DVT deep vein thrombosis forum

       Home    1

number of replies (13) - Page 1 of 1
Xarelto
Started by Char
Posted: January 16, 2009 at 17:57
Video from the Bayer Group concerning a new anti coagulant already approved in Europe and now Canada. Waiting for the FDA to stop protecting me from this new medication. It is OK with the FDA that others and I take rat poison daily.
http://www.webvideo.bayer.com/module/player/player-bayer.aspx?folderid=10157&application=bayer
10822
Re: Xarelto
Reply #1 by Tom in Connecticut
Posted: January 16, 2009 at 18:22
Char,

Dabigatran, Apixaban, Xarelto (Rivaroxaban) are all new oral anticoagulants undergoing Phase III Trials in the U.S.. Xarelto is probably the furthest ahead in its trial but still will not be market until at least 2010.

I agree all three oral anticoagulant will give patients a choice, however, what is not known or even being looked at is long-term use of these medications. There are no studies currently being looked at long-term side affects associated with their use so for us life-long Coumadin users, Coumadin will still be my choice. As with any medication, supplement or vitamins, there are pro's and con's to it's use. I am by no means anti-Coumadin, I've been on it since 1992 (on and off) and consistely since 2001. There are things I dislike about it, but at least I know it's long term affects.

Another concern regarding each of the new oral anticoagulant is how to reverse it's affects in case of major trauma. There are currently no fail safe for those taking these medications in the event of major bleeding. We know how to counteract Coumadin and LMWH. In the event of major bleeding while on the new oral anticoagulant, the dangers outweight coumadin.

Hopefully in time once the trials conclude, these areas will be looked at. Keep in mind, Europe and Canada all approved the medication Exanta back in 2003/2004. When Exanta underwent Phase III testing here in the U.S. we found out it caused increased liver enzymes and death. Since then, Canada and Europe pulled their approval of the medication and Exanta is no longer more. Though the FDA has Pro's and Con's about the organization, there are good practices that are done here in the States that protect the patient in the way we test medications and I'm grateful for that. Exanta was touted as being the replacement for Coumadin. For me, I'll stick to Coumadin use even when the new oral Anticoagulants are approved. If and when they approve long term use of these new oral anticoagulant I will still wait 10 years so long-term side affects pertaining to it's usage will be known.
10823
Re: Xarelto
Reply #2 by Char
Posted: January 16, 2009 at 19:31
Talked it over with my Hematologist he agrees with the use of Rivaroxaban, he has been following the trials. I probably do not have 10 years to wait and see. He expects it to be approved by the end of 2009. So far low dose Warfarin is not giving me major problems, nothing like the higher doses. Had extreme dizziness and that made me very disabled, the dizziness went away in November when I stopped the Warfarin. Now at 5mg per day I am OK and the other side effects are decreasing such as pain areas. My INR today was 1.8, target 2-3, but I will NOT take more than the 5mg, as extreme dizziness is as dangerous as blood clots. Just do not want to sit around because I am too dizzy to walk, bike or drive. Speaking of walking, because of the dizziness in October I walked into a counter in a store. Blood poured out from the laceration. UGH
I can tolerate most all the side effects but the disabling dizziness.

10827
Re: Xarelto
Reply #3 by hectors house
Posted: January 19, 2009 at 13:29

Char.

This drug is been used in the UK as a preventative measure for pre op patients who may be having surgery which leads to bed rest and they are under the impression through clinical trials that most DVT/PE are caused whilst the patient is immobile.

I was excited also about this product as a way to get off warfarin but its not been used this way as a long term anti coagulant especially with people like us who are on it for life.

I dont know your circumstances and prognosis. This is the primary usage for the UK in the wards and i will try to find out more information reference to this and i will post here.

Hector
10850
Re: Xarelto
Reply #4 by Char
Posted: January 19, 2009 at 17:43
Hey Hector
Presently there are trials with DVT/PE patients, I have read all the trials are in Penn (USA). I hope the trials show this is good for lifers on anti coagulants. As of Dec 2008, I am a lifer for my genetic clotting disorder. I refuse to take anymore than 5 mg Warfarin daily. That keeps my INR 1.8 to 2.2 and my side effects tolerable, each day brings less side effects. So far no dizziness and that was my main problem at 7.5 to 10mg daily of Warfarin. For some reason I feel better than I have for the last 10 years.
I am not a Vegan.
10852
Re: Xarelto
Reply #5 by Tom in Connecticut
Posted: January 20, 2009 at 13:28
Hector,

You are precisely right, the new oral anticoagulants are all aimed at patients who either just had a DVT or are underdoing hip/knee replacement surgery. Of course in the case of the DVT patient, the patient and the physician don't actually know if that patient is on the actual medication or a placebo.

Char, the trials are taking place nationwide and there have been some reports of patients not doing well on the new oral anticoagulant. The trials are not by any means aimed at long-term Coumadin/Warfarin use.

If you are on long term coumadin, a target range of 1.5 to 2.0 does very well for most patients. This low intensity Warfarin/Coumadin Treatment was documented in the PREVENT Trial. I was an original member of that trial and have been taking preventative dose coumadin (vice therapeutic which is the 2.0-3.0 target range) since 2001. As much as I dislike Coumadin, any medication you take has an adverse affect related to it. Coumadin has been the most studied and successful anticoagulant available. Though these new oral anticoagulants claim you don't need to have your blood tested monthly (or weekly) and that the bleeding risks are not as bad as Coumadin, at the same time, there is no antidote to reverse the fact that if you do bleed severely, physician can stop that bleeding. This should be of great concern to those considering it. I already know one patient who had to stop participating in the trial due to this fact. He know is on Lovenox until his INR level with Coumadin is therapeutic.

