Anticoagulant

Recently Answered

• QHow are anticoagulants used?

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  A RealAge answered

  Anticoagulants are medications that inhibit blood clotting. While they cannot dissolve an existing clot, they help prevent the formation of new clots and can keep existing clots from getting larger while the body dissolves the blood clot. Heparin is a fast-acting anticoagulant given either intravenously (IV) or via injection. Warfarin (coumadin) is a slow-acting anticoagulant taken by mouth.

  If your doctor prescribes anticoagulant therapy to treat or prevent blood clots, you'll receive heparin (fast-acting) and warfarin (slow-acting) simultaneously. Once warfarin levels build up sufficiently in the blood, heparin can be stopped while warfarin treatment continues for the remainder of the anticoagulant therapy. Newer agents like enoxaprin are also now being used. Others include rivaroxaban, fondaparinux and apixaban. Consult your doctor to see which medication may be best suited for you.

  The length of anticoagulant therapy depends on a person's risk factors and whether they are temporary. Some people receive anticoagulant therapy for a few months while others require life-long anticoagulant therapy.

• QAre there some tips on taking warfarin for atrial fibrillation?

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  A Dr. Douglas E. Severance, MD , Family Medicine, answered

  Warfarin (Coumadin) is a common blood thinner that's prescribed for people with atrial fibrillation. Because of the increased chance of blood clots and stroke with atrial fibrillation, keeping your blood thin is an important preventive measure. If you take warfarin or another anti-coagulant, be aware of activities and situations to avoid that can cause bleeding, including:
  
  -Avoid recreational activities such as football, soccer, or other sports that may result in a cut, injury, or open wound.
  -Use a soft toothbrush to brush your teeth to avoid cutting or injuring your gums.
  -Use an electric razor to avoid cutting your skin when shaving.
  -Prevent falling at home by removing objects out of the halls and pathways and having good lighting.
  -Don't climb on stools or ladders.
  -Don't walk on wet surfaces or icy ground.
  
  Also, check for signs of bleeding, including your gums bleeding, blood in the urine, bloody or black stools, vomiting blood, or heavy bleeding during a woman's period or between periods.

• QWhat should I tell my doctor before getting anticoagulant injections?

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  A Intermountain Healthcare answered

  Before you begin anticoagulant injections, tell your doctor if you:
  
        • have bleeding problems, kidney disease, liver disease, ulcers,
          stomach problems, or intestine problems
        • are currently pregnant or breastfeeding, or are trying to become
          pregnant
        • have had a recent surgery
        • have had a stroke
        • have ever had heart valve problems or heart valve surgery
        • are allergic to any medications
        • are allergic to pork products, since some anticoagulant
          medications are made from pigs. (Note: If you have dietary laws
          against pork, talk to your religious leader. In Judaism, dietary laws
          against pork-based products do not apply to injected
          medications.)
  
  You should also tell your doctor about any other medication you take, including over-the-counter remedies, herbs, and supplements.
• QWho should take an anticoagulant?

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  A Dr. Darria Gillespie, MD , Emergency Medicine, answered

  Warfarin, an anticoagulant, is recommended for people with heart failure, history of a stroke or a TIA (transient ischemic attack), and a history of a pulmonary embolism (blood clot in the lung). The target INR is 2 to 3. (INR is a measure of the blood's tendency to clot. Dabigatran, rivaroxaban, and apixaban are newer oral anticoagulants that do not require monitoring of INR. They are as effective as warfarin and have fewer drug and food interactions. However, they have adverse effects that may limit compliance and are more expensive, and there are no drugs that can reverse their effects.)
  
  Warfarin is also recommended after a heart attack that has severely damaged the front portion of heart (large anterior infarction). It is also advised for people with a blood clot in the left ventricle. Treatment is continued for at least 3 months, with a target INR of 2 to 3.
  
  People with atrial fibrillation are treated with an anticoagulant whether or not sinus rhythm is achieved. There is a high rate of silent recurrence of atrial fibrillation, and it increases the risk of blood clots. If the anticoagulant is warfarin, the INR should be maintained between 2 and 3. 
  
  This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor.

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• QIs it safe to stop taking blood thinners for afib before hip surgery?

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  A Dr. Rishi G. Anand, MD , Clinical Cardiac Electrophysiology, answered on behalf of Holy Cross Hospital

  If you suffer from atrial fibrillation (afib) and are taking blood thinners (anticoagulants), you will be taken off blood-thinning medications before hip surgery to avoid bleeding and serious complications. A preoperative evaluation will focus on the following:

  • assess your rate and/or rhythm control
  • identify whether you have valvular disease or heart failure
  • determine if you have experienced prior thromboembolic events
  • take a thorough history of previous management plans you used when cessation of anticoagulation was required 

  Your doctor will also perform a thorough cardiovascular examination, including a review of your ECG and prior echocardiograms. It is also important for him or her to know about prior factors that induced afib episodes, including any episodes occurring with prior surgical procedures.
   
