chinese warfarin

[ChouDoufu]

ok, here's my story. i was prescribed 90 days warfarin as i have a meat valve.
i was in range with 4mg, but change in diet ingredients and increase in exercise
raised my dosage to 5mg. i no longer had enough on hand, so had to buy
some local chinese produced warfarin.

i switched over to the chinese pills four days before my last pt-inr test.
that test showed my pt-time at 1.26, so i raised my dose to 6.5mg/day.

a week later, that would be today, i retested and my pt-inr is down to
1.08, which is like completely anti-coagulated. i expected i might be a
tad high judging by clotting speed after the nurse pulled the butterfly,
didn't expect no effect from the meds at all.

so either the test is off (probable) or the chinese medicine is crap (also
probable). [however i have been doing some heavy exercise lately, as
well as upping veggie consumption....]

so what to do?

a) continue at 6.25 for another two weeks when i run out.
b) increase to 7.5 for one week then run out.
c) trash the pills as i'm already over 90 days out.


photo below is the warfarin box. the first three characters are meaningless
here, they just make the sounds "HUA-FA-LIN", the next two characters
mean sodium tablet.

 

[Ross]

I vote for C myself.

You've already pushed the envelope and didn't drop over dead or stroke, so you should be ok now.

 

[Lisa in Katy]

I also vote for C. Unless you are having afib, you shouldn't need it anymore.

 

[Bina]

I'll vote for C also.....1 or 2 weeks of sub-standard warfarin wouldn't help you very much anyway.

 

[Adrienne]

I also vote for C. You might start taking some baby Aspirin which some doctors say to take for the rest of your life in any case.

 

[ChouDoufu]

"C" is for concencus. trash the HUA-FA-LIN. there goes 2 bucks down the toilet.

baby aspirin is no problem, as the only aspirin available is in 25 or 50 mg pills.
i miss the giant economy size bottles of 250mg pills from rite-aid!!

and once again, the characters are meaningless in context, just ask for A-SI-PI-LIN.

great, tomorrow can start 100mg/day.

 

[ALCapshaw2]

Chinese Warfarin?

NO WAY, Jose'!

NOT ME, NOT EVER (I hope!)

 

[catwoman]

As for Baby Aspirin -- I'm not convinced that even whole aspirin tablets (5 times as strong as baby aspirin and available around here for a buck for 250) cause that much of an increase in INR. Aspirin anticoagulates in a different way from warfarin (I think it makes platelets more slippery), and I'm not sure its effects will show up on an INR, but I haven't seen where it can substitute or should be used to supplement Warfarin therapy.

Aspirin does not affect the INR one iota. Bleeding, yes; INR, no.

 

[ALCapshaw2]

Al -- if you're taking generic, how do you really know where the hell it comes from?

The Mail Order Pharmacies used by my former employer and my local pharmacies both use Generic Warfarin from BARR (supposedly made in USA) and TARO (supposedly made in Israel).

I have had NO PROBLEMS (and NO Differences) with either of those sources.

My Local Pharmacy will sell *any* dose of Warfarin at $5 for 30 pills and $10 for 90 pills. I believe Wall Mart sells Warfarin for $4 for 30 pills.

'AL Capshaw'

 

[catwoman]

The Mail Order Pharmacies used by my former employer and my local pharmacies both use Generic Warfarin from BARR (supposedly made in USA) and TARO (supposedly made in Israel).

Barr was acquired in late December 2008 by an Israeli company, The Teva Group.

Interestingly, Coumadin is a registered trademark name for Taro in Israel.
from www.taro.com
* In Israel, Coumadin, Percodan and Percocet are registered trademarks of Taro Pharmaceuticals U.S.A., Inc. Elsewhere in the world, Coumadin is a trademark of the Bristol-Myers Squibb Company, and Percodan and Percocet are trademarks of Endo Pharmaceuticals, Inc.

Interesting reading about each company.

