Coumadin vs. Warfarin

[Rich]

Generic or name brand?A number of us have had this discussion in the past.Gina and I talked about this recently and agree what we will do but I'd like to hear what some of you think or have heard.
First let me emphasize that I realize how fortunate we are to have prescription coverage compared to a lot out there who do not.
Beginning Jan'03 my company will pay the cost of the generic minus the co-pay of course and we will be directly responsible for the cost difference between the generic and the name brand.
This doesn't bother me much except for the Coumadin.
My cardiologist recently told me once you are established on one or the other NEVER,NEVER switch.
Several years ago my wife was recovering from a severely shattered ankle and during the months she was in a cast her doctor put her on Coumadin as a precaution.A week or so after she got out of the hospital they inadvertently switched her to the generic.After several days on that she started to bleed internally.
A quick switch back to Coumadin stopped the problem almost immediately.That really got my attention!!
As a side note we were both taking the same dosage.
After 40+years of marriage we finally had something in common.
Just kidding
Adding up the cost for several prescriptions for both of us gets fairly pricey in a hurry.
What do you all think?

 

[Johnny Stephens]

Hey Rich

My switch from Coumadin brand to Barr generic warfarin took place approx. 2 months after my surgery and caused no fluctuations that I could conclusively say were caused by the switch. I've been stable over the last several months on warfarin, testing a 3.4 yesterday, which is in the middle of my 3.0 - 4.0 range. When they had to make dosage adjustments as I got well, the results seemed to follow the prediction, and luckily I haven't had to "chase" my dose other than in the first month (I was in much worse shape than most recovering folk).

My feeling is that if I had to change back to Coumadin, it would be pretty much a non-event based on the first time through.

As always, your mileage may vary

 

[JimL]

Rich,
"NEVER, NEVER" sounds a little strong to be realistic. It seems to be established that switching from coumadin to warfarin will affect your INR slightly, and switching from warfarin to coumadin will do the same, as will getting a flu shot, or taking some (?) antibiotics, etc, etc. But it's not at all on the same level as other things, like starting or stopping amiodarone, which doubles your effective coumadin dosage.
I think I've had a mixture of coumadin and warfarin through various prescriptions, but I'm hooked on Warfarin now, because that's what the prescription plan supplies.

 

[EVELYN]

Hi All....Tyce was switched over to the generic about 2 months post op without "missing a beat!" If there was a change in his INR, it was still within the normal range so we never even though of it. Paying $5 is a whole lot better as a copay than the difference between the two. He's been on Warfarin for about 2 months with no problem. He also should be off the amiodarone in about 2 weeks---down to 1/4 pill every other day this week and next, so we'll see what happens after that. So far with the reduction from 200mg to 100 mg. to 50 mg. all is well....no crazy INR and no a-fib.....keep your fingers crossed.

Evelyn

 

[John & Joann]

Cleveland Clinic and local doctors recommended that Joann never take generic coumadin. The major issue is that more than one company makes the generic. Barr is the most common brand, but others are in the business. Their quality control between brands will not be consistent.

Our insurace deductible will increase Jan. 1 also. We will stay with Coumadin. Generic on all other 9 durgs.

Remember that Joann is VERY HIGH risk for this issue. She has had a stroke and many TIA's, Double Valve, and Vascular issues in the leg. She also has atrial fib/flutter that comes and goes.

Each case is individual. We are fortunate that her IRN does not change very often. Keeping a good thing going for 31 years!

 

[Rich]

Thanks for the responses,
John and Joann it sounds like you are getting similar information
to what I'm getting.I guess the differences in manufacturers of the generic bothers me since I have had absolutely no problems in six and a half years on Coumadin.
I think I will stick with Coumadin and go generic with our other five medications.
I doubt I'll still be around to see 29 years with this valve and the Coumadin but your longevity sure is uplifting for people like myself.
And remember even though we are stuck in Michigan we are still Buckeyes and always will be.

