Anticoagulants: Blood-thinning drugs

Blood is essential to keep you alive as it feeds and oxygenates our organs. During an injury, blood coagulates in order to avoid hemorrhaging.

However, there are times when clots form when they should not. In these situations, anticoagulants may be prescribed to prevent the formation of new clots. This type of blood thinning drugs are unique and you should read up on them.

What types of medications thin the blood?

The best-known anticoagulant is warfarin, also known as Coumadin^TM. It is a very effective anticoagulant, but requires close monitoring with blood tests. This monitoring ensures that the medication is prescribed at the right dosage to be effective and safe. At the beginning of treatment, adjustments are common. Make sure you understand the dosage and follow it to a T.

There are also other anticoagulants that require less monitoring, such as:

• Apixaban (Eliquis^TM)
• Dabigatran (Pradaxa^TM)
• Edoxaban (Lixiana^TM)
• Rivaroxaban (Xarelto^TM)

Injection anticoagulants are also available, including:

• Heparin
• Dalteparin (Fragmin^TM)
• Enoxaparin (Lovenox^TM , Redesca^TM)
• Tinzaparin (Innohep^TM)
• Fondaparinux (Arixtra^TM)

Depending on your condition, your doctor will prescribe the most appropriate medication. In some cases, a combination may be necessary, especially at the beginning of treatment. The choice will depend on the diagnosis, your history and other medications you take. Other medications and natural products can also have an impact on blood clotting. Consult your healthcare professional to ensure compatibility with your medications. 

Under what circumstances are anticoagulants used?

Because they prevent clots from forming, anticoagulants will be used in conditions where it is critical to avoid clots. They are used in particular in the cases of:

• Atrial fibrillation
• Replacement valves
• Pulmonary embolism
• Thromboembolism
• Genetic condition related to certain coagulation factors 

They can also be used after surgery to prevent clots that may occur due to immobilization.

What are the side effects and risks associated with anticoagulants?

Because anticoagulants have been developed to interfere with blood clotting, the typical side effect is that they can increase the risk of bleeding.

In most cases, it will be benign, such as bleeding longer after a minor cut or having bleeding gums after brushing your teeth a little too hard. However, it is important to watch for the following and consult a healthcare professional if necessary:

• Presence of blood in the urine
• Black stools or blood in the stool
• Persistent nosebleeds
• Bloody sputum when coughing
• Following a severe fall, especially if there has been a blow to the head

It is important to inform all health professionals you meet, including dentists, that you are on anticoagulant medication. Wearing a bracelet indicating that you are taking this type of medication may be a good idea. It is also recommended that you carry a list of the medications you are taking, especially for medical and dental appointments. Your pharmacist can provide you with this list, so don't hesitate to ask them o during your next visit.

What are the precautions to take?

A few precautions are important when taking an anticoagulant medication:

• Respect the dosage to avoid any risks 
• Avoiding activities that can cause shocks or blows to the body 
• Opt for an electric razor rather than a blade razor
• Choose a toothbrush with soft bristles to minimize bleeding gums
• In case of a cut, apply pressure to stop the bleeding

Drug interactions are often problematic with anticoagulants. Warfarin is particularly sensitive to other drugs and foods. Because it blocks a vitamin K-dependent step in blood clotting, foods containing this vitamin can have a significant effect on coagulation. Alcohol can also have an effect on clotting, so caution is advised. If you have questions about interactions with your blood thinning medications, consult your healthcare professional.

Natural products, although seemingly harmless, can interact with anticoagulants. St. John's wort, glucosamine, garlic and chamomile should be avpoded. Before consuming a natural product, it is always preferable to validate its compatibility with your medication with a healthcare professional.

Learn more about how the blood system works in our free 100% blood guide.