Coumadin vs Xeralto vs Pradaxa

[Wonderyears1964]

My Dad who is 77 has been on Coumadin since 2005 after a DVT following surgery, He also has Afib and has had it for years, due to a thyroid condition. he also has a pacemaker. He's been on Armour thyroid for at least 4 years, and tried Armour instead of Synthoid to see if he would feel better on Synthoid's alternative. Which he does actually feel better emotionally on the Armour.  Here lately since his thyroid meds have been decreased it's been a struggle for him to maintain an INR of 2.5; his current dosing is 17.5 mg daily, and alternating 20mg every other day. Even with that dosing it's hard to keep his INR up. We are very careful with his diet and he basically eats no green leafy vegi. We have noticed since the addtition of the 20 mg every other day that his memory is fading quickly. We stuggle with the possibility of switching his blood thinner to Xeralto since he's had 2 falls in the past year and from what i've read if there is a bleeding event while on Xeralto, there is not way to stop it. Without an antedote we question if it would be wise to change. I should also mention that he did try Pradaxa last year and was on it for about 3 days when blood in his stool was noticed. Can you please help educate us on the benefits/risks for these drugs and is one any better or less dangerous for older folks. Thanks in advance for your help.

[DeltaDawn23]

I have been on Warfarin for over a year and have no significant problems with it.  I have a small salad or serving of Vitamin K veggies each day and the Coumadin clinic can help if I have any problems.  I do have a Phillips meter so I can check my INR at home.  My cardiologist says Warfarin is a well tested drug having been on the market for years.  The newer ones do not have an antidote and are expensive.  As long as I'm doing well on the Warfarin, I think I'll stick with it.  If you have a bleed, they can give you Vitamin K and/or plasma.  I do think the elderly have more issues with bleeding on the newer drugs.  Good luck with your Dad.

[Wonderyears1964]

Thank you for your input. It's helpful to know what others are experiencing.

[Jerry_NJ]

My only experience is Warfarin (generic Coumaden) for about 15 years.  I'm at 5 mg daily, and 7.5 mg a couple of times a week.  I am always in the 2-3 range, and guess Warfarin would hold be at 2.5 + if I took 7.5 mg a day.  I am not suggesting a dose change, just sharing experience.  

I eat green vegetables/salads often and it doesn't seem to make any big change.  I also take a mulch-vitamin that includes "K", and I wonder if that level addition each day helps stabilize my "K" level against my "K" input due to diet.  The supplement I take is a fractional "K" as I recall.  My understanding is one must achieve a balance of diet/coumadin  -  so the "K" in my vitamin is one rock solid on the input side.

I think we humans are very different, and the difference in your experience and mine stands as one example.

Wishing good luck in getting some helpful input for others.