Thrombosis, the formation of blood clots is responsible for various complications and conditions of the heart, including heart attack and stroke.  The formation of blood clots in arteries choke the blood vessel, either partially or completely, resulting in severe complications. Blood thinners or anticoagulants help prevent occurrence of heart attack or stroke that is attributed to thrombosis.  While the drug is effective and helps individuals from possible fatal or serious events, the risk of possible side effects of blood thinners cannot be entirely ruled out. Here is a detailed look at blood thinners, categories, uses, drug interactions and the undesirable effects of the medication. This will help users prevent and mitigate possible complications.

Overview of the medication and side effects of blood thinners

Pulmonary embolism refers to the formation of blood clots in major blood vessels in the lungs. Deep vein thrombosis refers to the formation of blood clot in the legs, and this could sometimes move upwards into the lungs resulting in pulmonary embolism. Other conditions that are attributed to the formation of blood clots include atherosclerosis, which refers to the accumulation of fatty deposits. The formation of blood clots and the narrowing of the arteries are conducive for the build up of fatty deposits, which can then block the arteries. While the formation of blood clots, is possible in any part of the body, occurrence is high in certain areas. The severity of the condition depends on the location of the blood clot formation.

Before we look at the side effects of blood thinners here is a quick look at the mechanism of action of the medication. Certain categories of blood thinners work by inhibiting the production of vitamin K which has an important role in coagulation. The process of development of blood clots includes the activation of thrombin for formation of thrombus. By binding to vitamin K, blood thinners irreversibly inhibit enzymes that have a role in the formation of blood clots. The anticoagulation effect can sometimes last for as long as fifty hours, and the only possible way to reverse this effect, is by providing vitamin K.

Different types of blood thinners

A better understanding of the side effects of blood thinners is only possible with awareness of the different types of blood thinners. Typically, blood thinners are classified into antiplatelets and anticoagulants, that have different mechanisms of action. Antiplatelets are available as oral medications, or injections that are administered intravenously. Commonly available antiplatelet drugs include aspirin, cilostazol, prasugrel, clopidogrel, dipyridamole, ticagrelor, tirofiban and eptifibatide.

Anticoagulants are further classified into heparin, direct oral anticoagulants and vitamin antagonists. Commonly available anticoagulant drugs include warfarin, heparin, enocaparin, dalteparin, edoxaban, dabigatran, rivaroxaban, and apixaban. The actual type of blood thinners for patients are prescribed on the basis of evaluation and various factors. For instance, the medical history of the patient and the family are assessed to identify the most suitable blood thinner. This helps in determining the risk of formation of blood clots. The next factor that is used to assess the suitability of particular types of blood thinners are the location of the blood clot, and the severity. Depending on the location and its impact on the health of the individual, an appropriate blood thinner is then prescribed. Additionally, the assessment also checks if the blood clot is the first incident experienced/reported by the patient.

Commonly reported side effects of blood thinners

As mentioned above, anticoagulants and anti-platelets are not free from undesirable effects. Here is a look at some of the commonly reported side effects of blood thinners. In some individuals the undesirable effects may be mild or moderate in nature, whereas in others the effects may be serious. One of the side effects of blood thinners that is common to all patients on the medication is the possibility of bleeding that may be relatively tough to stop due to lesser clotting ability. The amount of time taken for the bleeding to stop may be longer among patients on blood thinners. In certain instances, it may also be necessary to seek medical assistance for the same.

Antiplatelet medications are known to result in specific side effects, such as a possible increase in nose bleeds. Individuals are also known to observe traces of blood in urine. Similarly, patients on blood thinners may also end up getting bruised easily, resulting in possible loss of blood. In a small number of patients, this condition may be relatively serious in nature, resulting in excessive bleeding or possible hemorrhage that will require medical intervention at the earliest. Side effects of blood thinners include the possibility of bleeding in the stomach which can impact health seriously, in addition to causing pain and discomfort. Certain anti-platelet medications are also known to result in breathing difficulties that require appropriate attention in a healthcare facility.

