Warfarin

[Carole]

Does anyone know if you can get Warfarin in France. My doctor said no and yet I have looked at articles which talk about the use of Warfarin.

They tend to use a drug starting with P (cant remember, I need a brain transplant) but it has not been used in the UK for many years. I am reluctant to have to change as I have everything sorted out with Warfarin.

Thanks

Carole

[Richard]

The drug that is used here is Previscan. I don't think there's any alternative.

[Clair]

This page gives COUMADINE as the brand name for warfarin.

http://www.doctissimo.fr/medicament-COUMADINE.htm

Generally speaking, if you are using a specific medication, bring its notice with you and your GP can look for the active agent, whatever the brand name is.

The acive agent in Previscan is not warfarin but Fluindione.

[Carole]

Has anyone made the change from Warfarin to Previscan and if so were there any problems.

Am grateful for any information as this subject concerns me a bit as I had a DVT when I was taken off Warfarin last time just before an operation.

Thanks

[Patf]

There is also Plavix which is a blood-thinning medication, aimed at preventing blood clots. Prescribed very frequently here.

[Nickel]

Plavix, Warfarin and Fluidione are all antithrombotics but Plavix is very different in that it acts on the platelets (antiplatelet agent) in the blood stopping them clump together - just like aspirin does, the idea being that if the platelets dont clump together then a blood clot cannot be formed in the clump. 

Warfarin and Fluindione are anticoagulants and are similar to each other,  they act on the actual clotting mechanism of the blood -  against Vitamin K which is necessary for "clots" to form.

In France the anticoagulant of choice is Fluidione or Previscan whereas in England it is Warfarin.

They each ( anticoagulants and antiplatelet agents - plus others oh dear!!) play their roles in different conditions

I cannot see that there would be a problem in changing from one anticoagulant to the other as they act over a short period of time hence the need for frequent INRs

I hope that hasn't confused you even more! maybe I'll try and re write it.

 

 

 

[Chris]

My 90 year old mother changed from Warfarin to Previscan with no problems, but of course there was a monitoring period to ensure correct dosage.

["MIKE"]

Hi Nickel

You seem to know what you are talking about.

I have been on Previscan since undergoing a heart valve operation here in 2002. I had 2 metal valves inserted.

Everything has turned out fine, The only problem is trying to keep the INR at a steady level, mine should be between 3 - 4.5. INR.

Over the last year it has been all over the place, (for really no apparent reason), I am aware of the effects of eating food containing vitimin K, and this is not a factor. I normally take a 20m tablet once a day, and twice a week augment that with an extra 1/4. But this changes from month to month. Last month I decided to stay with one 20m per day for the month, because the previous months my INR had been getting too high (consistantly above 5). Last week I had a blood test and the result came back as 2.29 INR- (dangerously  low!).

I therefore increased the dose by an extra 1/2 over 2 days, ie: plus 20m, and then continued with 1 per day as normal. A week later (yesterday) I had another blood test and the result came back as an alarming 7+. this is crazy- a rise of 5+. It does not make any sense!

Today I have had yet another blood test and am awaiting the result.

Meanwhile my arms look like those of a lifetime junkie!!

Mike

[NormanH]

Préviscan is certainly the usual one in France, and yes it is very difficult to keep the INR stable.

I think it is  a question of keeping a regular diet, as much as avoiding certain foods.

I like brassicas and have always eaten them, so instead of cutting them out I started from the point of view that I would adapt the dose of Préviscan to what I wanted to  eat, not what I eat to the dose of a drug.

I was on it for 5 years and managed to keep within a range of + - 2 on the desired INR.

At the same time I am glad that my Cardiologist has now recommended a change to Plavix, and I have been taking it for 6 months.

Previously I had another milder version Asasantine, which works like Plavix as opposed to Préviscan, and I am convinced that it saved my life in that although I had a Phlebitis and 2 pulmonary embolisms while taking it they were not serious enough to kill me, largely I believe because it prevented the clotting from being even worse.

Thank you Nickel for your clear and informative post .

I sort of knew that but could never have explained it so well.

[Junlesley]

Hi Carole,

I take Coumadine which is Warfarine, it says so on the packet! the only difference is that its only available in 5mg and 2mg tablets, I have had no problem obtaining it at any chemist in Northern France.

[Scooby]

[quote user="NormanH"]

I think it is  a question of keeping a regular diet, as much as avoiding certain foods.

[/quote]

That's what I was told - I asked if I could still drink alcohol and was told that it was ok as long as I did it consistently...which was not a problem [;-)]

[frudi]

My husband takes Coumadin (Warfarin). We will be in Provence for 5 weeks and he needs to have his INR tested every three weeks. Where can we go for this?

[Gardian]

Drop by any laboratoire (always several in any decent-sized town) and they'll probably do it there and then without prior appointment. Take your UK GP's blood test prescription + the medication pack, which should suffice - after all, it's not exactly a contentious request. Result later that day-ish. 'INR' is an internationally recognised measurement (apologies if you were already well aware of that).

You'll have to pay (not sure, but €30 or so), but get a feuille de soins (invoice) and you'll get some of it reimbursed on submission back in the UK. 

[NormanH]

It's very quick too.

Mine was tested by the visiting nurse at 10 this morning, and by 4 pm I was able to phone the lab for the result.

