This post was written by Katherine Blystone, PharmD candidate, Parkview Health.
Blood thinners are often prescribed to prevent blood clots, which can lead to life-threatening complications, such as a heart attack or stroke. We’ll explore some of the most common questions patients have about these prescriptions below.
What types of blood thinners are available?
There are two types of blood thinning medications: antiplatelets and anticoagulants. Antiplatelet medications include aspirin, Plavix (clopidogrel), Effient (prasugrel) and Brilinta (ticagrelor). Anticoagulant medications include Coumadin (warfarin), Eliquis (apixaban), Xarelto (rivaroxaban), Pradaxa (dabigatran) and Lovenox (enoxaparin).
Are there herbal or natural blood thinners?
Ginger, turmeric, cinnamon, vitamin E and cayenne are popular herbal supplements that are thought to have some anticoagulation effects. Always consult your doctor or pharmacist before starting an herbal product for the purpose of anticoagulation.
How do blood thinners work?
They help prevent clots from forming in your blood. Antiplatelet medications work by preventing platelets from sticking together and forming a clot in your blood vessels. Anticoagulants work by slowing down your body’s process of forming a clot.
Why are blood thinners prescribed?
Anticoagulants and antiplatelets are prescribed to reduce your risk of a stroke or heart attack if you have risk factors that increase your risk of forming a clot. They also can keep existing clots from growing larger.
What are some common side effects?
Some common side effects that you could experience are bleeding and bruising. Blood thinners may cause bruising or bleeding without an injury or trauma.
Should I avoid anything while taking a blood thinner?
The following may cause severe bleeding or prevent anticoagulants from working properly:
• Medications you get over the counter may interact with your blood thinner. Talk to your doctor before taking NSAIDs like Motrin®, Aleve® or aspirin for pain. NSAIDs can increase your risk of bleeding.
• Alcohol may increase your risk for bleeding when taking anticoagulants. Consult your healthcare provider before taking blood thinners with alcohol.
• To prevent injury, avoid contact sports. Acceptable alternative modes of exercise include walking and swimming.
• Remember to be cautious while using a knife, scissors or shaving as these could lead to injury or bleeding.
• Anticoagulants like warfarin work best if you eat the same amount of Vitamin K foods every day. Foods that contain vitamin K include broccoli, kale and spinach. If you are taking warfarin, ask your doctor or pharmacist for a list of vitamin K foods that can interact with your anticoagulant.
Will my anticoagulant need monitoring?
Warfarin is a medication that has to be regularly monitored to make sure it is thinning your blood the right amount. The test used to verify this is called the International Normalized Ratio (INR). An INR measures how long it takes for your blood to clot. You will have an INR goal range that is specific to your disease state. Some of the newer blood thinners do not need regular blood tests.
Should all of my medical providers be aware that I was prescribed a blood thinner?
Yes! All of your doctors should be informed that you are taking a blood thinner. As mentioned above, Coumadin has many drug interactions, so make sure your doctors and pharmacists are aware that you are taking this drug. Make sure to inform your dentist if you are on a blood thinner because your gums may bleed more easily while on a blood thinner.
When should I seek medical treatment?
Patients should seek medical treatment:
• If you are experiencing a cut or a nosebleed that will not stop bleeding.
• If you fall or hit your head, you should seek medical treatment in case you have a bleed in your brain.
• If you experience blood in your urine, stool or vomit up blood or if your stool is dark red or black colored, as this may be a sign of bleeding in your intestinal or urinary tract.
• Let’s Talk About Anticoagulants and Antiplatelet Agents. American Stroke Association and American Heart Association 2020. Available at: www.stroke.org.
• Blood Thinner Pills: Your Guide to Using Them Safely. Agency for Healthcare Research and Quality (AHRQ). Published: September 2012, Updated: November 2018. Available at: www.ahrq.gov.
• Blood Thinners: Also called Anti-platelet drugs, Anticoagulants. National Institutes of Health. Updated: January 31, 2022. Available at: www.medlineplus.gov.
• The Healthline editorial team. 5 Natural Blood Thinners. Healthline. Updated April 20, 2020. Available at: www.healthline.com.
• Multiple entries. Lexi-Drugs. Lexi-Comp Online. Lexi-Comp, Inc. Hudson, OH. Available at: http://online.lexi.com/crlonline. Accessed July 20th, 2022.