Thursday, January 6, 2011

An Alternative to Coumadin (warfarin)

As many of you already seem to be aware, the FDA approved a medicine called Pradaxa in late October, 2010.

Currently, it is for use in patients who have a very common arrhythmia called atrial fibrillation (AFib) without any heart valve disease along with it. The purpose of the medication is to act as a "blood thinner" to prevent stroke due to the AFib.

Up until this time, the only way to do this was with a pill called Coumadin (warfarin). Aside from the 2% per year risk of serious bleeding due to the medication, it also requires frequent lab testing to be sure that the dose is adjusted correctly. Dose adjustments are common because many, many common foods and medicines can interfere with the metabolism of Coumadin.

The deal with Pradaxa, is that it works just as well as Coumadin in preventing AFib-related stroke, and is about the same in terms of side-effects and bleeding risks. However, the dose is largely the same for all patients, and does not require lab testing. Pradaxa can be used as a first medication, or as a change from Coumadin.

Currently, the cost of this medicine is about $200/month since no insurance plans cover it (the exception to this is the military's TriCARE insurance which covers all but a $20/month co-payment). Depending on you financial state of affairs and the value you place on your time and co-pays for lab testing, you may still find this worthwhile.

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