A small point: in French 'results'  are  plural; ask for les resultats ( but you don't pronounce the s ) 

The usual name in France is 'Préviscan' ..I've been on it for 6 years.

[Suninfrance]

My husband has been taking Previscan for the last few months and during the initial period of getting his INR to the right level, he was having weekly blood tests and speaking to his doctor about the results.   He is also taking tablets for blood pressure.

He has been fine on the tablets and his heart flutters have gone, but last night they were all over the place and his last blood results were 3.9 which is too high.

He is off to the docs this morning and hopefully will get another blood sorted out.

I just struck me that I know people who take Warfarin are supposed to steer clear of certain foods and wondered if this applied to Previscan too, as he was not told to avoid certain foods when he was given the Previscan.  I've just been reading this forum thread and it seems foods high in vitamin K could counteract the effects of the Previscan. 

Any advice on this subject gratefully received.

Jan

[Chancer]

[quote user="NormanH"]

A small point: in French 'results'  are  plural; ask for les resultats ( but you don't pronounce the s ) 

[/quote]

Hey Norman, Results are plural in English as well [:P]

But I do know where you are coming from though, as you say the "S" is not pronounced but just mispronouncing the "E" in "les" can make the following word incomprehensible to people around here. 

[NormanH]

[quote user="Suninfrance"]My husband has been taking Previscan for the last few months and during the initial period of getting his INR to the right level, he was having weekly blood tests and speaking to his doctor about the results.   He is also taking tablets for blood pressure.

He has been fine on the tablets and his heart flutters have gone, but last night they were all over the place and his last blood results were 3.9 which is too high.

He is off to the docs this morning and hopefully will get another blood sorted out.

I just struck me that I know people who take Warfarin are supposed to steer clear of certain foods and wondered if this applied to Previscan too, as he was not told to avoid certain foods when he was given the Previscan.  I've just been reading this forum thread and it seems foods high in vitamin K could counteract the effects of the Previscan. 

Any advice on this subject gratefully received.

Jan

[/quote]

Préviscan is an  'anti-vitamin K treatment' known here as AVK. Vitamin K is responsible for blood clotting.

Some healthy foods such as broccoli or tomatoes contain high does of Vitamin K.

If you look back up the tread you will see my strategy for coping with the conflict between foods rich in Vitamin K, but good for you, and the Warfarin treatment

[Gardian]

Just a question that hopefully someone can help with.

OH is on Previscan and her INR is usually pretty stable - in the 3's.  Saturday morning's routine test prompted a call from the lab early afternoon to say that it was up to 5.2 and 20% Taux de Prothrombine. No big problem: the lab had also contacted our GP and she hasn't followed it up. OH will simply reduce her dosage ever so slightly and have another test in 2 rather than 4 weeks.

My question though is over the meaning of Temps de Temoin (expressed in seconds) vs her own Temps de Patient & how does that convert to the Taux de Prothrombine? I appreciate that it's all to do with coagulation rates, but can't see a correlation between the figures.  The figures the time before were 12.6 secs / 22.7 secs / 31%.

 

[Dordogne Landlady]

Hi Carole, we have been in France since 2002 and my husband was taking Warfarin when we arrived. He had to switch to Previscan and has had no problems at all. Had to go for weekly blood tests to start with so the doctor could adjust the dose required. Now he has his monthly tests and controls the dose pretty much himself as he knows by now what is a high reading for him. Still drinks and eats everything, not always in moderation either!!

[Gardian]

I've just cut & pasted this because I think that my question may have got lost behind the subsequent post.

[quote user="Gardian"]

Just a question that hopefully someone can help with.

OH is on Previscan and her INR is usually pretty stable - in the 3's.  Saturday morning's routine test prompted a call from the lab early afternoon to say that it was up to 5.2 and 20% Taux de Prothrombine. No big problem: the lab had also contacted our GP and she hasn't followed it up. OH will simply reduce her dosage ever so slightly and have another test in 2 rather than 4 weeks.

My question though is over the meaning of Temps de Temoin (expressed in seconds) vs her own Temps de Patient & how does that convert to the Taux de Prothrombine? I appreciate that it's all to do with coagulation rates, but can't see a correlation between the figures.  The figures the time before were 12.6 secs / 22.7 secs / 31%.

 

[/quote]

[NormanH]

That's a weird one.

I have my own last results in front of me and they say nothing about any of that and never have.

I just have a level of TP and a level of INR.

There is a Wiki article here in English

and here in French

[Gardian]

Norman .............

I was hoping that you'd come back on this and was confident that you'd know. [:)]  Really, but thanks anyway.

Never mind, we'll ask the doc when we can finally get in to see her - standing room only in the waiting room this morning, I think all the locals got the gist of my instinctive "Bloody hell". Leave it a few days.  

[NormanH]

Apperently :

un plasma témoin (moyenne d'une cinquantaine de patients normaux).

So it's a ration between the clotting time of the patient, and that of the average of 50 'normal'  people.

How that could translate in to TP or INR I don't know without knowing the average TP for 50 normal'  people.....

[Gardian]

Well, that makes sense.  Have checked back over the last half a dozen checks & the TP was 12.6 or 12.8.

It's the % figure that I don't get, but clearly the lower it is, the worse.

Will post back when we see our doc.