Harvard Heart Letter

New alternatives to warfarin

Warfarin (Coumadin, generic) has been the mainstay for preventing blood clots caused by atrial fibrillation since the 1950s. Today, new prescriptions for novel anticoagulants approved in 2010 and 2012—dabigatran (Pradaxa), rivaroxaban (Xarelto), and apixaban (Eliquis)—now outnumber those for warfarin. The new drugs are safer than warfarin and carry only half the risk of dangerous bleeding within the skull. Harvard experts say the new drugs may be the best initial anticoagulant therapy for atrial fibrillation. However, there is no compelling reason for people doing well on warfarin to switch to one of the newer agents, which are 30 times more expensive than the older drug.
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