...the risk of under or over medication is far more likely than long term side effects.
I can only speak from my own experience which is that the risk has been minimal because of the constant testing that's carried out and I have found it very easy to adjust the diet and dosage by small amounts in order to ensure that the INR remains within the required range. If the suggestion that the risk of side effects are even less, then that will do me; having said that, I am considering a move to one of the other options.
With regard to the potential damage to liver, etc., I have annual tests which have always been normal to date, although I admit that I don't know if that will still be the case in another 5 years or whatever. So far, so good!
One of the, dare I say, advantages of warfarin over the other anticoagulant drugs is that it is possible to reverse the affects of warfarin should I require emergency treatment, although I am led to believe that this reversal isn't necessarily immediate. Because I always 'know where I am' with regard to the INR levels I have also been able to undergo a couple of minor operations without coming off warfarin - it's possible to 'manage' the INR at the bottom of the range.
I understand that with the other DOACs I would most likely have to stop taking them a couple of days before any op? I would be interested to hear if there has been any success with reversal agents for these newer drugs. I know that there has been some research with Andexanet Alfa, in 2015, but I'm not aware how that research (or any other) has progressed. I would be interested to find out if there has been any success and, if there has been, how long it might take before it becomes available to the medical profession (if it isn't already)?
I suppose there are pros and cons for everything.