Table of Contents

I. The Function of Blood Clots

II. How Do Blood Thinners Work?

III. Conditions That May Require Blood Thinners

IV. Blood Thinner Maintenance

V. FAQ: How Do I Take Blood Thinners Safely?

The Function of Blood Clots

Blood clots are a natural and necessary part of healing. When you get a cut or other injury, proteins, platelets, and other blood cells stick together to form a clot that helps stop the bleeding. Once the injury heals, the body usually breaks down and removes the clot. However, blood clots can sometimes form where they should not or fail to break down properly. These clots can block blood flow or travel through blood vessels, potentially affecting the lungs, brain, or heart and causing serious health problems. [1]

People who are at risk for blood clots may be prescribed blood-thinning medications to help prevent clots from forming or keep existing clots from getting bigger. Anticoagulants include medications such as Xarelto (rivaroxaban), Coumadin (warfarin), and Eliquis (apixaban). [2] Read on to learn more about common blood thinners and how they work.

How Do Blood Thinners Work?

Blood thinners are medications used to prevent blood clots from forming or to keep existing clots from getting bigger. [3] Despite their name, blood thinners do not actually make the blood thinner. [2] They also do not break up blood clots that have already formed. Instead, they reduce the body's ability to form clots, which can help lower the risk of problems such as heart attack and stroke in people who need these medications. [3]

There are two main types of blood thinners: anticoagulants and antiplatelet medications. Anticoagulants slow down the body's process of making clots, while antiplatelet medications prevent platelets from clumping together to form a clot. [3]

Anticoagulants

Anticoagulants are blood-thinning medications that act against clotting factors to reduce the formation of blood clots. Different anticoagulants interfere with the clotting process in different ways. For example, warfarin reduces the production of several vitamin K-dependent clotting factors, while dabigatran inhibits thrombin and rivaroxaban and apixaban inhibit factor Xa. [2] Anticoagulants are available in different forms, including oral medications, injections, and IV infusions. [4]

Common anticoagulants include:

• Rivaroxaban (Xarelto)
• Dabigatran (Pradaxa)
• Apixaban (Eliquis)
• Warfarin (Coumadin) [4]

Antiplatelets

Platelets are tiny fragments of blood cells that clump together at an injury site to help seal a wound and stop bleeding. Antiplatelet medications work by preventing platelets from sticking together and forming clots. These medications are mainly used to help prevent heart attacks and strokes. [2]

Common antiplatelet medications include:

• Clopidogrel (Plavix)
• Ticagrelor (Brilinta)
• Aspirin
• Prasugrel (Effient) [2]

Conditions That May Require Blood Thinners

Deep Vein Thrombosis (DVT)

Deep vein thrombosis is a blood clot that forms in a deep vein, usually in the leg, although it can also occur in other parts of the body. Factors that can increase the risk of DVT include immobility or bed rest, long flights, pregnancy, surgery, obesity, and certain medical conditions. Some cases may also be classified as unprovoked when there is no identifiable transient or persistent risk factor. [5] Possible signs and symptoms of DVT include:

• Pain
• Swelling
• Redness
• Tenderness
• Warm or red skin
• Prominent or dilated veins [5]

Heart Attack

A heart attack occurs when blood flow to an area of the heart muscle becomes blocked, preventing it from receiving enough oxygen. One cause is a buildup of plaque in the arteries. If plaque ruptures, a blood clot can quickly form and block blood flow to the heart. People who have experienced a heart attack may receive antithrombin or antiplatelet therapy, such as aspirin or clopidogrel, to help prevent further blood clotting. [6] Symptoms of a heart attack can include:

• Pressure, squeezing, pain, fullness, or discomfort in the center of the chest
• Pain or discomfort that spreads to the shoulders, neck, arms, or jaw
• Worsening chest pain
• Shortness of breath
• Sweating or cool, clammy skin
• Nausea or vomiting
• Dizziness or fainting
• Rapid or irregular pulse [6]

Ischemic Stroke

An ischemic stroke occurs when a blood vessel supplying the brain becomes obstructed. Atherosclerosis, or fatty plaque deposits along blood vessel walls, is a main cause. A clot may develop where plaque has formed in a vessel supplying the brain, or a clot may form elsewhere in the circulatory system, break loose, and travel to the brain. Ischemic stroke requires urgent treatment to remove the clot, which may involve clot-dissolving medications or mechanical treatments. [7]

Pulmonary Embolism (PE)

A pulmonary embolism occurs when a blood clot develops elsewhere in the body, often in the leg, and travels to an artery in the lung where it blocks blood flow. DVT is the most common cause of a pulmonary embolism because part of a clot in a deep leg vein can break off and travel to the lungs. Anticoagulants are one treatment option for PE because they decrease the blood's ability to clot, helping prevent an existing clot from getting bigger and preventing new clots from forming. [8] Symptoms of PE can include:

• Sudden shortness of breath
• Chest pain, usually worse with breathing
• Dizziness, lightheadedness, or fainting
• Irregular heartbeat or heart palpitations
• Coughing or coughing up blood
• Sweating [8]

Blood Thinner Maintenance

Monitoring is an important part of blood thinner treatment because the amount of medication needs to be sufficient to prevent clots without causing excessive bleeding. [3] Warfarin therapy is monitored using the International Normalized Ratio (INR), which measures the level of anticoagulation. Some newer anticoagulants have more predictable effects and generally do not require the same routine monitoring of drug levels. [2]

Bleeding is the most common side effect of blood thinners, so it is important to follow your healthcare provider's instructions carefully and report signs of serious bleeding. You should also make sure your healthcare provider knows about the medicines and supplements you are taking because blood thinners can interact with certain foods, medications, vitamins, and supplements. [3]

FAQ: How Do I Take Blood Thinners Safely?

To take blood thinners safely, follow your healthcare provider’s instructions exactly and make sure you understand why the medication was prescribed. Blood thinners help prevent new clots from forming and keep existing clots from getting bigger, but they do not break up clots that have already formed. Depending on your condition, your doctor may prescribe an anticoagulant such as Xarelto, Eliquis, warfarin, or another medication.

Because blood thinners reduce the body’s ability to clot, bleeding is the most common side effect. Some medications require routine monitoring, while others generally do not need the same regular blood tests. Your doctor will decide what follow-up is needed based on your medication, health history, and risk of bleeding.

To use blood thinners safely:

1. Take your medication exactly as prescribed.
2. Do not skip doses, double up, or stop treatment without medical guidance.
3. Tell your doctor and pharmacist about all medications, vitamins, and supplements you take.
4. Keep all recommended blood tests or follow-up appointments.
5. Tell your doctors and dentists that you take a blood thinner before procedures.
6. Report signs of serious bleeding, such as unusual bruising, blood in your urine or stool, vomiting blood, heavy bleeding, dizziness, weakness, or fainting.

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis, or treatment.