Other possible side effects of blood thinners include lower blood platelet count as a result of the mechanism of action of the anti-platelet medication. Asthma is another possible outcome of specific categories of blood thinners. Certain individuals have reported the growth of nasal polyps while on the medication. This refers to the benign growth on the nose, typically in the lining of the nose. Anticoagulants are known to cause bleeding in the eyes, in the digestive tract and in the brain. This may then require medical attention to prevent the manifestation of serious conditions. Undesirable effects of anticoagulants include possible pain in the stomach, that is not attributed to any other reason or condition.

Patients are also known to end up with nausea while on the medication. This may sometimes be accompanied by vomiting. Similarly, side effects of blood thinners include flatulence and bloating that is attributed to the mechanism of action of the medication. Individuals have also reported a distinct change of taste, when on the medication. This affects a relatively small section of patients on the medication. Other commonly reported undesirable effects include possible osteoporosis as a result of long-term use of the medication. Patients are known to suffer fractures relatively easily when on the medication. The onset of allergies is another possible side effect of the medication.  Patients on blood thinners are likely to end up with lesser levels of a hormone in the body that is responsible for regulating the salt and water levels in the body. This may affect overall health, as a result of the possible imbalance.


Reversing the side effects of blood thinners

Bleeding that is attributed to anticoagulants are often treated through intravenous administration of vitamin K. Similarly, the side effects of blood thinners are also managed through the administration of frozen plasma to help reverse the effects of the drugs. Prothrombin complex concentrate is also administered to manage or reverse the excessive bleeding occurring as a result of the medication. The newer direct oral anticoagulants are known to have a better side effect profile, with lesser instances of bleeding in the brain. Additionally, this category of medication also comes with medications that are easily available to reverse the action of the blood thinners. The commercial availability of these medications to reverse the actions helps patients to quickly find relief from possible undesirable outcomes. Specialists also typically, administer protamin sulfate to inactive certain categories of blood thinners. The helps to stop the effects of the medication and mitigate bleeding that is considered as heavy.

Side effects of blood thinners as a result of drug interactions

Medications are known to end up with drug interactions when taken in combination with certain other medications. This includes prescription medications over the counter formulations, herbal products, natural remedies, and food products. Side effects of blood thinners due to drug interactions include possible adverse outcomes when blood thinners are taken in combination with medications that cause bleeding. Similarly, diuretics are known to trigger outcomes that are undesirable. Blood thinners are typically not taken in combination with NSAIDs (non-steroidal anti-inflammatory drugs). Other drugs that are generally not prescribed alongside blood thinners include steroids.  Individuals on blood thinners are advised to stay off alcohol, as this could cause unwanted effects.

Other drug interactions include medications that are classified as opioids. Similarly, patients on medications for managing stomach ache such as omeprazole may also experience drug interactions when both the medications are combined. High doses of blood thinners are also known to interact with drugs that are prescribed to specific control heart ailments. For instance, patients diagnosed with arrhythmias are prescribed medications that are known as cardiac glycosides. When blood thinners and taken alongside cardiac glycosides, there is a possibility of drug interactions. Certain statin class of medications may also interact with blood thinners resulting in undesirable effects.

In addition to the above side effects of blood thinners, specialists also specifically monitor patients on other medications or remedies. For instance, herbal products used for treating various conditions can also trigger side effects, and it is essential to either discontinue the products or choose other products that do not cause allergies. Certain antibiotics are also known to cause interactions when taken with blood thinners. Food products that contain vitamin K will reduce the efficacy of blood thinners. As mentioned above, vitamin K is administered to reverse the effects of blood thinners and when both are taken together, the effects of the blood thinners are affected.

Doctors typically rely on the International Normalized Ratio count from blood tests to determine the effects of the medication on the patient. High INR readings indicate possible risk of bleeding, while low INR readings indicate possible risk of clotting. Specialists check the readings before prescribing the medication and also while patients are on the medication.

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