By
Roz Lewis
16:00 EST, 4 May 2013
|
03:41 EST, 6 May 2013
For the thousands of Britons who suffer life-threatening blood clots, warfarin is a lifeline.
However, the potent 65-year-old drug is made from the same chemicals found in rat poison, and some users need to be monitored at a GP surgery up to three times a week.
They can also suffer dramatic side effects, including spontaneous heavy bruising, internal bleeding and hair loss.
Tough times: Deep-vein thrombosis sufferer Hannah Rogers, 34, from Chelmsford, suffered a number of side effects from warfarin, including her hair falling out
But now a new range of blood-thinning
drugs that eliminate the need for regular testing has been given NHS
approval for patients who suffer a deep-vein thrombosis (DVT), the often
dangerous blood clots that develop in the legs and pelvis.
Rivaroxaban,
Dabigatran and Apixaban have the same benefits as warfarin but do not
have such severe and unpredictable side effects.
For
Hannah Rogers, 34, from Chelmsford, Essex, taking Rivaroxaban is a
welcome relief, especially as warfarin made her hair fall out.
‘I
first developed circulation problems when I was 25. Even though I was
quite overweight – I was 16st or 17st – and I wasn’t very active, it was
still quite a shock,’ says the mother of two.
‘After a driving holiday,
my right leg swelled dramatically. My GP sent me for tests but doctors
said initially that I didn’t have DVT. However, I later went for more
tests and these showed that I did have DVT.
‘There
was a blood clot in my right calf muscle. Doctors said it wasn’t a
danger, so I wasn’t given medication but instead I was told to wear
support stockings, keep active and tell my doctor if anything happened.’
Every
year 60,000 Britons develop DVT. The most common cause is simply
sitting still for long periods – when the legs are immobile for more
than 90 minutes, the blood flow drops by 50 per cent, making a clot more
likely.
Rat poison: Warfarin is also used to kill rodents
Those most at risk are hospital patients bedbound after an operation, but sitting for long periods on a plane is another known trigger. Illnesses including cancer also make the blood more likely to clot, as do pregnancy and hormonal treatments such as HRT. If a person does develop a clot, it may break off and travel around the body.
If the clots lodge in the lungs and block the pulmonary artery –which carries blood from the heart to the lungs – it is called a pulmonary embolism. This can starve the body of oxygen, and can prove fatal if not treated swiftly.
When Hannah discovered she was
pregnant with her first child, Elise, in late 2005, her doctor told her
to self-administer injections of the blood-thinning drug heparin to
manage her condition. Warfarin isn’t safe to take during pregnancy. ‘It
was a bit difficult at first but I soon got used to doing the
injections,’ she says.
After
giving birth in July 2006, Hannah continued the treatment for 12 weeks,
and was then told to use support stockings to help her leg.
Before
giving birth to her second child in March 2009, she followed the same
regime with heparin, but despite the medication, her leg continued to
swell randomly.
‘Every time
it did – and by now the ankle was permanently purple because of all the
blood that had pooled there in the past – I used to panic,’ says Hannah.
In January 2010, after her leg had once again become severely swollen, tests revealed that there was another blood clot.
‘I
started taking warfarin tablets in the February but I just didn’t get
on with them,’ she says. ‘My hair started to fall out. It was
horrifying. Getting my blood checked three times a week was a nuisance
too.’
She tried heparin
again and then two other types of blood-thinning medication over the
next two years, but neither really helped. ‘I tried one drug after
another, then warfarin again,’ recalls Hannah. ‘My hair actually fell
out even more dramatically when I was briefly put on another drug.
‘Last year I heard that Rivaroxaban was available, so I was pleased to be one of the first patients to try it last July. I felt better within two weeks or so. And I’m very pleased to say that my leg hasn’t swollen up at all since I’ve started taking it. Another benefit is that I don’t have to go to my GP to have my blood levels monitored.’
Rivaroxaban is vastly more expensive than warfarin – £2.10 per tablet compared with 5p. However, Dr Karen Breen, Consultant Haematologist at St Thomas’ Hospital in London, says: ‘Taking into account the costs of monitoring and hospitalisation around the use of warfarin, then the new drugs seem to be cost-effective.
‘They work differently to warfarin in that they target just one clotting factor in the blood rather than several. Results from big clinical studies are very promising.’
