safety medical

Pradaxa vs. Coumadin, Xarelto

Pradaxa is a medication that is a member of the class of drugs known as direct thrombin inhibitors. It is most commonly used to help prevent strokes in those with a high risk as well as prevents the formation of blood clots following hip or knee replacement surgery. Pradaxa does pose some serious side effects, such as an increased chance of heart attack and in high doses the increased likelihood of excessive bleeding. For this reason, as well as the fact that everyone’s body responds differently to different drugs, it is important to take a look at other anticoagulant medications compared with Pradaxa.

Pradaxa vs. Coumadin (warfarin)

Warfarin is another drug often prescribed in similar situations as Pradaxa is. Warfarin is also referred to as Coumadin. Warfarin has a different mechanism of action than Pradaxa and belongs to a different class of drugs. Warfarin is a Vitamin K antagonist which helps to stop blood clots by interfering with Vitamin K production which is essential for the body to successfully form clots. Because of its action on Vitamin K, warfarin requires those prescribed to regulate their diet to not include foods high in Vitamin K. This is a disadvantage when compared to Pradaxa which does not require any dietary restrictions.

Another disadvantage when comparing warfarin to Pradaxa is that warfarin requires numerous and frequent blood tests while Pradaxa does not. For those with a busy job, having frequent blood tests can become very inconvenient very quickly. An advantage that warfarin has over Pradaxa is that warfarin is reversible. This means the risk of excessive bleeding is lower as the anticoagulant effects of the medication can be easily reversed allowing wounds to heal more rapidly. warfarin does not have as bad of a reported withdrawal with uncomfortable side effects as Pradaxa does either.

Pradaxa vs. Xarelto (rivaroxaban)

Xarelto (rivaroxaban) is another medication frequently prescribed for use as an anticoagulant. It is sometimes referred to as rivaroxaban as well. It is the only drug on the market that is a direct Xa inhibitor. This means that Xarelto stops the actual production of thrombin whereas Pradaxa only inhibits the action of thrombin. The main disadvantage of Xarelto is that it is still largely new and untested in the medical community. Pradaxa is a relatively new medication as well, but there are more trials and evidence associated with it. Xarelto is specifically approved for treatment of stroke prevention as well as to be used after hip and knee replacement surgery.

One recent study has found the effects and risks of Pradaxa and Xarelto to be largely similar. Pradaxa, however, out-performed Xarelto when it came to comparing high doses of each drug for the use of preventing strokes. At low doses, the statistical outcome of both drugs was nearly identical. Xarelto also poses the same advantage that Pradaxa has of not needing frequent blood work done. Xarelto also does not have a way to reverse its effects so it can cause excessive bleeding, just like Pradaxa.

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I have been taking Xarelto for about 1 year - have no side effects. Now I hear that these drugs can cause heart attacks or strokes... What does one do ?

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