Warfarin has been used for many years to reduce the risk of stroke in people who have atrial fibrillation. The medicine is low-cost, and doctors understand its long-term effects. How much your risk will be reduced when you take warfarin depends on how high your risk was to start with.
When you take warfarin, you'll need to get regular blood tests to make sure you are taking the right dose. And you will need to watch how much vitamin K you eat and drink.
Warfarin may cause birth defects and problems if you take it while you are pregnant.
Taking dabigatran or rivaroxaban
Dabigatran and rivaroxaban are newer anticoagulants. Their long-term effects aren't known.
Dabigatran works slightly better than warfarin at preventing stroke.2 Rivaroxaban and warfarin work about the same to lower the risk of stroke.3 But with any anticoagulant, how much your risk will be reduced depends on how high your risk was to start with.
When you take dabigatran or rivaroxaban, you don't need to have regular blood tests or watch your vitamin K intake.
You can't take dabigatran or rivaroxaban if you have heart valve disease, an artificial heart valve, or severe kidney or liver disease.5 Doctors don't know how either of these anticoagulants will affect you if you take one while you are pregnant.
Dabigatran and rivaroxaban can cost about $3,000 for a 1-year supply. Warfarin costs about $48 for a 1-year supply.6 If you have health insurance, some or all of this cost may be covered.
If you have a bleeding problem or need surgery, your doctor may need to quickly reverse the effects of an anticoagulant.
Warfarin. Doctors know how to reverse the effects of warfarin to stop or prevent bleeding.
Dabigatran. Doctors do not have a way to reverse the effects of dabigatran. So if you have a bleeding problem or need surgery, it can take longer to reverse the blood-thinning effects.
Rivaroxaban. Doctors have a new medicine that can reverse the effects of rivaroxaban. But the medicine is new, and doctors do not have much experience with it yet.