Millions of Americans are prescribed blood thinners each year. These life-saving medications have proven to be successful, saving countless lives, but they come with some serious side effects as well.
If you’ve been recently prescribed blood thinners, you are sure to have some questions.
Brian Henry, MD, PhD, a cardiologist with Banner Health in Colorado, answered five frequently asked questions, explaining the medication, possible side effects and what you can do to keep safe.
What are blood thinners?
Blood thinners can prevent blood cells from getting too thick (clumping together). They can prevent dangerous blood clots from forming, and they can slow the growth of any existing clots.
The name “blood thinners” is a bit deceiving, because these medications don’t actually “thin” your blood. However, they do change how clots form.
“Blood clotting is a natural process that helps stop bleeding when you cut yourself, but for those with certain health conditions clotting can lead to serious health issues,” Dr. Henry said.
On average, the Centers for Disease Control and Prevention (CDC) reported that one American dies from a clot every six minutes. And, after you’ve had one clot, you’re more likely to have a second one.
What do blood thinners treat?
“Most often blood thinners are prescribed to treat any condition that is the result of abnormal blood clotting or condition that increases your risk of forming an inappropriate blood clot,” Dr. Henry said.
Your health care provider may prescribe a blood thinner if you have any of the following conditions:
- a history of pulmonary embolism, deep vein thrombosis (DVT), heart attack, stroke or atrial fibrillation (AFib)
- certain devices, such as metal heart valves or stents
- a genetic condition that increases your risk of blood clots, like a mutation or predisposition
- post-surgery when you have a risk of blood clotting
Other things that may put you at greater risk for a blood clot include cancer, taking birth control or hormone replacement therapy that contains estrogen, being overweight and smoking.
How do blood thinners work?
“Blood thinners work in different ways,” Dr. Henry said. “Some medications, known as antiplatelet agents, work by blocking platelets from sticking together to form a clot. While anticoagulants prevent clotting factors (proteins like thrombin or fibrin) from forming a clot.”
Anticoagulant blood thinners: “Anti” means against and “coagulant” means to thicken into a gel or solid. Coagulation is the process of blood clotting, so anticoagulants work to prevent this process from occurring.
The most prescribed blood thinner is warfarin (Coumadin). It’s been on the market for several decades and is typically the most affordable option. Some other prescribed drugs include heparin, dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixaban (Eliquis).
Antiplatelet blood thinners: Platelets – also known as thrombocytes – are a component of the blood that stops bleeding by clumping together at the site of blood vessel injuries. Antiplatelet medications prevent blood clots by inhibiting platelets from clumping together to form a clot.
Antiplatelet medications are often prescribed for those who are at risk of blood clots. These medications include aspirin, clopidogrel (Plavix), prasugrel (Effient) and ticagrelor (Brilinta).
What are the risks of blood thinners?
While taking these medications, there is always some risk of serious bleeding, especially if you’re injured or need surgery.
Other common side effects of the medications may include:
- Bruising
- Bleeding more or longer when you cut yourself
- Bleeding gums or gum sensitivity
- Rashes
Get help immediately, however, if you experience any of the following:
- You notice blood in your urine or stools
- You cough up blood
- You have a cut that won’t stop bleeding
- You feel sick, weak, dizzy or faint
How will blood thinners impact my lifestyle?
While there are some risks with taking certain blood thinning medications, it’s possible to live a healthy and active life. You can reduce the risks of both bleeding and clotting by doing the following:
Follow your treatment plan. Take your medication as prescribed—no skipping or taking more. Your health care provider will regularly monitor your dosage and adjust as needed.
Watch your diet. A diet centered around fruits, vegetables, whole grains and healthy proteins and fats are simple changes you can make to protect your heart. Limiting sodium and replacing saturated fats and processed foods with unsaturated fats are better for you too.
“Dietary restrictions are most important if you take warfarin, but otherwise there are no dietary restrictions,” Dr. Henry said. “Newer blood thinners don’t require you to watch your diet the way you have to with warfarin.” However, talk to your health care provider about any foods you should avoid or limit.
Avoid alcohol. Alcohol may either decrease or increase the effects of your medication—increasing the risk of excessive bleeding or clotting.
Be careful mixing medications and vitamins. Some medications, vitamins and supplements can increase your risk of bleeding, while others may lower the effectiveness of your blood thinner. Even products like Pepto-Bismol may cause problems.
Talk to your doctor and pharmacist before taking any new medications, vitamins or supplements.
Avoid contact sports or high-risk activities. It’s important to be safe while taking blood thinners. You don’t want to engage in activities that put you at high risk for a traumatic injury where you could have dangerous bleeding.
If you’re participating in low-risk activities, make sure you always wear proper safety gear, such as a helmet and gloves.
Takeaway
“Blood thinners are the most dangerous medications we have, but they also save countless lives,” Dr. Henry said. “If your doctor wants to start you on blood thinners it means they feel the benefits to your overall health outweigh the risks.”
The bottom line is that blood thinners save lives. If you’re at risk for a heart attack, stroke or DVT, blood thinners can save your life. You may just have to make slight adjustments to your current lifestyle to ensure your treatment is successful.
If you have questions about blood thinners and potential risks, talk to your health care provider. You can also visit the National Blood Clot Alliance for more information regarding treatment and medications.
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