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Suggest Reasonably Priced Alternative Medication For Pradaxa
Question: My Husband is on Pradexa after Coumadin course for non valvular Afib. Praddaxa and Xeralto are very expensive druga, can he take aspirine and Plaavix instead?
Brief Answer:
Can you please send me following clinical details mam?
Detailed Answer:
Hi, I did review your concern.
As I can understand your husband has been shifted to pradaxa from coumadin course for nonvalvular Afibrillation to prevent thrombus Formation.
First of all the issue with aspirin and Plavix (clopidogrel) is that both are antiplatelet agents and this combination has worked for coronary artery disease but not for preventing thrombus in heart. In few trials (ACTIVE A and ACTIVE W trials) it has been clearly shown that although they might prevent thrombus in some instances they are not as effective as warfarin in preventing stroke and have similar or slightly higher bleeding risk as compared to oral anticoagulants.
Aspirin plus plavix are used in very very rare instances
Can you give me following information?-
1)why was he shifted from coumadin to Pradexa?
2)Does he have diabetes?
3)Does he have any past occurences of stroke or transient ischemic attacks?
4)Does he have Hypertension?
This would help me stratify his risk of thrombus formation.
As far as comparison between Pradexa or Xeralto vs coumadin(warfarin) is considered many recent large trials have shown that they are much better as compared to warfarin in decreasing stroke risk as well as decreasing bleeding risk and hence they are prescribed as first line medications these days by many cardiologists.
However, if a person is doing good on coumadin or if there are cost issues and no bleeding risk with coumadin than coumadin can be used instead of Pradexa or Xeralto.
I hope this helps.
Waiting for your reply.
Let me know if you have any more questions or concerns.
Wish you all the best mam.
Sincerely,
Dr Parth Desai
Can you please send me following clinical details mam?
Detailed Answer:
Hi, I did review your concern.
As I can understand your husband has been shifted to pradaxa from coumadin course for nonvalvular Afibrillation to prevent thrombus Formation.
First of all the issue with aspirin and Plavix (clopidogrel) is that both are antiplatelet agents and this combination has worked for coronary artery disease but not for preventing thrombus in heart. In few trials (ACTIVE A and ACTIVE W trials) it has been clearly shown that although they might prevent thrombus in some instances they are not as effective as warfarin in preventing stroke and have similar or slightly higher bleeding risk as compared to oral anticoagulants.
Aspirin plus plavix are used in very very rare instances
Can you give me following information?-
1)why was he shifted from coumadin to Pradexa?
2)Does he have diabetes?
3)Does he have any past occurences of stroke or transient ischemic attacks?
4)Does he have Hypertension?
This would help me stratify his risk of thrombus formation.
As far as comparison between Pradexa or Xeralto vs coumadin(warfarin) is considered many recent large trials have shown that they are much better as compared to warfarin in decreasing stroke risk as well as decreasing bleeding risk and hence they are prescribed as first line medications these days by many cardiologists.
However, if a person is doing good on coumadin or if there are cost issues and no bleeding risk with coumadin than coumadin can be used instead of Pradexa or Xeralto.
I hope this helps.
Waiting for your reply.
Let me know if you have any more questions or concerns.
Wish you all the best mam.
Sincerely,
Dr Parth Desai
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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