For Hannah, who has lost more than 4st over the past year after starting a new fitness regime, the new drug is definitely progress.
‘If I have to be on blood-thinners for the rest of my life, then I am glad this new drug is on the market,’ she says. ‘So far I feel very well on it, and I am hoping that my health continues to improve.’
thrombosis-charity.org.uk
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Warfarin has an antidote should you start bleeding to death. These new drugs have no antidote.
They are not the miracle drugs you might imagine them to be. At least 65 years of use has earned
warfarin some trust.
Mizme
,
Toronto,
06/5/2013 01:34
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You could also say that a drug that keeps blood from clotting in humans and prevents their death, happens to be used in rat poison as well. Kind of puts a different spin on it, doesn’t it. I know quite a few people that are taking warfarin because of blood clotting issues. They look fine to me and are alive, in part, because of warfarin. So nice of DM to publish a story that might scare people into not taking it.
Linder
,
Kingston, United Kingdom,
06/5/2013 01:25
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I know two people close to me who take warfarin due to pulmonary thrombosis, neither have to go in 3 times a week, monitoring is weekly if INR levels go up and down, monthly if they stay consistent for more than 2 weeks. Bruising is a problem and if you cut yourself. You can get insurance if you travel and it is expensive, but I’m sure the pleasure this gives people outweighs the cost of the insurance. It means my Mum gets to see her son and grand daughter in America which far outweighs the cost of the insurance.
Dee Dee
,
Watford, United Kingdom,
05/5/2013 23:37
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I’d just like to point out that warfarin isn’t actually used as rat poison anymore as they are now immune to it…so yeah…
Someone
,
London, United Kingdom,
05/5/2013 23:04
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Nice attempt to promote not-so-new drugs developed by pharmaceutical companies interested only in lining their own pockets. As others have commented here already, the effect of these drugs cannot be reversed and those people who lost their lives in the process of trying them out are cleverly left out in the studies. If one accidentally overdoses on Warfarin, which has been around many years and has been tried and tested extensively, it is possible to counteract this by injecting Vit. K. Furthermore, it is known that statistically a few more people die from heart attacks as a side effect of these “new†anticoagulants than are saved from lethal strokes. If I was to choose a drug to prevent blood clots, I know which one I’d go for. Do not believe everything drug companies tell you.
Nevergiveup
,
Germany, United Kingdom,
05/5/2013 22:10
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My husband took wafarin for 5 years but it eventually caused a dramatic bleed in his brain.
We live in France so it was even more frought because he had to travel 180Km to go to Toulouse hospital for an emergency operation. However the hospital was wonderful as were all the staff. After two weeks in an induced coma he was sent for several more weeks to a specialized clinic (even further away from home!) There they put him together with intesive phisio and wonderful nursing. Voila! he’s back to his old self again. No thanks to god just thanks to the wonderful French health service and an Italian surgeon.
sue Figeac
,
figeac,
05/5/2013 22:00
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Perhaps if weight loss was the first treatment then alternative drug therapy wouldn’t of been required.
WhyOhWhy
,
Dorset,
05/5/2013 21:46
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05/5/2013 13:08….Warfarin is Rat Poison… It was developed as a Rat Poison.. Use as a Blood thinner was incidental.
– Jiohn Germanq , Reading, 05/5/2013 16:03Strange you say this. Wiki states it was discovered in the US as an anticoagulant when cattle which had eaten mouldy sweet clover silage bled to death after horn removal and after much experimenting they isolated the active ingredient the cattle had ingested. Its development as a rodenticide and its use as a pharmaceutical were co-incidental.
Very Very Grumpy
,
Edinburgh,
05/5/2013 21:36
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I had a PE aged 21, with no risk factors. I took Warfarin for six months, and I felt great on it, I stopped having headaches which I had suffered from for years etc. Obviously it’s not perfect, and not every medication can work from everyone, so alternatives should be explored, but don’t scaremonger about a common drug which has actually improved some people’s health/lives.
Lass
,
Scotland, United Kingdom,
05/5/2013 21:30
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I have been taking warfarin for years. I do have side effects from it but I’d rather have them than to have another flare up and spend time in the hospital. I get my blood checked every month and so far I’m doing well.
My insurance will probably not cover the new drugs out anyway and I wouldn’t be able to afford them otherwise.
Shelly Roberts, Mulga AL USA
radarno28
,
Mulga, United States,
05/5/2013 19:35
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