Was curious to know if anyone can answer how many reported deaths have occurred from Warfarin. I heard a lot of Doctors don't report adverse events anymore from Warfarin because it has been around for so long. I'm curious to see if anyone can answer. I'm certain so many people die on Warfarin everyday all around the world but no one seems concerned.

Steve with Coumadin, it's very hard to say. Many people have listed, as their cause of death being Coumadin related, but the fact of the matter is, not many professionals understand how to dose the drug properly. I see it every day. The best answer I can give you comes from a certified anticoagulation expert, Algha Lodwick, who is now retired.

"32

1998 = 12

1999 = 17

2000 = 39

2001 = 39

2002 = 27

2003 = 44

2004 = 46

Total = 224 over 7 years for an average of 32 per year.

This is data from death certificates listing this as the cause of death.

There were an estimated 30,600,000 prescriptions filled for warfarin in 2004. This is an estimated increase of 45% from 1998.

So for every 10 million prescriptions filled for warfarin, approximately 1 person died with the primary cause of death being anticoagulation.

Reference: Wysowski DK et al. Bleeding Complications with Warfarin Use. Arch Intern Med. 2007;167:1414-9"

If professionals would learn to dose the drug properly, patients would be compliant, I'm sure you'd see the Coumadin death rates fall like a rock. At least Coumadin has an antidote, which cannot be said for Pradaxa.

Sorry, I forgot to post the question Al had asked.

"BETWEEN 1998 AND 2004 AN AVERAGE OF HOW MANY PEOPLE PER YEAR

IN THE UNITED STATES BLED TO DEATH FROM ANTICOAGULATION?"

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The numbers are just frightening.

A couple of quick comments - to Dr. Restaino: If a patient on warfarin needs emergency reversal, vitamin K will take 15 to 17 hours to reverse warfarin. Pradaxa has a half life of 12 hours. So in reality, you end up in the same situation - you cannot do anything immediately to reverse warfarin - so practically speaking, in an emergency situation, you do not have an antidote for warfarin in reality. Second and more importantly, the data on Pradaxa shows it significantly reduces intracranial bleeds and hemorrhagic strokes both of which are high with patients on warfarin and can be devastating. Physicians have to make choices everyday - the benefits of Pradaxa (in significantly reducing strokes) far outweigh the risks we take everyday with warfarin and placing the patient sometimes on sub optimal therapy. All products come with side effects and potential risks - physicians have to be educated and manage those risks better to provide the greatest benefits to patients.

Dr. Jim, your leaving out fresh frozen plasma along with vitamin K as a rapid reversal agent. I've needed rapid reversal twice in 12 years. Had I been on Pradaxa, I would be dead today. Even with a half life of 12 hours, that is too long when your having a major bleed event. That kind of risk is totally unacceptable to me.

I think why so many doctors prefer to put patients on Pradaxa is because it relieves them of responsibility and places it on the patient.

I can ask 5 different doctors a Warfarin dosing hypothesis and I'll get 5 different answers every time. The problem with Coumadin is not the drug. It is those managing it and patients that are not compliant or sick of being vein stuck and never being in range more then 55% of the time. I'm watching someone right now going to a Coumadin clinic, being tested every 2 days, dose being changed just as often as tested and this is going on the third week and he's still not even close to in range. Why? Simple. Testing before the first dose has had a chance to reach it's peak effectiveness, the dose being changed constantly, which does nothing more then create a yo yo effect. What I'd like to see is standard dosing protocol followed by every physician. If that were implemented, which I don't think will happen in my life time, it would do wonders for the negativity about Coumadin. Not only that, but there are still professionals out there scaring the living daylights out of their patients with misinformation about the drug.

Patient self testing and self management would, in all likelihood, cut the number of deaths and increase the number of in range times.

I'd love to have Dr. Jack Ansell weigh in on this topic.

