March 21, 2018
Warfarin is the most commonly prescribed anticoagulant (blood thinner) in the UK.
Although common and frequently used, it’s naturally essential that anyone who is prescribed Warfarin is aware of possible side effects and is able to make an informed decision as to whether it is a suitable form of medication to take in a specific situation.
Essentially, Warfarin and other types of anti-coagulant are taken in order to increase the time it takes for blood to clot; disrupting the clotting process and reducing risks of a potentially fatal blood clot forming. Warfarin blocks one of the enzymes which uses vitamin K to produce blood clotting factors. It is commonly prescribed when people have medical problems caused by an initial clot, such as:-
- Heart attack
- Atrial fibrillation (an irregular heart rhythm)
- Pulmonary embolism (a blood clot in the lung); or
- Deep vein thrombosis (a blood clot within a deep vein – usually in the leg)
It is also prescribed when people are at an increased risk of developing harmful blood clots, such as:
- Following surgery to insert prosthetic heart valves
- When someone has a blood clotting disorder (e.g. thrombophilia); or
- To reduce the risk of blood clots following surgery
Warfarin has been prescribed for more than 60 years which means that there is a wealth of clinical information available to doctors about how the drug works and what the side effects are. The main benefit of the use of warfarin is how it prevents harmful blood clots with the consequent reduction in the risk of having a stroke or a heart attack. For instance, someone suffering from atrial fibrillation could reduce the risk of suffering a stroke by some 60-70% by taking Warfarin.
Warfarin levels in the blood vary with time and with certain changes. For example, levels can change if a patient is suffering from an unrelated illness or infections, with alcohol intake, when taken at the same time as other prescribed medication and even with changes in diet.
Such variations mean that levels must be regularly monitored to enable necessary adjustment. Indeed, regular necessary blood tests are often considered to be one of the “downsides” to taking the medication. That said, it naturally goes without saying that this is a minor consideration in the context of the benefits of taking the medication and its ability to significantly reduce the risk of blood clots.
Warfarin, like any drug, has side effects and isn’t suitable for everyone. For example, if individuals are prone to bleeding because of a medical condition i.e. if he/she has a blood cell disorder, an aneurysm, any previous history of gastrointestinal bleeding or uncontrolled high blood pressure then Warfarin will not be suitable.
The main side effect associated with Warfarin is excessive bleeding. However, other side effects also include bleeding gums, nosebleeds, skin rashes, hair loss and unusual headaches.
Risk of early discontinuation
An early discontinuation of Warfarin increases the risk of not only potential future blood clotting, but also the risk of stroke; which is more than double in comparison to someone who remains on the treatment.
This is especially relevant to people who have atrial fibrillation or hold several stroke risk factors. The more risk factors an individual has, the higher the risk of stroke, therefore the greater the need for Warfarin.
As such, any decision to discontinue the medication must be carefully risk assessed including determining if the risk of bleeding outweighs the potential benefit to the individual concerned.
Spencers Solicitors – cases involving Warfarin
Recently, one of the Clinical Negligence Solicitors, here at Spencers; Andrea Ribchester-Hodgson, settled a claim for damages in the sum of £250,000 in a case where Warfarin was incorrectly discontinued.
The client in question was diagnosed with congestive cardiac failure and atrial fibrillation resulting in the Defendant, his private Consultant Cardiologist, initially prescribing Warfarin. However, following his final surgery, the Defendant Cardiologist did not correctly assess the risks of stopping our client’s medication and discontinued his Warfarin when it was not suitable to do so.
As a consequence, within a very short period of time, our client suffered a stroke in the left side of his brain. The stroke affected the whole of the right side of his face and body, in addition to causing dysphasia. Our client had several stroke risk factors which effectively more than doubled the risk of a stroke when Warfarin was discontinued and is a stark example of clinical negligence.
About the Authors
Andrea Ribchester-Hodgson is a Solicitors within our Serious Injury Team.
Andrea, who joined the team in 2015, qualified as a Solicitor in 2001. With over 15 years of experience, Andrea specialises in helping people with Personal Injury and Clinical Negligence cases. Andrea deals with claims involving adults and children who have suffered serious and catastrophic injury including fatal injuries. Andrea’s clients also include individuals living with spinal injuries, traumatic brain injuries, complex pain and multiple orthopaedic injuries.
Kathleen Kilgarriff is a Paralegal within our Serious Injury Team.
Kathleen is an undergraduate Law student from Nottingham Trent University who joined the business in June 2017 for her placement year. With her career aspiration to become a Serious Injury Solicitor, Kathleen has joined the team to gain first-hand experience to enhance her knowledge and career prospects by providing support and assistance with the Serious Injury Team. Kathleen also assists in producing instructive blogs for the website about important events , in addition to providing support in the Employment Law Team.