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Alternative to warfarin for atrial fibrilation


Reshy Gomes, MD,  is a cardiologist on staff at Banner Thunderbird Medical Center in Glendale. Her office can be reached at 602-298-7777.

Question: I have taken Coumadin (warfarin) for some time and recently heard about a new drug that has been approved by the FDA that is as effective but doesn't require the blood testing. Is this true?

Answer: In a word, yes. Pradaxa, or Dabigatran, and was approved by the FDA on Oct. 20, 2010, as an effective therapy for preventing strokes and blood clots in patients with atrial fibrillation.

A-fib is essentially an irregular heartbeat in the left upper chamber of the heart - the left atrium - that affects more than 2 million people in the U.S. When the heart beats irregularly, blood can collect in the left atrium, increasing the risk of a blood clot releasing and, ultimately, increasing the likelihood of a stroke. In fact, the presence of A-fib increases an individual's risk of stroke by four to six times.

We've traditionally tried to minimize the risk of blood clots by giving patients with A-fib anticoagulants, such as aspirin or warfarin. While warfarin has been the most commonly prescribed anticoagulant drug for decades, the blood levels of patients taking it must be frequently monitored to make sure the blood doesn't get too thin and cause excessive bleeding.

Pradaxa has been used in Europe for the last couple of years, and recent clinical trials, specifically a trial called RE-LY, have found that Pradaxa (Dabigatran) is as effective as warfarin in preventing blood clots in patients with A-fib, if not more so, but does not require blood monitoring. So, not only is Pradaxa an equal replacement for warfarin therapeutically, but it also cuts down on patients' need to go back and forth to the doctor or lab, not to mention pesky needle pokes.

If you take warfarin for atrial fibrillation, talk with your physician to determine whether Pradaxa is an appropriate option for you.

Reviewed November 2010

Page Last Modified: 09/03/2015
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