Coumadin vs. warfarin?

[catwoman]

My PCP (and cardiologist) insists that I take Coumadin, not warfarin. I've been told there really is a measureable difference in results. One time the pharmacy gave generic because Dr. didn't specify only Coumadin. PCP's office insisted I change back to Coumadin.
As I interpret upcoming changes in my insurance plan, it will be cheaper to buy Coumadin outright than via my insurance, even mail-ordering the scrip. HOWEVER, if I switch to warfarin, I'll come out ahead.
How different are Coumadin and warfarin? Results, other drug interactions, etc.?
I've been taking 5mg and have ranged from 3.3 to 2.5 the last 6 weeks. It has been as high as 3.9 and as low as 2.2 before that.

Also, my PCP says he will give me a letter of medical necessity so I can badger my insurer to kick in for me a Coaguchek or ProTime machine. ProTime hasn't sent me the paperwork. Does anyone have a name and phone # there?

Thanks,
Marsha

 

[fyrfytr]

Hi Marsha,
Al Lodwick would be the one that can give you the info on this. You can go to his website at www.warfarin.com or PM him with your questions. In his book and according to my Cardiologist, there are no published studies that showed any significant difference between the two. I know that there are some members who have taken both and maybe you will here from them also.
Take Care

Dave
__________________________
Surgery: 4/21/03
Aortic Aneurysm Repair
AVR, with a St. Jude Mechanical

 

[Karlynn]

Hi Marsha,
I asked the same question a few months ago. If I remember correctly, some people saw no difference, others did find differences. My Card. insists on Coumadin and I do pay much more for it with the insurance I have.

Al can weigh in on this with his wisdom, but my thought is that if you do make the switch, that you keep a good eye on your INR for a while.

Karlynn

 

[alicia]

I've been on Warfarin since my surgery in Jan 03 and had many problems with my INR/PT being out of whack and he suggested that I switch to only Coumadin and since I've switched my levels have been normal for a change. Theres a big price difference on my drug card co-pay but I guess its worth it if its going to regulate or straighten out my levels IF that is the reason they are normal here lately (last 2 weeks).

Alicia

 

[KristyW]

Up to you

Up to you

Marsha,

I think that if you're comfortable with the Coumadin and your PCP & Cardiologist's recommendations, then by all means buy the Coumadin.

That said, I have been on generic warfarin by Barr Labs since my discharge from the hospital over 2 years ago. My INR is extremely stable. I've only been out of range 1 time and that was of my own making. (I stopped taking iron supplements AND I ran out of my daily multivitamin.)

Maybe Al Lodwick will weigh in on this, but his comment will probably be that there is no scientific evidence that Coumadin is superior to generic warfarin only more expensive.

Just thought that I'd give you another view.

 

[ALCapshaw2]

Kristy et. al.,

I have seen another endorsement for Warfarin made by Barr.

Unfortunately for me, there is NO guarantee on what manufacturer my mail order pharmacy may have made their latest purchase from order to order. Bummer.

I take 3.5 mg (3.0 and split 1.0's for the other 0.5). I'm thinking of staying on Coumadin for the 3.0 and switching to generic for the 1.0's since the copay is the same regardless of dose and any variation in dose would only amount to a few percent when taken with a 3.0 dose of Coumadin.

Insurance companies do allow for appeals if your Doctor will write a letter defending your appeal.

'AL'

 

[wlaldridge]

Have been on various doses of generic warfarin since leaving the hospital and thankfully my INR has always been in range plus or minus 10% . I prefer to manage the dose to the high side since my target range is 2.0 to 3.0 a 3.3 or 3.5 would not bother me at all since many have targets that high. I don't like 1.7 or 1.8 much though. Clotting scares me-my surgeon calls that a "rusty" valve and he wants it to stay nice and clean and "rust" free.

I find that the concerns I had about taking warfarin were unfounded. From all I read Barr just about owns the generic market. Most of the big chains use them and the stuff is pretty cheap, thank Goodness.

Everyone is different and have different lifestyles, which have a lot to do with the stabiliy of the INR.

I suspect that the great marketing coupled with the relatively low cost of even the Branded product Coumadin. leads the docs to prefer the comfort level they get with the Brand named stuff.

Personally, I think the generic is just right for me. My $.02.

Bill

 

[JimL]

As stated, some (such as Rich) feel very strongly about coumadin only.
I've been on warfarin nearly two years. I may have had coumadin at the beginning, but the pharmacy switched me.
Although there is probably no significant, demonstrable difference between the two , it makes sense to stick with one or the other.

 

[Joe Gutstadt]

Coumadin has always worked for me!

Coumadin has always worked for me!

Having been on coumadin for going on to nine
years now, my philosophy is simple...............

"IF IT'S NOT BROKE, DON'T FIX IT"

 

[Granbonny]

Marsha

Marsha

QAS 800-298-4515...I have been on warfarin for 17 months. No problems ever with INR staying in range.

 

[Ross]

I've used both, I've combined both, and I can't say that I've seen any difference whatsoever.

 

[Rich]

Hi Marsha,
As Jim said earlier my wife had a bad reaction when accidentally being switched from Coumadin to Warfarin.
It resulted in internal bleeding but when she was put back on Coumadin everything cleared up.
So it's not that i'm a fan of one or the other but I believe as does our cardiologist that once established on either one don't make a switch.
I fully understand the costs involved.
We are fortunate that our prescription program is not real expensive YET.
We pay $30 for a three month supply of Comadin where Warfarin would be $10 for the same three months.

Rich

 

[Guest]

Your doctor is listening to the sales rep and reading the medical literature. (And hasn't even heard one of them say it in over 5 years.) It is possible that some people had a reaction when they changed, but as everyone on this site knows, there are so many things that can throw the INR out of range that it would be impossible to pinpoint one item. I have probably treated about 2,000 patient years for people who have switched, not switched etc and I can assure you of that the only conclusion that can be drawn is that overall there is no difference. Remeber that DuPont (when they still owned Coumadin) lost a multi-multi million $$$ lawsuit for saying that Coumadin was superior.

I used to give talks for DuPont and made good money for doing so. But when I refused to say that Coumadin was better, I killed the goose that laid the golden egg. However, I had to be true to what I believed. I refused to prostitute myself.

 

[catwoman]

Al:

That's what I thought.
I had dinner Saturday night with some friends, one of whom is a pharmacist. He said the same thing, but he doesn't directly work with patients on anticoagulants like you do.

Thanks.