<p>myturnnow, I’m guessing, repeat, guessing, that taking a fast actin anticoagulant, in the event of known episodes of A fib, would be a rather handy safety measure. Many, if not most don’t know when they are in A fib, which is why taking an anticoagulant regularly is far safer and the usual recommended approach. </p>
<p>jym, fascinating. Let me know if there is anything about lisinopril and generics. When I’m handed yet another new generic, I always wonder if it will be as effective as the last one. </p>
<p>thanks for the feedback, my doc isn’t prescribing starting regular use of an anticoagulant as I haven’t had an A-fib episode in over 4 yrs. I suspect his current recommendation may have to do with concern that as I age A-fib becomes more likely, and since I was able to recognize an episode when it happened, (not the first,but the next two) he suggested having Zarelto on hand to take as a safety measure if I believe I’m having an episode, and then come into the office to verify if it was in fact an A-fib episode. He stated if taken and was no A-fib no harm done. I suspect if the episode was verified, (I have a pacemaker so it can easily be tracked) that he might then prescribe it to be used regularly. </p>
<p>OP, your husband is correct about the issues with Xarelto but the convenience factor outweighs the risks when compared to coumadin. So many of my patients have reported feeling liberated after being switched from coumadin to Xarelto. Being tied to constant INR checks is quickly becoming a thing of the past. In a healthy young patient, he would be tied to 50+ years of monthly checks, dietary restrictions and several medication adjustments that are not an issue with Xarelto. If I remember correctly, the half life of Xarelto is 9 hours. So, too much of a big deal if ypu need a reversal for surgery. Though, no one knows how to immediately address the anticoagulation.</p>
<p>the hematologist told my husband to take his last xarelto on the 19th before a procedure on the 21st This compares to 10 days for coumadin and the day before the procedure for the unicorn’s blood. So far (a year I think) we have been very happy with the switch (hematologist had to argue his case with the insurance company as xeralto isn’t marketed as a blood thinner and from what I understand will have to do the same annually - you’d think the insurance company would be happy not to be paying for the unicorn’s blood at several thousand dollars a month - I know we are!!)</p>
<p>@myturnnow I am more familiar with being Rx a pill like Toprol or something to take if one feels an A fib episode coming on. I am not sure what good one anticoagulant would do, other than of course possibly prevent a clot. But it would not do anything to treat the A fib, AFAIK. </p>
<p>There is another drug that my DH’s cardiologist mentioned as a “pill in the pocket” solution for a fib episodes, but the first dose always has to be in the hospital in case of a bad reaction. I forget the name because he was not a candidate for it.</p>
<p>Also, re: warfarin, I believe you cannot have alcohol on that either.</p>
<p>Surf, the point with warfarin or xeralto is to prevent a clot. Rate control, is of course hopefully achieved with another drug, Toprol, which is a beta blocker, or a calcium channel blocker, or a few others, including some that require hospital monitoring. </p>
<p>Thank you for this discussion. After one month of warfarin, following a cardiac surgery, there is still difficulty with the dosing. INR too low. I asked for and was granted a new prescription, not generic. We’ll see how that works. </p>
<p>My cardiac doc put me on Lasix a month ago and it has required tinkering with the warfarin. Hasn’t heard about not drinking alcohol while on warfarin – not that I drink much or often, but when I do, I tend to be on vacation and not near my docs, so if this creates a problem, would be good to know!</p>
<p>Alcohol intake can affect how the body metabolizes warfarin. Patients undergoing warfarin therapy should avoid drinking alcohol on a daily basis. Alcohol should be limited to no more than 1 to 2 servings of alcohol occasionally. The antiplatelet effect of alcohol increases the risk of major bleeding, even if the INR remains within the target range.</p>