Should I take a novel anticoagulant instead of warfarin if I have A Fib?

Douglas E. Severance, MD
Family Medicine
If you have atrial fibrillation (also called A Fib), a common heart rhythm disorder, you may be taking warfarin, an older blood thinner, to prevent an ischemic stroke. An ischemic stroke happens when the blood supply to the brain is blocked by a clot. Blood thinners help prevent clot formation. Today, novel anticoagulants may be prescribed instead of warfarin for several reasons.

First, novel anticoagulants are taken only once or twice a day, and no dietary monitoring is necessary. Also, you don't have to see your doctor frequently for blood work to make sure the medication is working. In addition, depending on your genetic makeup, you may not metabolize warfarin in the usual way. Some people have specific genes that make them extremely sensitive or resistant to the effects of warfarin. This puts people at risk for dangerous bleeding or for the formation of blood clots while taking warfarin. Genetic testing can determine whether you have the genes that cause these problems. Also, you may find that the drug interactions between warfarin and other medications you take are hard to live with.

Any of these issues related to warfarin treatment may be reason enough to try a novel anticoagulant. Still, it is important to talk with your doctor before stopping warfarin. He or she can help you decide if a novel anticoagulant drug is a better choice for your situation.

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