  Preoperative management will include optimizing the heart rate, which is individualized according to your needs. Medications known as AV nodal blockers are typically continued around the time of surgery, and a post-op plan should be made for continuing these agents, taking into account whether or not oral food and fluids will be withheld from you after the procedure (if you are "NPO", or nothing by mouth). Your preoperative management should generally include a discussion with your cardiologist if you are receiving antiarrhythmic medications, such as sotalol, propafenone, and amiodarone.
   
  The use of anticoagulation around the time of your surgery requires complex decision-making.  A plan should be developed prior to surgery whenever possible. This plan should include anticipating the postoperative conditions affecting the resumption of anticoagulation. 
   
  If you are being treated for atrial fibrillation and will be undergoing any type of surgery, talk your doctor about management of your afib and blood thinners around the time of surgery.
  
  Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.
• QWhy do I have to stop taking my blood thinners before knee surgery?

  1 Answer

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  A Dr. Rishi G. Anand, MD , Clinical Cardiac Electrophysiology, answered on behalf of Holy Cross Hospital

  If you suffer from atrial fibrillation (afib) or are taking blood thinners (anticoagulants), you will be taken off blood-thinning medications before knee surgery to avoid bleeding and serious complications. Because even though knee surgery is a non-cardiac surgery, you can still have cardiac complications if you suffer from afib.
   
  The management of anticoagulation when you are undergoing surgical procedures is challenging because interrupting anticoagulation for a procedure increases your risk of forming blood clots that can be carried to other vessels in your body (thromboembolism), which can lead to a more serious condition or death. At the same time, surgery and invasive procedures have associated bleeding risks that are increased by the anticoagulant(s) you take for thromboembolism prevention. A balance between reducing the risk of thromboembolism and preventing excessive bleeding must be reached.
   
  If you are being treated for afib and will be undergoing any type of surgery, talk your doctor about management of your afib and blood thinners around the time of surgery.
  
  Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.
• QWhat drugs may interact with anticoagulants?

  1 Answer

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  A Dr. Darria Gillespie, MD , Emergency Medicine, answered

  The following drugs may interact with anticoagulant drugs, leading to side effects:

  • antiplatelet agents (may interact with apixaban and rivaroxaban)
  • aspirin (may interact with dabigatran)
  • conivaptan (may interact with apixaban and rivaroxaban)
  • CYP3A4 inducer (may interact with apixaban and rivaroxaban)
  • deferasirox
  • deoxycholic acidcurrent medication: enzalutamide (174) [48541]
  • enzalutamide (may interact with warfarin)
  • ibritumomab (may interact with dabigatran and warfarin)
  • ibrutinib (may interact with warfarin)
  • idelalisib (may interact with apixaban and rivaroxaban)
  • milnacipran (may interact with warfarin)
  • naproxen (may interact with apixaban and rivaroxaban)
  • nonsteroidal anti-inflammatory drugs (may interact with dabigatran)
  • obinutuzumab
  • omacetaxine
  • regorafenib (may interact with warfarin)
  • tositumomab (may interact with dabigatran)
  • venlafaxine (may interact with warfarin)
  • vorpaxar (may interact with apixaban, rivaroxaban, dabigatran, and warfarin)

  If you take warfarin, you should avoid ginkgo biloba and green tea. If you take apixaban or rivaroxaban, you should avoid St. John's wort. 
  
  This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor.
• QWhat are some safety tips when taking anticoagulants?

  2 Answers

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  A Intermountain Healthcare answered

  When you are taking anticoagulants, you need to be careful about foods and other medications that may interact with them. Be sure to do the following:
  

  • Check with your doctor before starting or stopping any other medications, including prescriptions, over-the-counter medications, or supplements.
  • If you are taking anticoagulant medications, do not take aspirin, medications that contain aspirin, or pain relievers known as nonsteroidal anti-inflammatory drugs (NSAIDs) (ibuprofen, Advil, or Aleve). You may take acetaminophen (Tylenol).
  • If you are taking Coumadin, be very consistent about the amount of foods containing vitamin K that you eat. Ask your doctor or nurse for more information.
  • Tell all your healthcare providers, including your dentist, that you're taking anticoagulants. They need to know this before prescribing anything else.

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• QWhat are side effects of anticoagulants?

  2 Answers

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  A Intermountain Healthcare answered

  Normal side effects of anticoagulants can include:
  

  • Bruising
  • Prolonged bleeding from small cuts
  • Nosebleeds
  • Headache
  • Bloated or crampy stomach
  • Loss of appetite

  Contact your doctor if you experience:
  

  • Headache that is not relieved by pain medication
  • Large areas of bruising
  • Nosebleeds that won't stop
  • Rash or hives

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• QWhat are anticoagulants?

  4 Answers

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  A SCAI answered

  Anticoagulants are medications that prevent blood from clotting, thereby reducing the chance of a heart attack or stroke. Anticoagulants are prescribed for patients who have had a heart attack or stroke, deep vein thrombosis, or who have had a stent placement.
  
  Examples of Anticoagulants:

  warfarin (Coumadin)

  heparin

  lovenox

  
  

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