Comparison of the New Blood Thinners for Atrial Fibrillation

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Coumadin (warfarin) has been the mainstay of treatment for stroke prevention in folks with atrial fibrillation. When the atrium is fibrillating, and losing its atrial kick, there is a higher risk of clot forming in the atrium which will break off into the ventricle, then head to your brain and cause a stroke.

For that reason, we treat some folks with atrial fibrillation with blood thinners to prevent that stroke risk. Major changes have occurred in this area where newer more convenient anticoagulants (blood thinners) have emerged. This new group of 4 meds saves you from having blood tests routinely to check your levels, which is called having your “INR” checked. So are these newer agents worth it, and is one better than the other?

Here is what you need to know:

Safer, maybe slightly better, but more expensive.

What do you think?

Dr O.

Pradaxa, Xarelto, and Eliquis are currently available, and may cost from just under to just over $300 per month. All three have manufacturer co-pay cards (for insured patients) and assistance programs (for uninsured patients) available. Lixiana (edoxaban) is currently approved in Japan, and as of January 2014 the manufacturer has submitted an application to the FDA for approval in the US.

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