Harvard Heart Letter

New drug offers warfarin alternative for atrial fibrillation

An immediate switch is right for some people, but not necessary for all.

A newly approved alternative to warfarin, a drug called dabigatran (sold under the brand name Pradaxa), fights stroke better than warfarin, with less bleeding into the brain, among people with atrial fibrillation. It could also make life a little bit easier for them.

For more than 60 years, warfarin (Coumadin, Jantoven, generic) has been the mainstay "blood thinner" used by millions of people with atrial fibrillation to lessen the chances of developing a harmful, or possibly fatal, blood clot. Warfarin is a good drug — it is effective at preventing the formation of clots in the bloodstream, widely available, and inexpensive. But taking it is a bit like walking a tightrope. If you don't get enough of the drug, you run the risk of forming blood clots. Get too much, and your blood takes too long to clot, making you prone to bleeding problems. Many things can jiggle the tightrope, including what you eat and drink, your health, and a number of drugs, vitamins, supplements, and herbal remedies.

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