One of the greatly touted benefits of Xarelto is highlighted on its website: “With XARELTO®, you can say goodbye to Warfarin’s blood monitoring routine.” But there is more to the story. While the benefits might be enticing you to switch your blood thinner medication, as a personal injury attorney, I want to take some time to explain some of the negative consequences of switching your medication to help you avoid future accident, injury and legal issues.
What Is Xarelto?
As I discussed in my personal story with Warfarin and Xarelto, Xarelto is a blood thinner used primarily for prevention of stroke and embolism in patients with certain heart conditions. It can be used to prevent Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) in people undergoing knee or hip surgery. Xarelto approved for use in the United States in 2011. It is the second most prescribed anti-clotting medication behind Warfarin.
Why Should You Be Concerned About Xarelto?
All blood thinners have a risk of major bleeding events that can be serious. For those with an active lifestyle, falling off a bike or being injured in a pickup soccer game can turn a normal injury that you would otherwise walk away from, into an emergency room visit. These are well known risks, and are highlighted and discussed on the product labeling.
The way to reduce this risk, at least in the case of the alternative medication, Warfarin, is regular blood testing with dose adjustment. Xarelto however, is marketed specifically for not requiring such regular monitoring.
Anticoagulation effects of these drugs are widely variable between people, and even in the same person over time. They are measured with INR, called the International Normalized Ratio. The goal is to keep INR between 2-3. If you are below 2, you have increased risk of clotting or stroke. If it is above 3, you have an increased risk of a major bleeding event.
Just like Warfarin, Xarelto patients are at risk of experiencing major bleeding events and strokes or clots if they are not monitored. As Xarelto has become more popular, the number of Adverse Drug Events (ADE’s) has increased. Articles in medical journals, including the Thrombosis Journal, the Journal of Thrombosis and Haemostasis, and Thrombosis Research, are calling for the need to monitor the INR levels with this drug. Even the Food and Drug Administration (FDA) has agreed that more frequent monitoring to ensure appropriate dosing should be implemented.
Changes In Medication Safety, Dosage That Could Affect You
In addition to the fact that Xarelto requires less monitoring, the drug is also marketed heavily on the fact that is only requires a single dose each day. This would make it easier to remember to take the medication and reduce the inconvenience of multiple dosing requirements. Warfarin, Xarelto’s major competitor, requires one or sometimes two doses each day.
It is important for you to know that recently, Xarelto’s dosage requirements have been called into question and subjected to criticism. In fact, the drug manufacturer, Janssen, now recommends twice daily dosages for DVT and PE prevention on its website. It turns out, all of the great benefits of switching from Warfarin to Xarelto have all but disappeared. Moreover, individuals who are not aware of the monitoring and dosage changes with Xarelto are at an increased risk of experiencing problems with the medication.
Warfarin Offers An Emergency Antidote, Xarelto Does Not
While all blood thinners carry the risk of internal bleeding, Warfarin created an emergency antidote with the ability to stop bleeding; that is not the case for Xarelto. There is no emergency antidote to reverse the effects, and this makes it difficult for doctors to treat patients in an emergency situation. My own family doctor pointed out this problem a couple of years ago when I inquired about the drug, and I feel fortunate that I did not make the decision to change medications.
We are currently reviewing cases for individuals who have been on Xarelto and have experienced bleeding episodes that could not be controlled. If you or an immediate family member would like us to review a potential case involving this drug, please contact us to discuss your legal options.
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