Anticoagulants (blood thinners) are medicines used to prevent formation of blood clots or worsening of existing clots.
Blood thinners can be useful in many medical conditions which cause blood clots to form more easily.
These common medical conditions include but are not limited to treatment or protection against deep vein thrombosis, a blood clot in the leg, or pulmonary embolism, a blood clot in the lung; stroke caused by atrial fibrillation (an irregular heartbeat which increases risk of stroke due to a blood clot), and blood clots caused by artificial heart valves.
Blood thinning medicines have an increased risk of harm compared to most other medicines, and require close monitoring to ensure safe use. The main risk associated with blood thinners is an increased risk of bruising or bleeding. Bruising or bleeding can be different for each patient depending on his or her age, diet, other medicines they are taking, how well their kidneys work, and other factors. Because of those potential safety risks, it is important for patients to understand how the medications work, how to take them appropriately, and when they need to seek medical help due to a side effect or adverse event. All patients who take blood thinners must be monitored for bruising and bleeding on a regular basis.
There are several blood thinners available which can be taken by mouth at home, including warfarin (Coumadin or Jantoven) and newer agents such as apixaban (Eliquis), betrixaban (Bevyxxa), dabigatran (Pradaxa), edoxaban (Savaysa), and rivaroxaban (Xarelto). Each of these medications works differently in the body to slow the clotting process. They also differ in how they are taken, monitored, reversed in case of a bleeding issue, how much they cost, and whether or not they are covered by insurance.
If you are started on a blood thinner, you can expect that your health care provider to discuss the above information with you and consider your personal preferences when deciding which medication may be best for you.
Important safety points to keep in mind regarding blood thinners:
• Contact your provider if you notice unusual or easy bruising, or minor (limited) bleeding. You should seek emergency care at the nearest emergency room for prolonged or significant bleeding issues;
• If you fall while on an anticoagulant, you should be taken to the emergency room to be assessed for potential bleeding that may not be visible (internal bleeding);
• Let your provider know if anything with your health changes, including illness, medication changes, or diet changes. Also, be sure to let your anticoagulation provider know if you have an upcoming surgery or other procedure so that your medication may be managed appropriately at that time;
• Take your medicine at the same time every day;
• Make sure you always have enough medicine on hand so that you don’t run out;
• Take your medication only as prescribed. Do not share your medicine with others, as they affect everybody differently;
• Dispose of your unused medications safely to prevent them from getting into the hands of others (including children and pets). Many local pharmacies, such as the Bassett, FoxCare and O’Connor outpatient pharmacies, as well as local police offices, provide safe disposal sites for dropping off your medicines; call or inquire within.
Blood thinners are very effective when used for specific medical conditions, but careful attention is needed to ensure safety. It is important to work closely with your health care team to get the safest and most effective use out of your blood thinner. Do not hesitate to contact your provider or pharmacist if you have any questions or concerns about your blood thinning therapy.
Youssef Bessada is a pharmacy intern at the Bassett Healthcare Network.