The experiment took thirty-three minutes and forty-one seconds.  That’s about the time it takes to see a new heart-rhythm patient or implant a defibrillator. I was just curious. I wanted to dip my toes into the icy waters which so many primary care doctors have already acclimated to. A denial? Are they kidding, that medicine […]
Category: Dabigatran/Rivaroxaban/Apixaban
Pradaxa Xarelto Eliquis
Yesterday marked the two-month anniversary of the availability of the novel blood-thinner dabigatran (Pradaxa). It was approved for the use of preventing stroke in patients with non-valvular AF, but it has quickly taken on the inaccurate moniker of “the warfarin-substitute.” Here’s the thinking: If stroke prevention in AF is accomplished by thinning the blood, and […]
The end of the year marks a time for list-intensive posts. Recently, Larry Husten, from Cardio-Exchange and Cardiobrief, asked for my opinion on the three most important cardiology-related news stories of 2010. Additionally, he also wanted three predictions for 2011. (I assume cardiology predictions.) Here goes… My top three cardiology stories of 2010: —By far, the […]
I loved my old status. Perhaps, reveled in it would be a better description. I was a crotchety generic-medicine only doctor.** Sadly, my status changed today. Dabigatran (Pradaxa) was the culprit. It was a little nerve-racking. I wrote the order, looked at it, thought it out again, talking to myself, “John, are you sure you […]
It will not last forever, nothing ever does. Some day I will have to find another big-pharma punching bag. It’s true; our pal dronedarone (Multaq) is back in the news again. This time the Multaq news (as reported on Cardiobrief and Pharmalot) is not about its inefficacy or Sanofi-sponsored professors, but rather concerns about it’s […]
I remember in high school, as an assignment, I wrote a letter to a prominent business person. I will try it again. In 2010, this would be an e-letter. To: J Martin CarrollCEO of Boehringer Ingelheim Corporation: The makers of the recently-released exciting new oral blood-thinner, dabigatran (Pradaxa). Dear Sir, To start off on a positive […]
There can only be one cardiology story to report today. Earlier today, the FDA approved Dabigatran (Pradaxa), an oral anticoagulant for the prevention of stroke in atrial fibrillation. Previously, the only drug approved to prevent stroke in patients’ with AF was warfarin. Despite the well known sound scientific data in support of warfarin for the […]
I have heard this for years, “Doc, that stuff is rat poison!” But only lately have I heard this, “Doctor M, that company who can’t talk about their drug brought lunch again today.” Well, it is finally here (well almost), the first warfarin substitute, dabigatran. Sine antiquity, or at least it seems that long, the blood […]
This morning I am told, “Dr Mandrola, there are two ladies from this company, Boehinger Ingelheim, who need to to give you a secret, sealed envelope.” I wonder whether the department of Health and Human Services knows about this exciting new potential warfarin substitute. Surely they do, as replacing the ubiquitous blood thinner warfarin with […]
Much energy in previous posts have centered on the ablation of heart rhythm disturbances. Navigating a GPS guided catheter through the beating heart, triangulating the source of the ectopic impulse, and then delivering a cautery-like RF lesion is fun to do, gratifying to all involved, and makes for decent writing topics. However cool ablation is […]