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Which Anticoagulant Medication is Right for You?

by Carissa Andrews - May 23 , 2017


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For a healthy individual, typical coagulation of the blood is a total win. If you hurt yourself, the clotting of the blood allows a wound to scab over, and triggers the healing process to begin. However, there are circumstances where the coagulation can cause serious side-effects, and even death.

The number one thing anticoagulants do is ensure the body doesn’t produce blood clots. The problem with any development of blood clots (particularly due to the conditions listed in the next section), is the risk of it breaking away and causing blockage, or further damage to the body.

In the past decade, a number of new anticoagulant medications have hit the market. For those who need these often life-saving medications, you might be wondering which one is best for you. Perhaps you haven’t needed them yet, but may sometime in the future.

Who Needs Anticoagulants?

There are several conditions for which someone may need to take anticoagulant medications. Most of them can be life threatening, if a blood clot were to develop.

Here are some of the common reason blood clots form and why anticoagulants may be prescribed:

• Atrial fibrillation (irregular heartbeat)

• Mechanical or artificial heart valves (can cause a ‘foreign body’ reaction)

• Deep Vein Thrombosis (DVT)

• Previous heart attack causing damage to heart muscle (and to prevent a reoccurrences)

• Stroke (or to prevent it)

• Post-surgery (such as knee or hip replacement)

Anticoagulant Medications

Over the years, one of the most prescribed anticoagulant medications was Coumadin (warfarin). However, with the constant need for blood tests, and having to cut out green leafy vegetables such as spinach, collard greens, and kale – it was only a matter of time before alternatives would hit the scene. There are a few that have entered the market since 2010, all of which are viable alternatives, depending upon their use.

These newer medications do have an advantage over Coumadin, in that there are fewer drug interactions, and no need for routine blood testing. However, their newness means their overall interaction will not be as well known, and not all of them have a reversal agent in case of emergency. They’re also going to be more expensive up front, as any generic versions are still going to be years off.

Let's take a closer look at some of the alternatives to Coumadin and see how they fair:

Eliquis (apixaban)

Eliquis is an anticoagulant that blocks clotting substances in the blood and was approved by the FDA in December 2012. It’s mainly used to reduce the risk of stroke caused by blood clots that stem from a heart rhythm disorder called atrial fibrillation. It is also prescribed to treat patients who have a risk for a certain type of blood clot known as deep vein thrombosis (DVT), which can ultimately lead to a pulmonary embolism (PE). Often, this prevention or treatment is seen prescribed after knee or hip replacement surgery.

Xarelto (rivaroxaban)

Xarelto is another anticoagulant that blocks clotting and was approved in July 2011 by the FDA. It’s used mostly to prevent DVT, and PE – but it is also used to treat patients with atrial fibrillation, and to lower the risk of stroke.

Pradaxa (dabigatran)

Pradaxa is an anticoagulant to help prevent the formation of blood clots. It was approved by the FDA in October 2010 and is used for reducing the risk of stroke and clots in patients with atrial fibrillation. In addition, it can be prescribed to treat DVT, PE, and lower the risk of reoccurrence if a patient has ever suffered with them. It is also approved for treatment of venous thromboembolism (VTE) after hip or knee replacement surgery.

Plavix (clopidogrel)

Plavix is also used as an anticoagulant to prevent blood clots and was originally approved by the FDA in 1997, though several generic versions were approved in 2012. It’s generally used after a recent heart attack or stroke, as well as with people who have certain disorders of the heart or blood vessels

Brilinta (ticagrelor)

Brilinta helps prevent platelets in your blood from forming a blood clot and was approved in July 2011. Its main uses are to treat acute coronary syndrome and prevent or lower the risk of stroke and heart attack. It has a slightly lower death rate than Plavix in acute coronary syndrome, but because it is fairly new, it’s side effects aren’t as well known.

A Word on Reversal Agents

Keep in mind, that while these are great for preventing strokes and most have a rapid response, many do not have a reversal agent for emergency rooms to prevent bleed out. Brilinta’s Astra Zeneca does have Praxbind (idarucizumab) available, with Xarelto and Eliquis developing their own – which will hopefully be available soon.

Overall, the best thing a patient can do is talk with their doctor about which anticoagulant medication is right for them. There’s never a one-size-fits-all approach, as there are many variables to consider. Luckily for us, there are more options out there now. If you feel the medication you’ve been on isn’t a good fit, consider talking with your health care provider about looking into alternative options.

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Carissa Andrew considers herself a triple threat: write, design and marketing. Her passion lies in mixing these three together with creativity and sass.


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