4 Things You Need to Know About Blood Thinners

By Barbara Pierce

“People have been on this medication for 10 years and no one has had problems with it,” said my cardiologist as she handed me a prescription for Coumadin, a blood thinner.

Though I was young, I’d had a stroke. The blood thinner would prevent another stroke.

Nearly 30 years later, I’m still taking it. Now it’s the genetic Warfarin. I’ve led a full, active life, never had serious problems, though I know a few people who did. And one who refused to take it, and died because she had a stroke.

I was apprehensive about taking it, as are most people. But I’ve learned it’s not a big deal, not at all. It does take regular monitoring, to make sure my blood clots are within the desired range, not too slow or too fast.

We asked physician Mario Wassel of Mohawk Valley Health System in Barneveld to respond to concerns you may have about taking a blood thinner, if it’s been prescribed for you.

1 — Why is a blood thinner prescribed?

Mario Wassel

Blood thinners, also called anticoagulation medications, are prescribed to treat and prevent blood clots, said Wassel, who is family medicine doctor. Patients are placed on anticoagulation therapy if they’re at increased risk of developing a blood clot. If a blood clot should reach the heart, the lungs or the brain, it could cause a heart attack, a clot in the lungs (referred to as a pulmonary embolism) or a stroke.

Some of the conditions that increase the risk of developing a blood clot include an irregular heartbeat, such as atrial fibrillation; a history of heart surgery, such as a valve replacement; or other surgery, such as a hip or knee replacement; or a congenital heart defect. Also, certain types of cancers or other disease that increase the risk of blood clots forming, or for being at higher risk of stroke or heart attack for any reason, Wassel said.

2 — What are the most important things a person should know when they first begin taking it?

People should be aware of the potential increased risk of bleeding while taking anticoagulation, said Wassel. Since blood thinners slow the clotting of blood, unwanted bleeding can occur; this is the most common side effect.

Report any unusual bruising or bleeding you experience to your healthcare provider right away. Also, let them know if you have a serious fall or serious head injury.

Wassel also cautions that we should be aware of interactions with other medications which may make the risk of bleeding higher or the clotting higher. Some medications, including over the counter and herbal supplements, can interact with the blood thinner. This may reduce the effectiveness of blood thinners and causing clotting or may increase the effect of the blood thinners and cause more bleeding. It’s important to discuss all your medications, including over the counter, with your health care provider.

Also, it’s best to let your dentist know you’re taking a blood thinner.

Another consideration is that the foods you eat can affect how well your blood thinner will work. High amounts of vitamin K work against Warfarin. Other blood thinners are not affected by vitamin K. Ask your health care professional if your diet can affect your blood thinner. (Vitamin K is found in green leafy vegetables; I was advised to keep my intake of foods with Vitamin K pretty much the same every day. For example, if I’m going to eat a lettuce salad, eat it most days.)

Always take your blood thinner as directed. For example, some blood thinners need to be taken at the same time of day, every day. Never skip a dose and never take a double dose.

The older blood thinners do require regular blood tests to make sure your dose is high enough to work, but not so high that it puts you at risk of a bleed. An INR range will be set for you (International Normalized Ratio).

I do in home testing through a finger stick, which is most convenient. The technician adjusts my dose if needed.

The new anticoagulants do not require monitoring.

3 — Can you ever stop taking a blood thinner?

This depends on the reason it’s been prescribed for you, replied Wassel. For example, if it’s been given after surgery, you may just need it for a short time. Longer duration maybe indicated for patients who develop a blood clot in the legs or lungs without an underlying condition. Some may need to use anticoagulation therapy for lifetime due to underlying condition as mentioned above (example: cardiac arrhythmias) or certain types of cancers or autoimmune disorders.

4 — Are there any consequences of taking it long-term?

These medications are generally safe and well tolerated, said Wassel. They’re effective at treating and preventing clots. In the long-term patients should be aware of the potential increased risk of bleeding, and should contact their health care provider if they develop any type of abnormal bleeding.