I believe there might be a bad lot of Warfarin out there.
I had strokes on 12/27/07 and 12/28/07. I started on generic warfarin in January of 2008.
After six months, my doctor took me off the warfarin to see “what would happen”. (Really) I had a TIA. Just six months after being off warfarin.
I tried other anti-coagulants and platelet inhibitors, but they each had serious side effects. So my neurologist has to take me off the new/bad thing for a couple of months before switching back tot he warfarin. EVERY time I’ve gone OFF the warfarin, I’ve had a stroke/TIA within six months.
Going back on the generic warfarin has usually raised my INR to an acceptable therapeutic level. The last two bottles I’ve bought have been from Walgreens in San Francisco (January 2010), and Walgreens in Portland OR (March 2010). Between those months, my INR actually DECREASED significantly while using that version of the drug. (FYI – no, I didn’t miss any doses, start eating massive amounts of vitamin K, start taking any new drugs, or anything else that inhibits the warfarin – as I said, I’ve been taking it for years, so I’ve got the drill down. It’s my LIFE; I’m kind of fond of it.)
When I saw my INR specialist on 04/22/10, my INR had dropped to 1.3, so he increased my dosage to 10mg 2x a week and 7.5 the other 5 days. I believe I had another TIA on 05/07/10 (the symptoms were all the same; but I can’t afford $17K for the ER to tell me that the clot had passed). But when I got checked on 05/12/10, my INR guy and I were both alarmed to discover that my INR had dropped to 1. That’s NORMAL and not at all appropriate for a person on warfarin. So he increased the dosage to 10mg 5x weekly and 12.5mg the other 2 days. After consulting my neurologist, I bought the non-generic version: Coumadin, which is $143 more than the generic. But when you consider that I had a TIA because my INR was too low (despite my increased dosage) the ramifications are pretty scary. This could pose a life-threatening risk to me and many, many other patients.
Walgreens and the FDA don’t seem to think it’s an issue. My neurologist seems a little confused but largely indifferent.
Are there tests that can be performed on this lot of warfarin? It apparently comes from a company called Taro in Israel. But they don’t say where it’s actually manufactured.
I think this is a serious issue that needs to be addressed. Any ideas on how to go about this?
Drug Information: NDC: 51672-4032-01 / WIC: 481368-3 / SIMS/UPC:35167-240321