 

[Gisele]

Ram

Ram

When I worked for cardio docs their protocol was: NEVER switch. If a patient was started on generic upon discharge-for them to stay on generic. All 8 cardio docs (and we monitored over 350 patients) preferred the patients be maintained on Coumadin brand pills. I believe it is suppose to be more stable for most or some patients. Not worth the risk to change (at least for me). We would supply patients with free sample if we knew that they had limited funds, but the reps stopped bringing Coumadin samples about one year ago. I don't know why Dupont stopped this.

There is however a program by nearly every pharmacutical company referred to as the "indigent program". They each have their own guidelines, but if anyone is having financial difficulty DO NOT hestistate to ask your office if you can apply for FREE medication on this program. You might be surprised to find out that you can get your meds for free!

Gisele

 

[Guest]

The doctors who say never switch fell for the marketing department arguments. I have switched hundreds of people and would be hard pressed to tell who was who. Switched or not, everybody has times when they get out of range as you all know.

 

[wweir]

My cardiologist told me that Coumadin is the ?gold standard?. Generic manufacturers can apparently deviate to some degree from that standard. As a result he advised me that when purchasing generic warfarin to ask for and stay with the same supplier.

I am currently taking Barr produced warfarin and get it locally at Walgreen?s.

Walter

 

[Guest]

The reason that I say that the doctors fell prey to the marketing department is that they only took the word of the sales rep. If they had read the medical journals they would have found that Barr made their generic to tighter standards than Coumadin. Coumadin lost a multi-multi million dollar lawsuit for having their reps tell doctors this.
I have seen more warfarin patients in the past 5+ years than any doctor would see in two lifetimes. I've had hundreds change all types of generics and there are no more problems than with people who stick to Coumadin and spend lots of extra money.
There have been dozens of studies that showed that they were equal and NONE that showed they were unequal.
I used to give talks for Coumadin and they refused to hire me any more when I would not shill for them and say that their was better when it clearly wasn't.
I don't know if the doctors make any money for saying that Coumadin is better but I clearly refused to take their money for saying things that I knew were untrue.

 

[wweir]

allodwick


Thanks for your post. It made me feel a lot better and safer. I will continue to insist on the Barr product.

Walter

 

[MarkU]

With all due respect to allodwick, my cardiologist and his lab staff (who I trust completely) have told me that some patients of theirs have had problems when switching from Coumadin to generics.
Fortunately for me the economics are not an issue, but even if it were, I would still opt for the Coumadin. The way I look at it the difference in price is cheap insurance for the peace of mind. Same reasoning that I use to justify using Mobil 1 synthetic oil in my Corvette when regular motor oil would probably suffice...

Mark

 

[Davidcv67]

Funny I guess I could draw a parallel to my industry. I sell & service copiers & supplies for them. OEM raves that their toner is far superior to that of 3rd party supplies. However the fact is that the 2 get their toner from the same manufacturer!

 

[Guest]

I hear the statement every week about people having problems when they switched. My answer is look at how many people had problems and did not switch.

I respect anyone's right to buy the more expensive product but they need to do so after being informed of the pros and cons.

 

[MarkU]

Are you implying that all those who had problems with Coumadin and switched to Warfarin had their problems go away? Sorry, but I don't quite grasp the logic of your argument.

I've had no problems with Coumadin in two years since my surgery.

My insurance co-pay is the same for both Coumadin and Warfarin.

From my standpoint, switching from Coumadin to Warfarin would be the risky move.

If I had experienced any problems with Coumadin I might feel differently, but I certainly would never make any such decision without serious consultation with my cardiologist.


Mark

 

[Guest]

The problems are the same no matter which group you are in.

 

[Rich]

Mark,
I think you and I are on the same page.
I like the idea of cheaper drugs since there are six prescriptions between my wife and myself.
But when it comes to Coumadin I'll pay the price.
After well over six years on it and having absolutely no problems with it I won't take a chance on switching.
I do want to thank everyone who responded so far.
There has been a lot of good information for all of us.

 

[Gnusgal]

Hey! That's not fair! I have seven presciptions just for me! And you get to split your six with your wife??? I'm feeling a bit medicated....

 

[Rich]

Hey you are right that isn't fair and it's not fair that someone as young as you are has to take all of those meds.
But I guess it beats the alternative.