'Therapeutic Range' Very Important for Patients on Blood Thinners Coumadin, Pradaxa
Patients with atrial fibrillation are at increased risk of stroke from blood clots. In order to manage that risk, doctors might use a blood thinner like Coumadin, which has been on the market for decades. Or they might use Pradaxa, which has just recently arrived on the market.
The problem with Pradaxa, however, is that it just doesn't work like Coumadin, according to Ned McWilliams on Ring of Fire Radio, although it's marketed as though it does.
Doctors typically try to get patients within the "therapeutic range" for any given drug, which generally means finding the right dose for any particular patient. The goal is to provide the intended medical benefit (thinning the blood and preventing strokes, for example) while minimizing toxicity and adverse side effects.
Not all patients can maintain a therapeutic range on Coumadin. In other words, these patients need to try something else to prevent blood clots. They're just not good candidates for managing atrial fibrillation with the use of Coumadin.
Pradaxa is supposed to help these types of patients.
The problem, however, is that Pradaxa has been promoted as though it's the "new-and-improved" drug, as though it should be used in place of Coumadin. The overall effect is that Pradaxa could be prescribed to patients who should probably be on Coumadin instead.
This is a problem - especially as blood thinning drugs are notoriously difficult to manage.
Source: FDA Continues to Get it Wrong with Pradaxa