Andrea M. Russo, MD, Director of the Cooper Electrophysiology and Arrhythmia Service at the Cooper Heart Institute
If you watch news during the dinner hour, it’s hard to miss all the pharmaceutical advertisements, many of which talk about a condition called atrial fibrillation (AFib) and are selling a category of drugs called blood thinners or anticoagulants. Atrial fibrillation (or arrhythmia) is a heart problem causing an irregular heart rate or rhythm, or abnormal heartbeat. During this arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm. It is associated with an increased risk of complications from blood clots, including stroke.
Blood thinners are designed to do exactly what they say. They lower the ability of the blood to clot, which for many patients is a necessary treatment for reducing the risk of heart attack and stroke. In fact, more than 2 million people take blood thinners every day to keep them from developing dangerous blood clots.
People often worry about how routine medicines like blood thinner pills will affect their lifestyles. With a few simple steps, taking a blood thinner can be safe and easy. However, the risks and benefits must be weighed in each individual patient, and the types of blood thinners must be considered carefully.
Some patients who were at very low risk may require only aspirin, while others may require stronger medications. In all cases, close monitoring, follow-up and patient education are important in all individuals who are prescribed anticoagulant therapy.
Up until recently, blood thinners (oral anticoagulant therapy) have been limited to a medication called warfarin. This medication requires frequent blood tests and monitoring. In addition, certain medications or foods, such as green vegetables, can interact with warfarin, making it difficult to regulate the levels of this medication and control dietary considerations.
However, there are now new oral blood thinners you may have been hearing about. These medications are also very effective in reducing the potential for stroke. These newer anticoagulants (referred to as “novel oral anticoagulants”) include dabigatran, apixaban and rivaroxaban.
The advantages of these medications include the absence of any need for frequent blood work for monitoring of anticoagulation levels. In addition, they do not require that patients refrain from eating green vegetables, something obviously healthy for all patients.
Using Other Medicines
Tell your doctor about every medicine you take. Your doctor needs to know about all your medicines, including medicines you were taking before you started taking a blood thinner.
Other medicines can change the way your blood thinner works, and vice versa. Your blood thinner can also change the way other medicines you may be taking will work. Blood thinners can be very effective in preventing the side effects of blood clotting. However, like any other medication, they can also have side effects of their own, and some may interact with foods, other medications or even dietary supplements. Working very closely with your health care professional and being regularly monitored can go a long way toward maintaining the effectiveness of the medications and assuring that you will not experience negative effects from these medications or others you may be taking.