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.
Dabigatran is a newer anticoagulant. Its long-term effects aren't known. It works slightly better than warfarin at preventing stroke.2 But like warfarin, how much your risk will be reduced depends on how high your risk was to start with. You don't need to have regular blood tests or watch your vitamin K intake with dabigatran.
You can't take dabigatran if you have heart valve disease, an artificial heart valve, or severe kidney or liver disease.4 Doctors don't know how dabigatran will affect you if you take it while you are pregnant.
Dabigatran costs about $3000 for a 1-year supply. Warfarin costs about $48 for a 1-year supply. If you have health insurance, some or all of this cost may be covered.5
Doctors know how to monitor warfarin and how to reverse its effects if you need surgery. Since dabigatran is newer, doctors still don't know about long-term side effects. If you are taking dabigatran and need surgery, it may take longer to reverse the blood-thinning effects.