Response to Ross - appreciate your comments - perhaps a paper published just this week in STROKE (May 3rd) by Dowlatshahi, et al on behalf of the Canadian PCC registry investigators may help

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Jim appreciate your comments also.

One has to wonder what the outcomes of those patients would have been had they had no anticoagulation at all. I'm willing to bet that they would have still had poor outcomes. This is one area that I don't think, regardless of how many studies are done, will ever give the honest result. They based that study on older patients, which we know are prone to weakened vessels from the natural aging process. Given the time frame that Pradaxa has been out, who can really say for sure that it doesn't have the same effect? We won't really know for years yet. Meanwhile, we do know that Pradaxa has proven to show an increased risk of Myocardial Infarction and Acute Coronary Syndrome and an unusually high death rate for a drug that hasn't been out very long.

I don't think they studied the drug long enough or the FDA simply inked the OK without really giving it much thought when they allowed Pradaxa to go on the market.

Never the less, my whole point revolves around the fact that there are far too many professional managers/clinics/doctors that have no clue how to dose Coumadin/Warfarin. Europe is light years ahead of the U.S. in this field.

The drug has been out for over 50 years. You'd think by now, there would be a standardized protocol for dosing, yet I cannot find but a handful of places or people that know how to manage Coumadin properly. If everyone were managed properly and patients were compliant,I know there are some who are not, could you imagine how the number of deaths from Coumadin would drop?

Trying to answer Steve's question is difficult because of all the possible scenarios involved. I believe many times, anticoagulation is blamed for something simply because a person was taking it. Again, I wonder what the outcome would be if they weren't on it. I don't think we'll ever be able to answer that one with any degree of certainty.

Here is a gentlemen that's been on Warfarin for 51 years. There is a lot to be learned from people like him.

51 Years On Warfarin Congratulations RCB-10/27/2011

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I am a Geriatric social worker and worry about seniors on Pradaxa.The blood vessels in the Brain become extemely fragile with the aging process. With poor balance seniors are prone to falling bumping and head injury. Many seniors live alone and do not keep good records of medications. If a senior fractures a hip while on Pradaxa emergency surgery could be fatal. Our Pradaxa helpline can be reached at 1 877 522-2123

Beware Pradaxa Users:

Our Father during January 2012, came into the research Hospital, Doctors took my father off Pradaxa and waited 36 hours (24 hours per Per Drug Company) to have a procedural tap done on his lung, short period after being sent back to his hospital room he collapse, within minutes after rushing him to icu he coded with crack ribs and all, recover, doctors notice he was bleeding inside out from the lung tap and perform a chest tap to release the blood formation from outside of the lung, he coded again and was revived, some 20 to 30 of our country top doctors were involved in the icu trying to save my father life, the doctors were lost, they ended up flooding his body with units of blood for days until the lung stop bleeding inside out, the doctors realize his organs (kidney, heart, etc) would be damage from the over flooding of blood, he made it thru without brain damage but had to live on a breathing tube for over three weeks in icu, after three weeks his organs were shutting down, medical staff tried everything to help him survive, he finally realize his time on this was very short, but for him and his family to suffer for over five weeks, to finally here the doctors say he is finished he had lost his battle, the family made the decision to let him go peacefully, for over four days the family sat with him around the clock waiting for him to pass on, on his last day our mother went in to see him to say it is ok for you to go and told an inside joke between our parents was we have seven brats to take care of mother, they were married for over 59 years, my father squeeze my mother hand while he was under from the drugs and pain killers, mother went back to her hospital room, hour half later while my sister was holding his hand the iv drip waring bell was ringing next to his bed where my sister (register nurse) was sitting as she got up turn the warning bell off she notice the screen said near end (iv bag empty), as she sat down to call the nurse my father squeeze my sister hand looking at her with wide eyes seconds later he closed them and passed away with his last breath of air.

Please share this with your families,Pradaxa is a very dangerous drug to be taking.

A little more awakening:

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