Marcoumar vs. Coumadin or Generics

[PhilipZanon]

I had mitral valve (St. Jude) replacement in 2003 in Switzerland and used Marcoumar (Roche). In 2004 I moved to the USA and had to switch to Coumadin because Marcoumar is not available to my knowledge. I am 36 and I am taking a little under 9 mg per day (the generic version of Coumadin) for a target INR between 2.5 and 3.5.

I have experienced great difficulties to get adjusted when I switched over and had to use Lovenox for about two weeks and now after one year I can say that anticoagulation varies in a broader range that it had using Marcoumar. My question is if there is anybody having experience with both drugs and if there is a way to get Marcoumar in the USA. The other question is whether there's a significant difference between Coumadin and the Generics.

Philip, North Carolina

[Ross]

Hi Philip and welcome aboard.

I'll let Al Lodwick address most of this post. He is a certified professional anticoagulant expert and phamacist. He should be able to really address this.

As far as I know, in the U.S. our choices are Brand Name Coumadin, Janoven or Generic Barr or Taro Warfarin. That's only what I know, Al will pick it up and fix it. In the U.S. No, there is no difference except price between Brand and Generic. Now some people swear they are much more stable on brand name but there is no direct evidence to support that claim, just the experience off some here. ;)

[allodwick]

Marcoumar is fenprocoumon. It is similar to but not the same as warfarin. I think that two weeks of difficulty in adjusting doses is very reasonable. The only way that I know to get it in the US, is to have someone purchase it in Europe and send it to you. This is probably a violation of the import law so you would always run the risk of having it seized in customs.

I'm not sure why some European countries settled on these things similar to warfarin, but not as well tested. Perhaps there was some anti-American feeling.

[catwoman]

Al:

What are the differences between fenprocoumon and warfarin?

[allodwick]

I don't know.

Different countries prefer different things. It is like choosing a car.

In the US we think that chloroform is deadly. IN the UK it has been a preferred anesthetic. It doesn't explode like ether does. No that we use either any more.