 

[Bina]

.......... I've gone nearly three year without testing, with God's help, a lot of luck, and a fairly close eye on any symptoms that my indicate over- or under-coagulation)

Are you joking?......

 

[ChouDoufu]

Chinese Warfarin?

NO WAY, Jose'!

NOT ME, NOT EVER (I hope!)

c'mon, it's just rat poison! we're not talking important stuff like drywall or power tools.

 

[Bina]

ClickerMark, don't you test at a hospital, clinic, somewhere?
If not, why?

 

[Bridgette]

Sorry Mark, I don't know much about the American health system, but if your troubles are financial wouldn't you qualify for Medicaid or whatever it is called?
In NZ it doesn't cost anything to have an INR test - it is paid for by the nationalised health care funded via taxes. There MUST be some provision in the States for financially destitute people to access a vital blood test like this, surely????
Who is prescribing your Warfarin - doesn't he/she have some way to help you get tested?

 

[ALCapshaw2]

Mark,

I'm curious as to what "symptoms" to too much anti-coagulation you used for you guideline...

In the "Good Olde Days", if you "peed red" you backed off.
If you had a Stroke, you added more, if you could make the logical connection after your stroke.

FYI, Walmart sells Generic Warfarin for $4 for 30 pills and may have another price for 90 pills. My Local Pharmacy sells 30 pills for $5 and 90 pills for $10 (but you need a Prescription).

 

[catwoman]

In other posts, I mentioned that many pharmacies will fill generic warfarin prescriptions for $10 for 90 days -- which makes foreign warfarin much less attractive.

FWIW -- my PCP writes Rxes for 1, 2 and 10mg. I halve the tablets, and because I generally take 5 or 5.5mg daily, depending on my INR, this stretches my bucks much farther than getting only 1s and 5s.

 

[Lisa in Katy]

The nonprofit to perform INR testing sounds like a good idea, although I see I few problems with it. In most areas of the country, and certainly in the Los Angeles area, there are plenty of clinics that already provide this service - not necessarily the fingerstick, but certainly a lab draw. They already have sliding scales in place, based on ability to pay, so I would think it would be difficult to prove a need. As far as actually getting enough money to keep it going.... I have insurance and the lab reimbursement for my INR is now $2.03, of which I pay nothing. So I wouldn't be willing to pay more than nothing! If you are talking about people who don't have insurance, but are able to pay $25 or so as supplemental financing for your nonprofit, that sounds good, but I'm not sure there are enough people in that situation who also happen to take Warfarin. Finally, it you are counting on donations, I'm not sure this is the right time. Most people who have that kind of money are already upset at the amount of "donations" in the form of taxes we already have to give to support those who aren't paying their share.

 

[Bina]

If I didn't have insurance, I would also ask to buy pills in double my dose and take a half pill daily. That's a good idea.

 

[Lisa in Katy]

A month of Warfarin is only $4 at many places (Walmart, Target, Safeway, CVS, Walgreens chains, at least), and $10 for a 90-day supply, so the savings by buying larger pills, in quantity, or even foreign medicine is almost nil. The cost involved for someone without insurance is actually more in the doctor's appointment and the lab testing. However, I think you could see a doctor annually and have 4 annual tests (the minimum to be somewhat safe, but not really safe) for about $300. I'm basing this on the amount that LabCorp bills my insurance (about $50) and $100 for a doctor's visit, which is what my husband paid recently to go to the urgent care clinic when he had strep and it was a weekend.

 

[catwoman]

A month of Warfarin is only $4 at many places (Walmart, Target, Safeway, CVS, Walgreens chains, at least), and $10 for a 90-day supply, so the savings by buying larger pills, in quantity, or even foreign medicine is almost nil.

Lisa:

Buying larger pills and halving them saves about $20 a year, based on just 2 Rxes. That doesn't sound like much, but it's $20 I am able to apply to something else.
(AARP recommends doing such in its magazine.)