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Xarelto: More Dangerous than Warfarin?

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Cases have recently been filed in courts around the U.S. relating to bleeding injuries and death caused by the drug Xarelto.

Xarelto-pill_MainXarelto is an oral anticoagulant manufactured by Bayer Pharmaceuticals and Janssen Pharmaceuticals (a Johnson & Johnson affiliate).  It was brought to market in 2011 and has been extensively promoted as an alternative to warfarin (coumadin).  Xarelto was originally approved to prevent blood clots (and stroke) in patients with atrial fibrillation and in patients undergoing knee or hip replacement surgery.

Until the release of Xarelto and other new oral anticoagulants (“NOACs”), warfarin had long been the standard care for preventing blood clots.  The NOACs, including Xarelto and Pradaxa, have been widely marketed by their manufacturers as better alternatives to warfarin because patients would no longer have to undergo regular blood testing and frequent doctor visits to monitor proper dosage and kidney function.

It has since been demonstrated, however, that the claim of added convenience of Xarelto comes at a steep and often devastating cost to many patients.  Xarelto has been linked to medical complications including intestinal bleeding, rectal bleeding, blood clots, brain hemorrhaging, pulmonary embolism, and deep vein thrombosis.  Many of these conditions can lead to severe disability or death.  Ironically, it appears that these devastating bleeds could often be prevented if the patients on the NOACs underwent regular blood testing – just like patients taking warfarin – to ensure that their dose was appropriate.  Such a recommendation, however, would be in stark contrast to the marketing strategy for Xarelto – that it is more convenient and thus superior to warfarin.  As a result, no such recommendation has been made by the manufacturers of Xarelto.

xarelto 2The failure of manufacturers to recommend blood monitoring in patients taking Xarelto is even more dangerous in light of the fact that, unlike warfarin, there is no known antidote to stop bleeding caused by this medication. If you develop a bleed from taking warfarin, simple vitamin K therapy is generally sufficient to treat the condition and promote clotting.  This is not the case with Xarelto.  Until an effective antidote is created and approved for use in Xarelto patients, there will continue to be an unreasonably high number of uncontrollable bleeds and deaths caused by the drug.

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