10864
Re: Xarelto
Reply #6 by Char
Posted: January 20, 2009 at 18:58
Hey Tom
My problem has been with Doctors, as most Doctors want me to take enough Coumadin for target range of 2-3. My Hematologist is more reasonable and even my 1.8 is acceptable. I read that Prevent trial, many Doctors are not aware of the Prevent trial, as even my GP had no clue. I do not see her for my Protein S Deficiency. I feel very good at 5mg Warfarin with limited side effects, no dizziness. Rivaroxaban seemed to be the answer, it is wait and see.
My Hematologist is working with me and understands the side effects, he does not deny them.
10868
Re: Xarelto
Reply #7 by Joe
Posted: January 21, 2009 at 04:34
Just my 2 cents... Hi Char /Tom...

Currently Im on 3mg day warfarin... inr is 2.6... no major side effects to speak of...

Char/Tom - I wonder why We (Dr's and us) dont use supplements to increase the effect of warfarin while taking Lower doses of warfarin... For example, char, if you took 600mg -800mg of vitamin E with 3-4 mg of warfarin, could you achieve a 2-3 inr...

or even take a low dose of ibuprofin with warfarin... Not suggesting ... just asking...

Why is it we do not do that...

10873
Re: Xarelto
Reply #8 by Char
Posted: January 21, 2009 at 11:21
Hey Joe, that is exactly what I am doing, Vitamin E, fish oil capsules, baby aspirin, with Warfarin 5mg, usually stay at INR 2.2
Last 2 INR's 1.8 as I have been eating too many greens, had company and eating out, to many spinach salads.
My Hematologist is working with me and he gets my INR report. I will not take more than 5mg, but I will take more supplements if necessary.
10877
Re: Xarelto
Reply #9 by Tom in Connecticut
Posted: January 21, 2009 at 13:28
Joe,

Despite the fact that my own thrombophilia specialist was part of the trial which showed that Vitamin E helps reduce the chances of a blood clot there was also another study which showed it can increase the risks of developing a DVT. Here is the CBS News article on this topic. I tried to pull up the peer review manuscripts from the trial but they are now contained in a member only section of the website

http://www.cbsnews.com/stories/2007/09/11/health/webmd/main3249949.shtml?source=related_story

As far as IBUPROFIN, much like aspirin and PLAVIX, it is listed as a antiplatlet medication. It may help in prevention of arterial clots but a different clotting mechanism is involved with venous blood clots (DVT/PE). Here is an Q&A done by a friend of mine, Dr. Stephan Moll of the University of Chapel Hill in North Carolina. This particular Q&A discusses the difference between arterial clotting medications and venous medications. Please note, IBUPROFEN is not listed in this particular discussion but falls under the same category of antiplate medications as Aspirin and PLAVIX. One exception, IBUPROFEN "is" used when a patient has a superficial clot.

Char, here is the link to a Q&A which discusses the PREVENT Trial. Again, the target INR for patients who take "preventative" doses of Coumadin are 1.5 to 2.0 . Though not all patients make good candidates for low intensity warfarin treatment, those who do have not noticed any of the problems which therapeutic (INR target of 2.0 to 3.0) complain about: http://www.fvleiden.org/ask/09.html . Are you here in the U.S.? Reason I ask is, if you are your physician can contact my organization if he/she has any questions about the PREVENT Trial. The web address is www.stoptheclot.org


10882
Re: Xarelto
Reply #10 by Char
Posted: January 21, 2009 at 14:30
Hey Tom, I have seen and read both of those websites, not sure if my Hematologist is aware of the Prevent trial, but he was very willing to work with me. I probably am his first patient taking supplements with Warfarin. For many years I took aspirin and Vit E daily, about 12 years ago, I stopped the aspirin it bothered my stomach. Stopped the Vit E as there was some adverse news and some medical friends advised against taking it. Both of those might have prevented blood clotting as family members that did not take them had early age blood clots.
At INR of 2.5 or higher I am dizzy, as I have to take so much more Warfarin. I have refused and I am feeling good taking 5mg.

10885
Re: Xarelto
Reply #11 by ruth
Posted: November 19, 2012 at 04:43
my husband has been on warfarin{coumadin) for years. just recently he was put on xarelto. when on coumadin he had to check his inr every 2-3 weeks to see if he was in therapeutic range which is between 2-3. what is in xarelto that reduces his risk of getting blood clots or strokes. if anybody could answer this question i would appreciate it.
26941
Re: Xarelto
Reply #12 by Dharma
Posted: November 20, 2012 at 03:58
I just started taking this blood thinner and will be on this or some type of anti-
coagulation for a minimum of a year. Has anyone had any experience with
Xarelto? I can't tolerate the side effects of warfarin and am looking for an
alternative. Thank you.
26957
Re: Xarelto
Reply #13 by carmen
Posted: October 4, 2013 at 13:39
Started xarelto for a dvt after 9 days was rushed by ambulance, the drug had failed me I
now have embolisms on both lungs!
27965
   1
Reply to this topic    or     Start New Topic

Your Name:
Reply Subject: Re: Xarelto
Comments:
(You may enter up to 3001 characters)

characters left

Type the characters shown in the image for verification 2: