoagulants. For example, the cost of a month’s supply of warfarin is between $10 and $20. A month’s supply of Pradaxa is more than $300 as is the cost of Eliquis. The cost of Xarelto is similar to the other newer agents. If you have to pay out of pocket, the cost of the newer agents might be prohibitive. Even if you have insurance that pays for drugs, you may have to pay a higher price for these expensive drugs than you would have to pay for warfarin.
8. It has been FDA approved for more conditions than the newer agents since 1954.
The newer agents have recently been approved by the FDA, most for the management of blood clots in people who have atrial fibrillation. One is also approved for the treatment of deep vein thrombosis. On the other hand, warfarin was approved by the Food and Drug Administration in 1954, more than sixty years ago. It is approved for the management of a wide variety of clotting problems besides atrial fibrillation and deep vein thrombosis.
9. If emergency surgery is necessary, you don’t have to wait until the drug clears the system as with the newer agents.
If you need emergency surgery, you don’t want bleeding complications to add to your problems. If you are on one of the newer anticoagulants, you’ll need to wait until the drug is out of your system before you can have surgery. In an emergency situation while on warfarin, doctors need only to counteract the warfarin with vitamin K injections and you can safely have your surgery after that. The difference between taking warfarin or a newer agent can save your life in an emergency.
10. Taking warfarin is simple.
Warfarin is taken just once a day. It is a good idea to be consistent in your intake of foods high in vitamin K such as spinach, brussel sprouts, kale, mustard greens, chard, collard greens and green tea, as these can make warfarin less effective. In addition, these foods can inadvertently increase the effectiveness of warfarin and should be limited: cranberry juice and alcohol. Your doctor will periodically check your blood to make sure the warfarin is at the correct dosage.