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 Pradaxa 110mg per day? Endometriosis?

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theoriginalrachel



Posts : 3
Join date : 2011-04-20

PostSubject: Pradaxa 110mg per day? Endometriosis?   Tue Apr 26, 2011 3:37 am

First of all, I just want to say thank you to everyone who posts on here; it has made my experience over the last 2 1/2 weeks much less frightening! I was diagnosed 17 days ago with DVT and then a week later with PE. I'm 27, perfectly healthy and had no risk factors for clotting other than taking Yasmin for 5 years (and until this week, I had no idea that it had a 3x higher risk of clotting than other birth control pills!).
I was having terrible side effects from the warfarin and so my doctor has suggested that I switch to Pradaxa. However, he has told me to take only one 110 mg dose per day and that seems to contradict all the information online and on the insert in the packaging (minimum recommended dose should be 2 pills or 220 mg per day). I am quite concerned that my blood will not be thin enough and want to know if anyone else is taking such a low dose. I have no kidney problems and I am average height/weight.
I've found answers on LADVT for all the other questions I have had (ie about side effects such as hair loss, fatigue, joint pain, petechiae) and I'm hoping someone can tell me if they are on the same dose. Obviously I'm quite anxious about all of this but have found it very reassuring every time I read about someone in the same boat.
And, two more questions:
Is anyone taking Pradaxa with Nexium? Any suggestions for timing the pills?
Any suggestions for treatment for endometriosis that doesn't raise the clotting risk? I've been told I can't take most birth control pills ever again but I'm not ready to have my ovaries cauterized...
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dero
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Posts : 904
Join date : 2007-12-09
Age : 57
Location : Near Ottawa, Ontario Canada.

PostSubject: Re: Pradaxa 110mg per day? Endometriosis?   Tue Apr 26, 2011 1:45 pm

Hi Rachel,
Welcome to LADVT, please check your PMs. (private messages)

dero
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theoriginalrachel



Posts : 3
Join date : 2011-04-20

PostSubject: Re: Pradaxa 110mg per day? Endometriosis?   Thu May 05, 2011 1:45 am

Pradaxa update:
If your doctor recommends this instead of warfarin, make sure he knows what he's talking about!! The minimum dose required for the equivalent effect of warfarin with INR between 2-3 is 220mg per day. 300mg per day is more effective than warfarin but has a higher bleeding risk.
My doctor gave me a dose that was apparently "lower than a pediatric dose" according to the ER dr I saw when my OTHER leg (the one the DVT was not diagnosed in) started clotting. The problem is NOT that Pradaxa isn't effective at the correct dose; rather, it's that Canadian hospitals and doctors are not prepared to deal with it. Until Health Canada approves it and hospitals are able to do the ecarin clotting time test in their labs, there is no accurate way for a doctor to know how thin your blood is.
In my case, the ER dr wouldn't even give me heparin/delta-parin as he was nervous about causing hemmoraging. A hematologist had to be consulted so that I could be switched back to the warfarin.
The aPTT is a rough estimate of Pradaxa activity but many doctors do not want to rely on it as it is unpredictable at best. If you've read other threads about Pradaxa, you'll know that one of the major concerns is that it is not reversible. It has a half life of 12-17 hours but can then stay in your bloodstream for 24-48 hours so if you get into an accident or require emergency surgery, NOTHING can be done to stop the excessive bleeding and hospitals have not yet come up with emergency protocols to deal with this situation. It appears right now the only options available are blood transfusions to replace lost blood or dialysis to remove Pradaxa from your system.
I don't want to be totally negative about Pradaxa; I had virtually no side-effects on it in comparison to warfarin and IF Health Canada approves it and comes up with educational material for doctors and hospitals, I would switch to it.
As for my doctor, I will never see him again. I discovered that in addition to his negligence in prescribing me such a low dose of Pradaxa and telling me he didn't need to see me or test my blood for 6 months, he was also trying to get my INR below 2 while I was on warfarin. Pretty scary stuff!
The one thing I have learned is that I need to take total control over my healthcare and I can't be afraid to question my doctor's advice. Doctors see thousands of patients and if you don't advocate for yourself, you might fall through the cracks. If something doesn't feel right or sound right, speak up! Your life could depend on it.
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