Switching to warfarin?

[catwoman]

I have been on Coumadin since my surgery in June. I had been paying $20/mo retail or $40/90 tabs mail order. Mail order in 2004 is now $58.41/90 for 5mg, $52.05/90 for 1mg. The 5mg would be $233.64 annually; it had been $160, mail order, for a year.
That's about a 50% increase.
I'm debating whether to have my PCP switch me to warfarin when the 2 bottles I just mail-ordered run out. 90 tabs would be $40.
I'm taking 5.5mg MWFSat, 5 TThSun. So the 1mg bottle lasts me 10 months. I could reduce my Rx bill to maybe $120 a year, as opposed to about $330. This is the only Rx I take at this time.

Anyone have any experience in switching from Coumadin to warfarin?

 

[Guest]

There are some people who have had problems but for the most part they are few. I have switched hundreds of people. You may need a small dosage adjustment (up or down about 1 tablet per week).

If the insurance company thought that it would cost them even 1 visit for you to the emergency room, they would not allow you to switch.

 

[MarciaB]

Somewhere in a thread, Ross (I think), directed me to an interesting web site about Coumadin. It mentioned a study that showed Coumadin to be more stable than warfarin. I think it was pooh-poohed by both Al and Ross, but maybe Ross can find it for you anyway. I think an informed decision is always the best. I understand that you may need to be checked more often during the switch.

 

[Ross]

It wasn't I. I've used both, mixed both, and I've never seen one lick of difference besides cost of the product. There are some who swear their more stable on brand name, but I haven't found that to be true in my experience.

 

[Guest]

Actually the Barr Labs generic was shown to be held in a stricter tolerance than was the brand Coumadin.

The battle was more fought in the marketing departments than with any scientific evidence.

The brand name Coumadin has been bought and sold so many times that the generics are marketed more consistently by the same company.

I can remember Endo, DuPont-Merck, DuPont, and Bristol-Myers Squibb owning the rights to the name Coumadin.

As I have said before, I could have made a lot of money saying that Coumadin was better. There may have been some lab studies that made it look better but the outcomes in large groups of people were almost always the same. So when I wouldn'y go against my princliple and say something that I did not believe to be true, I quit getting speaking engagements.

Then there was the huge class action lawsuit that DuPont lost for implying that Coumadin was better. The FDA says that they all meet the same standards.

Some people fly in 1st class and some people buy the cheapest ticket, but the plane all lands at the same time. If you want to spend it on Coumadin - go ahead.

 

[Rich]

I have seen problems first hand but that's another story.
Check with your doctor and see what he says.
The cost of these things is really out of hand.

 

[Johnny Stephens]

Have made the switch back and forth (twice I think). Started on Coumadin, am now on warfarin. No unusual fluctuations during the switches that warranted attention.

Your mileage may vary.

 

[Guest]

Very few doctors see enough warfarin patients or keep up with the latest journal articles to be able to make a judgement. Warfarin has an average of one article per day posted on the National Library of Medicine database. As we have seen so often on this site, doctors tend to make excessive changes in the warfarin dose. They then tend to blame this on switching from brand to generic etc.

 

[catwoman]

Al, thanks for your input. And thanks to others for their personal experience.

My PCP is a pro-Coumadin person. But, he's not buying my meds.

I would think there might be a slight change in adjusting from one to the other. However, how can you tell it's because of the Rx and not what you're eating, OTC/Rx meds you're taking, external factors?

I'm going to give him the figures and let him see the light. Don't know how many patients he has on Coumadin, but maybe some will be changing this year....

 

[MarciaB]

Sorry Ross,

I just had OHS and I'm so CONFUSED! Maybe it was Nancy, she's quick with a website.

Marcia