What Are Anticoagulants?
Prescription medications designed to decrease your blood’s ability to clot are called anticoagulants, or less accurately, blood thinners. However, anticoagulants don’t actually denature your blood. Instead, they work to suppress production of certain liver proteins (cofactors) responsible for promoting the formation of blood clots.
Regulating the creation of these cofactors is vitamin K, a nutrient needed for bone metabolism. Anticoagulants also target two important cofactors called fibrin and thrombin to further prevent your blood from clotting abnormally.
Why Would You Need to Take Anticoagulants?
Therapeutic use of blood thinners may help prevent a wide variety of adverse health disorders related to excessive blood clot formation:
- Myocardial infarction
- Deep vein thrombosis
- Pulmonary embolism
- Congestive heart failure
- Acquired hypercoaguability
Expedited by proteins and blood cells called platelets, blood coagulation is necessary to stop excessive bleeding when blood vessels are damaged. Normally, the body will dissolve blood clots naturally once a wound has healed. However, when blood clots form inside arteries or veins that have not been injured, an anticoagulant may be prescribed to facilitate dissolution of these blood clots.
If arteries and/or veins are blocked by blood clots, blood flow is slow or restricted altogether. Swelling and pain often results when blood accumulates behind blood clots (deep vein thrombosis). In addition, areas of the body may not receive oxygenated blood, which is essential for organ and tissue health.
Sometimes, clots become dislodged and find their way into a lung artery. Pulmonary embolism, a serious disease causing shortness of breath, chest pains and mucus-filled cough, requires immediate treatment with anticoagulants or “clot-busting” medications called thrombolytics.
Possible Side Effects of Anticoagulants
Common side effects of taking anticoagulants are:
- Gas and bloating
- Nausea and vomiting
- Reduced appetite
Coughing up blood, darker than normal stools, skin rash/itching and hair loss are less common side effects reported by users of blood thinners.
If you suffer one or more of the following side effects while taking an anticoagulant, you should call your doctor immediately:
- Brownish-red or red urine/bowel movements
- Bleeding from your nose or gums
- Brown or bright red vomit
- Severe abdominal or head pain
- Bruising unnecessarily
- Profuse bleeding that cannot be stopped
- Weakness, dizziness or disorientation
Medication and Food Interactions with Anticoagulants
Several herbs and foods may increase the anti-clotting effects of blood thinners.
People prescribed anticoagulants should reduce consumption or simply avoid consuming the following:
- Fish oil
- Green tea
- Multivitamins that contain vitamin K and calcium
- Spinach, cabbage, cauliflower and other foods containing rich amounts of vitamin K
You should also avoid using these medications that can significantly increase anticoagulant activity:
- Some antibiotics and anti-convulsive drugs
If you must take one of the above medications, always consult with your physician first.
Types of Anticoagulant Drugs
One of the most well-known and commonly prescribed anticoagulants is Coumadin (warfarin). A vitamin K antagonist derived from a plant material called coumarin, warfarin begins dissolving blood clots within 72 hours of ingestion.
For people unexpectedly diagnosed with pulmonary embolism or deep-vein thrombosis, physicians will give patients heparin concomitantly with warfarin so that anticoagulation of blood clots begins almost immediately.
Direct Thrombin Inhibitors
A new class of anticoagulants called direct thrombin inhibitors bind directly to thrombin, a pro-inflammatory co-factor involved in blood clotting and development of atherosclerosis.
Two prominent direct thrombin inhibitors are Argatroban and Bivalirudin. DTIs are also being investigated as therapeutic approaches to liver and/or systemic inflammation in people with metabolic disease and obesity.
Developed by pharmaceutical giants Johnson & Johnson and Janssen Pharmaceutica, the anticoagulant Xarelto (rivaroxaban) was approved by the U.S FDA in 2011 for prevention of deep vein thrombosis, pulmonary embolism and stroke prophylaxis in patient suffering non-valvular atrial fibrillation.
Sold to physicians and their patients on the premise that taking Xarelto would not require patients to have blood tests and blood monitoring performed every month, Xarelto was also billed as the only, once-a-day anticoagulant for people suffering atrial fibrillation not caused by damaged heart valves.
However, early Xarelto patients began reporting adverse side effects that included severe internal bleeding, fainting, extremity pain and muscle pain spasms. Many required lengthy hospital stays and some people claimed loved ones died as a result of taking Xarelto. Unlike warfarin, which has an antidote to prevent uncontrollable bleeding if it occurs, Xarelto has no antidote.
Xarelto Class Action Lawsuits
Litigants of class action lawsuits against Bayer and Janssen advertising and selling Xarelto claim that these pharmaceutical companies continued selling Xarelto even after they found out people were nearly dying from severe, internal bleeding caused by taking Xarelto.
In 2014, Xarelto lawsuits were sent to federal litigation where complaints continue to be added to the list of people harmed by Xarelto. Although a settlement has yet to be reached between Johnson & Johnson and plaintiffs, legal experts expect attorneys asking for compensation for lost wages, medical expenses and other damages due to taking Xarelto to eventually win their case.