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More Frequently Asked Questions
be gone in 2 to 4 days. This could last a little longer in a few people.
Is there much difference between the brand Coumadin and generic warfarin? There have been a few published reports of people having this INR increase or decrease when they were switched from one to the other. However, there have been no published studies the showed any significant difference. I have not seen anyone who had any serious problem from making the switch. For a good review of this, copy the line below and paste it into your browser's address section. http://www.medscape.com/SMA/SMJ/2001/v94.n01/smj9401.03.hend/smj9401.03.hend-05.html
I have had several blood clots in my legs which went to my lungs. If I have a filter put in to catch the clots, will I have to continue to take
warfarin? It seems wise to continue the warfarin. The filter and warfarin
are designed to be used together to prevent potentially fatal clots from
getting to the lungs. It is possible that your doctor may not want to use both. In this case ask the doctor the reason why both will not be used.
What is the risk of having atrial fibrillation? Stroke. Atrial
fibrillation is the leading cause of stroke.
How effective is warfarin in preventing stroke? It cuts the risk by up to
80% in some groups of people.
Should everyone who has atrial fibrillation take warfarin? Not everyone,
but almost everyone. If your physician does not want you to take warfarin
for atrial fibrillation, then you should be given a reason why you cannot
take it.
Is old age a reason to not take warfarin? Not really. The older you get,
the greater your risk of stroke. Therefore, the greater the protection is
from warfarin. I have seen several dozen patients in their nineties who did
very well on warfarin. The oldest I have ever seen is 104 years old -- she
is doing well. This is not just my opinion. Here are some medical journal
references:
White RH et al. Oral Anticoagulation in Patients with Atrial Fibrillation:
Adherence to Guidelines in an Elderly Cohort. Am J Med 1999;106:165-171
Mendelson G. Underutilization of Warfarin in Older Persons with Chronic
Nonvalvular Atrial Fibrillation at High Risk for Developing Stroke. J Am
Geriatr Soc 1998;46:1423-1424
Lightowlers S et al. Cost-Effectiveness of Anticoagulation in Nonrheumatic
Atrial Fibrillation in the Primary Prevention of Stroke. Stroke
1998;29:1827-1832
Brass LM et al Warfarin Use Following Ischemic Stroke Among Medicare
Patients with Atrial Fibrillation. Arch Intern Med 1998;158:2093-2100.
There are many, many more articles like these.
Why isn't my INR level the same every time? There are so many things that can effect the INR, that it is unusual if it is the same for two consecutive visits. It is affected by, then time between when the doses were give and the time the blood was drawn, what you ate over the past several days, other medications, physical activity, fever, and probably some things that we do not even know about yet.
My friend's doctor said to take aspirin for atrial fibrillation instead of
warfarin. Why can't I just take aspirin? Aspirin should be used ONLY for
those people who absolutely cannot take warfarin. Aspirin offers so much
less protection from a stroke that the physician should give a person a good
reason why they are recommending aspirin. Some physicians do not like
warfarin because it takes more work to monitor it. This is not a valid
reason for choosing aspirin over warfarin. You are fortunate that your
physician is recommending the most effective treatment.
I've heard a lot of "horror stories" about warfarin and am afraid to take
it. Should I believe these stories? Yes. BUT. The monitoring techniques
and lower doses of warfarin that we use today make many of the horror
stories things of the past. Bad things still happen but much less
frequently than they did years ago.
Can a small change in the warfarin dose make a big change in the INR? Very much so. There is no direct relationship between the warfarin dose and the INR.
Can I lift weights for a workout? There is not much data on this. Weights up to 15 pounds or so don't seem to pose much of a problem. One woman wrote and said that she was a powerlifter and resumed lifting weights up to 200 pounds. You have to make your own choice on this one because there is so little known about it.
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Last updated August 4, 2003