Anticoagulants, or blood thinners, are a type of prescription medication used to decrease the blood’s ability and tendency to clot. Blood thinners don’t actually make the blood thinner, they simply make it so that it takes longer for the blood to form a thrombus (blood clot). While this can be dangerous for serious cuts or internal injuries, for many people, anticoagulants are a lifesaver. For some people facing the dangers of clotting blood, simply taking a low dose of Aspirin may be sufficient, although even that comes with complications like stomach ulcers. For other people, aspirin isn’t enough, and stronger prescription anticoagulants may be needed for the prevention of blood clots, heart attacks, and strokes.
More commonly known by its brand name, Coumadin, warfarin is considered the most effective blood thinner. It works by preventing the liver from producing as much vitamin K, the key ingredient for the clotting procedure. During warfarin use, it’s important to receive periodic prothrombin time tests (INR), which checks clotting time. It’s also important to eat foods with a high vitamin K content sparingly, as too much can make warfarin less effective.
Patients on warfarin may bruise more easily, and other common side effects include upset stomach, bloating or gas, and a change in the way you taste things. Menstrual bleeding may be heavier, and the gums may bleed more easily when brushing your teeth. Some people have also experienced allergic reactions to warfarin.
Be sure to inform your doctor of any prescription medications or medical conditions present, as this drug can interact badly with some medications, as well as making certain conditions worse. Less common but serious side effects that merit immediate medical attention include skin necrosis (gangrene) or toes developing pain or turning dark or purple in color. Discuss all possible side effects and what to do if they occur with your doctor before starting warfarin.
Xarelto, Eliquis, and Pradaxa arrived to the anticoagulant market in the last five years as alternatives to warfarin. Experts say that patients who find warfarin effective need not switch, but if it isn’t working, these three are a breakthrough. They work differently from warfarin: Xarelto and Eliquis inhibit the production of the Factor Xa protein, thus preventing thrombin (another clotting protein) from forming. Pradaxa, on the other hand, goes straight to the thrombin, directly preventing it. So far, studies have found them to be equally effective amongst themselves.
One of the biggest perks of these new alternatives is dosing. Finding the correct dose of warfarin is a delicate dance. Too much can cause extremely excessive bleeding, while too little does nothing for the dangers of clotting. The new triad, however, each come in a standard dose, making finding the right amount much easier. Because they have no effect on the amount of vitamin K being produced, the need to worry about diet and vitamin K intake is negated. On the other hand, these medications tend to be more expensive. Additionally, they too can cause serious side effects, like internal bleeding. Ultimately, it’s important to discuss all the alternatives with your doctor to figure out the best option for you and your circumstances.