Coumadin vs. warfarin

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Rich

Rich

Well-known member
Joined
Nov 11, 2002
Messages
1,314
Location
S.E. Mi
We have had a discussion regarding this subject a number of times.
After eleven and a half years on Coumadin, I was asked to try warfarin.
So two weeks ago I had my INR checked and then started warfarin that day.
My INR was 3.0 which is dead center for my range.
Today I had another blood draw to see how the switch may have affected me.
I am at 1.9!!:mad:
There have been absolutely no changes to my diet, activity level or any meds.
So today I told the doctor we are switching back immediately.
Fortunately I have enough of a supply for a few more weeks to stay on Coumadin. Maybe it doesn't affect a lot of people, but I'm convinced warfarin is not for me.
I do take a fairly low dosage compared to a lot of our members.
I take 5mg Monday and Friday and 2.5mg the rest of the week.
I did notice a big difference in the texture of the warfarin tablets( from Taro in this case) compared to coumadin.
Could that make it metabolize faster in one's system?
Bottom line is I was shocked after pretty much staying in range for all these years. The only problems I ever had were caused by new meds, or a drastic increase in activity level.
I would appreciate your input,
Rich
 
Rich,

Your comment about the "texture" being different caught my attention. I wonder if those tablets had been 'contaminated' by humidity or something... OR, if someone is trying to 'sluff off' some out-of-date tablets...

OR, could you have had a bad test?

Something just sounds suspicious (but I do understand your concern). It might be useful to return those 'strange looking' tablets to the pharmacy and have them tested.

Someone else reported a similar result with some 'different looking' tablets. I can't help but wonder if some offshore manufacturer isn't "counterfeiting" these drugs. There was a report of such activity with high priced Cancer and Pain Pills (coming from the 'Far East'). (yea, counterfeiting generic warfarin does seem a bit far fetched, I confess).

FWIW, I used generic from TARO for a few years until my insurance changed mail order suppliers. Since then I've been using generic from BARR. NO PROBLEMS with either. Both are reputable suppliers.

FWIW2, my insurance company will only pay up to the amount they will pay for a Generic and there is a substantial price difference between generic and name brand Coumadin (which has been manufactured by several different companies as the 'Brand Name' has been sold from company to company to company).

'AL Capshaw'
 
Bina said:
Freddie, I think some insurance companies request the less expensive generic brands of meds.
Click to expand...


Insurance companies do & will do that to patients unless their doctors write a new Rx & say "no generics!" My cardio has always told me that he wants me to take "coumadin" not "warfarin" so he writes this on the prescription! I will not accept a generic for coumadin!

Last week I went to go pick up my refill for Altace & it had been substituted with "Ramipril" instead. :mad: I was pretty upset but they said that my insurance would only pay for the generic unless my doctor said otherwise. I asked them if I wanted to pay it out of my pocket, how much it would be? $50!:eek: So I took the generic but in a week I go see my doctor & I will ask him to give me a new RX for Altace!

If you've been taking coumadin & your INR has been stable, go back to your doctor & ask him to write another RX saying "no substitute!"

Good luck!:)
 
Just because a Doctor writes an Rx as "No Substitute" is NO GUARANTEE that the insurance company will Pay the extra cost of Name Brand drugs.

IF a Generic is available, my insurance company will only pay the amount they allow for the Generic, regardless of what the Doctor wrote. The PATIENT has to pay the difference.

'AL Capshaw'
 
In my case I am a retired engineer from GM.
They along with Medco who handles our prescription plan are pushing VERY hard for people to switch to generics. For a name brand we are charged the going difference between the generic and the name brand. It can get a little pricy.
So tommorow I will pick up my prescription and order more Coumadin, and it will say DAW on it!!
The good news is I split my 5mg tablets five days a week, so a 90 day supply lasts me closer to six months. And even though our co-pays keep rising I still feel pretty fortunate with what we have.And no I never was a member of the UAW, they get a far better deal than us salaried retirees.
Al, I am not sure at this point. I have never had a bad blood test in all these years. Only one time was there a typo mistake regarding my annual PSA test.
They typed .10 when it actually was 10.0. Thankfully I caught that one right away.
The warfarin tablets seem much softer than the Coumadin I'm used to. They also don't split cleanly like the Coumadin always has. Maybe I was sent a bad batch, I don't know. I'm sure Medco would say that's not possible.
So today I switched back, took 5mg instead of 2.5, will do that again tommorow, and then resume my normal dosage and get a blood draw in a week. Hope to get right back on track.
Rich
 
Hmmm...

the engineer in me keeps wondering what the "root cause" of the problem is...

I *assume* you have a Local Pharmacist that you use for short term medications. It might be worth asking him/her to take a look at your TARO tablets (and / or compare to TARO tablets that he might have).

When I was taking TARO tablets, it was through the same distributor and there was NO change in my INR when I changed from Coumadin to Generic Warfarin made by TARO (and NO change when changing from TARO to BARR). I actually prefer the Generic's because to my mind, they split easier (I could split them without having to use a razor bladed pill splitter).

