Coumadin vs. Warfarin

[901]

Has anyone noticed a difference in INR when taking Coumadin vs. taking Warfarin. I seem to have a lower INR when I take Coumadin vs. the same dose of Warfarin.
If they are the "same", why would I see different INRs?

 

[Ross]

Some people swear they do. That has not been my experience however. Users choice?

 

[geebee]

No difference here.

 

[imhayley]

good question

good question

I was just changed from warfarin to coumiden on Friday because they said (my INR's are bouncing all over) some ppl are more sensitive to the warafin. I think THEY need more training but we shall see. Im glad I found this post so I didnt have to ask.

 

[carbomedic]

No change for me

No change for me

I changed to Warfarin about a year ago due to $$$$.
Absolutely no adjustments needed, only to my flex account!

carbo

 

[DrAllan]

Generic variation re Coumadin

Generic variation re Coumadin

There are several things that you need to know about generic versus brand drugs. First of all, the FDA in certifying the equivalence of drugs only demands those aspects such as the availability and strength of the drug be within 80% of the standard. Thus there can be a 20% variation between any two pills that you have. In regards to Coumadin, manufactured by Bristol-Myers-Squibb, they claim that their degree of variation does not fall below 97%. Secondly, I believe that there are 3-7 generic manufactures authorized for sale in the US. Because your pharmacy purchases on price, the generic your receive today may not be the same one from the same manufacturer next month.

Thus depending on your own variability regarding response to drug, diet, and other factors, the generic may or may not be a variable in your therapy.

 

[carbomedic]

Well....

Well....

Right after my AVR, the surgeon insisted on Coumadin only. Since then I have moved my INR management to a more local source. When I asked if I could switch to warfarin, my medical support stated that she has people on both and has seen some individuals needing adjustment, and some not, so, like everything else since 2/2002, be conssitant and they will adjust dose.
Even after an nightmarish ordeal with wisdom teeth removal, I habe not experianced any "unusual" situations.
And as a member of this site, the good doctor Lodwick has not led me to believe that I have taken a gamble with my situation. That is my preception.

 

[Guest]

One of the problems with this argument is that Barr Labs warfarin tested in a tighter range than Coumadin.

There has never been a study that showed that switching made any difference. There are several that showed that over a large population, there was no difference no matter how people switched around.

When DuPont owned Coumadin, they lost a huge lawsuit by making that argument when the evidence showed just the opposite. For many years I believed DuPont's (Endo Labs before that) argument. It may have been true years ago. Anyhow we are about to find out because as of today Medicare people are going to a new prescription plan and I understand that there will be no Coumadin offered on it.

 

[gijanet]

Hmmm.......

Hmmm.......

Well, we were the opposite of most, except for Haley. We were on warfarin post-op when we left UofM and for the first refill at home. Then Katie's PC insisted on coumadin, so we have been on that ever since. We didn't notice any major changes one way or the other. We were fairly stable before (even though for a short time) and fairly stable now.................except for stomach bugs!!!! Hugs. J.

 

[geebee]

I used to buy into the "coumadin is better" theory too and for years would pay the little extra my insurance company required for name brands. Then I left the job with the great insurance plan and ended up with a plan that had such a high deductible and copay for brand drugs that I had no choice but to go generic. I now sometimes get Barr and sometimes Taro warfarin and there has been absolutely no difference in my INR levels or dosage. I have been on ACT for over 25 years so I have some experience for comparison. With the exception of a few minor tweaks over the years, I have been on the same dose for 25 years. I have lived in many different climates, my weight has been up and down, I rarely think about the foods I eat and I drink occasionally. None of these factors, nor the switch to generic, has made a difference in my doses.

Maybe "bad" batches come out of manufacturing facilities now and then but I am sure that can happen with Coumadin just as with warfarin.

I believe the "Coumadin is better than warfarin" is just hype and now would fall into the category of urban legend. Don't waste your money (or the insurance companies) and contribute to the rising medical costs. Unless you're like Janet and Katie, and your doctor won't write your prescription allowing generic, go with the generic.

 

[Guest]

I work with mainly retired union members from a steel mill. A few years ago their insurance raised the deductable on brand names to $60 per month. Many of these people are on such tight budgets that they have to wait until the first of the next month to get an antibiotic prescription worked into their finances. Needless to say, they all switched to generic - hundreds of them. I have every clinic visit (about 30,000) on an Excel spreadsheet month-by-month going back to 1998 (before this change happened). Every month the percentage of people in range comes within 2% variation. I know that there may be some people who think that they do better on one or the other, but I also know that the statistics show that when it comes to what happens to a large group of real people over a period of years, there is no difference.

 

[Ross]

Al don't know if this makes a difference, though it may, I'm on the new Medicare Prescription Plan through a Medicare HMO. They have Coumadin listed but will only fill with generic warfarin unless there is a DAW on the prescription.

 

[Guest]

I know that there are various state laws about DAW "Dispense as Written" but it hasn't been clear to me how they will affect the Medicare plan and whether or not the Ohio (for example) state board of pharmacy can enforce the law on a prescription dispensed in Nevada (for example) to be shipped to Ohio. All this will have to be worked out in the coming years.

 

[Granbonny]

Just picked up my 30 days of Warfarin today..5 mg....Noticed..it said, you have saved $14.90 by choosing a generic....Mine was ..$18.39......$.61 cents a day.. .....for a drug that keeps me alive. ..Picked up hubby's B/P med...$129.59...30 days.......Thank goodness for insurance.....NOT to flame anyone..but I pay more than that for pet food....at least $2.00 a day compared to my $61 cents for Warfarin.....Is this comparable with others?..My cost of Warfarin?Bonnie

 

[geebee]

Bonnie,

I pay $34.99 for 90 of the 5mg generic at drugstore.com. That comes out to about 39 cents per pill. You might want to check into it. I have been buying from them for awhile and they send either Barr or Taro - both work fine for me.

 

[Praline]

Cost

Cost

I take warfarin and I pay $10.00 per prescription for one month. It is the same price however much the doctor prescribes for a month. At first he prescribed 30 5-mg tablets. When I had to up the dosage, he had to write a new prescription and I had to renew the prescription before the month was up and pay another $10.00 co-pay. Now he writes it for 45 pills per month.
I also take Toprol and my co-pay on that is $30.00 per month. My asthma medication, Flovent, is $30.00 per month copay. It sure adds up. But then my insurance premium is only about $40.00 per month. The school board picks up the rest.

 

[Blanche]

Al takes several different strengths of Coumadin. The most costly is $15.49 for 3 months. He could save about half that amount if he changed to generic. All four of his doctors are convinced that Coumadin is the way to go. I don't care whether they are right or not. Just don't want to mound-up the dirt, stick-in the flag and go to war with four doctors over this. There are too many more important battles that need winning. Sometimes you have to go along to get along.
Blanche

 

[Rich]

This discussion has occured many times over the years.
Since being on Coumadin for almost ten years and having few problems, I will stay with Coumadin at least for the forseeable future.
As I mentioned in the past, my wife had some bleeding problems when she was switched to the generic.
My cardiologist feels Coumadin is more reliable and insisted I stick with it.
He even sent a letter to the appeals division of Medco.
This gives me Coumadin at $30 for a 90 day supply.
Funny thing is I had a long conversation with a pharmacist at Medco,he also agrees regarding the variation between manufacturers.
I guess it's the engineer in me saying nothing is made perfect, there are tolerances on everything, and they have always varied between different companies.
Rich