Coumadin vs. Warfarin

[OrlandoTommy]

Everyone,

Just wanted to share my quick story about the two drugs, and im no expert but this is just from what i experienced in the past 6 weeks...

I was on Warafin when i was released from the hospital, i was on it up until about a week and a half ago.

While i was on Warafin my levels were all over the place, 2.3, then 2.9, then 1.7, 3.2..etc...

I got on Coumadin and my levels have stayed at 2.8 consistantly since i started taking it.

There is a different in these two drugs with certain people, i guess im one of those people, just wanted to let you know in case you or someone you know is on Warafin that has levels going up and down like I did.

Tommy

 

[geebee]

I have learned that nothing is impossible. However, you must remember that it takes a few weeks for your INR to stabilize once on ACT. It is entirely possible that you were at a point where your INR became stable around the same time that you switched to the brand drug.

Without switching back to warfarin to find out if your INR destabilizes, there is no way to prove that the brand drug is responsible for the change.

That all being said, whatever you are comfortable doing or taking, is the way you should proceed. If the cost of coumadin is not any issue, then there is no reason not to take it.

 

[dick0236]

I was on the brand "coumadin" for 38 years and have been on the generic "warfarin" for the past 2 years. I have had INR swings such as you've listed with either brand or generic. Why the swings occur I am not sure, but they are probably due to diet, exercise, life style, other meds, INR testing inaccuracy, poor anti-coagulant management or any one of a number of other "gremlins". I have been assured by the FDA, two leading warfarin drug manufacturers, a number of pharmacists and even Bristol, Myers Squibb (owner of the brand Coumadin) that there are no differences in the active ingredients of the brand and generic. There is some difference in the inactive ingredients and that might account for some people experiencing some differences between the meds.

Incidently, other than the 1.7 which you listed, I would be satisfied with any of your INR numbers. Any numbers between 2.5-3.5 +/- are OK for my own INR range. It has been impossible for me to maintain any narrow INR range over the years I have taken the drug and I honestly believe that a narrow range in unecessary. For me it is important that I take the drug warfarin as prescribed, monitor it regularly and adjust dosage as needed.

Then there is the cost. My annual cost of 5mg warfarin is $48. My annual cost or 5mg Coumadin was $360 copay. It wasn't that long ago that I believe I was paying $1000+ for Coumadin. Only the inroads of the generic wararin drugs have driven down the cost of Coumadin.

 

[ALCapshaw2]

Since your surgery was just this last March I suspect your variations were the natural result of adjusting to your surgery and recovery and NOT necessarily due to any difference between Coumadin and Warfarin.

It is a KNOWN FACT that INR will drop with increased activity / metabolism and that alone could account from the drop to 1.7 .... or it could have simply been an erroneous reading (they DO happen!).

FWIW, I switched from Coumadin to Generic Warfarin after my insurance would no longer pay the difference in price. NO PROBLEMS with generic Warfarin made by either TARO or BARR.

'AL Capshaw'

 

[catwoman]

Tommy:

I agree with Al, Dick & Gina.
You are only 2 months out from surgery. It's darned impossible, although not undoable, to become consistently stable that soon after VR surgery, mainly because your physical condition isn't consistent yet.

If this was 1 year post-p and you were being managed by a CACP (certified anticoagulation care provider), that might be another story, one for the CACP to investigate by carefully examining your lifestyle & meds.

I encounter medical professionals who swear there is a discernible difference between the trademark & the generic, because they've seen INR swings in patients.

BTW, I too had swings in my INR just 2-4 months post-op -- while on Coumadin.

 

[Bionic Man]

Warfarin for 2.5 years

Warfarin for 2.5 years

I've been pretty steady on warfarin. My INR has been the same for my first year with a slight increase in summer and then a decrease in winter each year but otherwise it's been exactly the same for 6 months at a time.

For me I'm insanely careful about what foods I eat (staying away from Mayo, too many greens etc) and I am very very careful about what vitamins I take so I don't get too much vitamin K or E.

So I don't know if that makes a difference or not but I've been bang-on from visit to visit with a slight change every 6 months and that's even with the doc giving me 5's so I have to break every other one in half.

 

[Guest]

I agree that it is much more likely that your fluctuating INRs were due to the short time after surgery than the difference between warfarin and Coumadin.

I have been in Tucson when it snowed and London when it was 92 degrees. In my experience London is much hotter than Tucson. One person's opinion counts for very little whenyou are trying to determine cause and effect.

Please look at the studied about this that I have posted at http://warfarinfo.com/generic.htm

 

[Sunshine susan]

10 years on coumadin...2 months on warfarin

10 years on coumadin...2 months on warfarin

After AVR just about 10 years ago, I was on coumadin from the get-go. Due to recent insurance changes, I decided to try a switch to warfarin. So far, no problems. I am generally within the 2.5-3.5 range and that hasn't changed.

I also used to be something of a fanatic about what I ate. No more. I eat and drink what I want when I want. I just don't overdo any of it. All things in moderation. No need to deprive yourself too much. Maybe I'm just lucky, but my ranges don't fluctuate much...but I like to think I trained it from the start!

Bionic Man---(I refer to myself as the Bionic Woman, so I'm with ya there....) I found your dental work thread very interesting as I am facing the same thing. I just keep putting it off though--OI, but good to hear from someone who did the deed! That's encouraging for sure.

Sue