This is perplexing, and a bit worrysome to those of us who use Generic Warfarin and would like to continue to believe there is NO difference (which IS the result of the vast majority of users of Generic Warfarin).

On another subject, I'm surprised that after all these years, you / your Coumadin manager doesn't use a Finger Stick Tester. Do you go to a Coumadin Clinic? If not, who manages your Coumadin?

'AL Capshaw'
 
I tend to agree with Al, it may be worth asking your pharmacist to check the tablets he/she gave you....

Over here (NZ) I have had both Marevan (name brand) and generic Warfarin, and have not had any trouble with my INR.
But that is just my personal experience.

Bridgette
 
I too use Marevan here in Perth, West Australia....glad to know its a 'named brand'.

I remember sometime being told that it was the same as "xyz" just manufactured in a different plant in another part of the world so thats why it had a different name.

Only been on that so can't comment on any changes experienced by swapping between brands.
 
I have no comment on Warfarin vs Coumadin ... I have always been Warfarin and always stable:rolleyes: except when on antibiotics.

I did switch from Toprol XL to the generic Metoprolol recently for insurance reasons. At 25mg on both my BP is lower and seems more stable on the generic.
 
My husband tried taking warfarin two years ago to try and cut down on some of our copays. He had also been steady at 2.5 to 3.5 for three years. The first month on the generic he went to 1.7. Maybe most people can take the generic but he appears to be one who can't. We paid for his coumadin out of pocket for a month until his doctor wrote a letter to the insurance company saying he needed to be on brand. They agreed. His copay is 30.00 but 30 coumadin tablets cost us under 50.00 at KMART without insurance.
 
Sue,
It sounds like your husband had exactly the same experience as me.
I do have to clarify one thing.My co-pay for a 90 day supply from Medco is $50 min for a brand drug. It can be higher depending on the dollar difference between the generic and brand. They have a preferred and non-preferred list of drugs. Of course any brand drug that has a generic alternative is on the non-preferred list.
Al,
That sounds like a good idea to have the tablets looked at locally. Wheather permitting I may take them to my local CVS. Medco and CVS are one and the same company anyway.
As far as my testing goes that is handled by my cardiologist. I go to the hospital and have a vein draw, it's never been a problem. My nieghbor goes to his doctor for a finger poke but this also costs him an office call.
With Medicare mine is 100% paid for whether it's once a week or once a month. I can go as often as neccesary and never pay a dime. My hospital has a special outpatient lab just for people like us, so there is little or no waiting, and I get my results the same day.
Rich
 
Rich said:
Sue,
It sounds like your husband had exactly the same experience as me.
I do have to clarify one thing.My co-pay for a 90 day supply from Medco is $50 min for a brand drug. It can be higher depending on the dollar difference between the generic and brand. They have a preferred and non-preferred list of drugs. Of course any brand drug that has a generic alternative is on the non-preferred list.
Al,
That sounds like a good idea to have the tablets looked at locally. Wheather permitting I may take them to my local CVS. Medco and CVS are one and the same company anyway.
As far as my testing goes that is handled by my cardiologist. I go to the hospital and have a vein draw, it's never been a problem. My nieghbor goes to his doctor for a finger poke but this also costs him an office call.
With Medicare mine is 100% paid for whether it's once a week or once a month. I can go as often as neccesary and never pay a dime. My hospital has a special outpatient lab just for people like us, so there is little or no waiting, and I get my results the same day.
Rich
Click to expand...

Rich....your post would be easier to read and enjoy if the font was a bit larger ... These old eyes ain't what they use to be:eek: :)
 
cooker said:
Rich....your post would be easier to read and enjoy if the font was a bit larger ... These old eyes ain't what they use to be:eek: :)
Click to expand...
Go to the vet and get some glasses.
 
why not self test

why not self test

Rich said:
Sue,
It sounds like your husband had exactly the same experience as me.
I do have to clarify one thing.My co-pay for a 90 day supply from Medco is $50 min for a brand drug. It can be higher depending on the dollar difference between the generic and brand. They have a preferred and non-preferred list of drugs. Of course any brand drug that has a generic alternative is on the non-preferred list.
Al,
That sounds like a good idea to have the tablets looked at locally. Wheather permitting I may take them to my local CVS. Medco and CVS are one and the same company anyway.
As far as my testing goes that is handled by my cardiologist. I go to the hospital and have a vein draw, it's never been a problem. My nieghbor goes to his doctor for a finger poke but this also costs him an office call.
With Medicare mine is 100% paid for whether it's once a week or once a month. I can go as often as neccesary and never pay a dime. My hospital has a special outpatient lab just for people like us, so there is little or no waiting, and I get my results the same day.
Rich
Click to expand...
Rich,
You mention that you have medicare. Is there a reason that you don't self test? Medicare covers self testing.
 
Warren,
I never really thought about it. Our hospital is only ten minutes away and like I mentioned they have a special lab just for people like us.
They opened it some years ago because the main lab is really crowded all day, every day.
Rich
 
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