What Are Anticoagulants, and Why Do Doctors Prescribe Them?

What are anticoagulants

What are anticoagulants? They are prescription blood thinners that help prevent clots from forming or traveling throughout your body. Your doctor may prescribe one to treat heart or blood vessel disease, atrial fibrillation, or improve circulation to the brain. Anticoagulants can reduce risk of heart attack or stroke for deep vein thrombosis and pulmonary embolism patients. What’s most important to know is that today, millions of Americans take these medications. Anticoagulants drive $1 billion in sales annually, with 4.2 million Americans aged 18 and older prescribed some blood thinner medication.

What New Anticoagulants Are On the Market?

For the last 60 years, warfarin (Coumadin®) was the most commonly prescribed blood thinner. But over the last decade, four “new wave” blood thinners were introduced to consumers, stealing market share away from warfarin. These newer anticoagulants include:

  • Apixaban (Eliquis®)
  • Dabigatran (Pradaxa®)
  • Rivaroxaban (Xarelto®)
  • Edoxaban (Savaysa®)

Each anticoagulant is sold in pill form and used once daily. Doctors are prescribing these “new wave” drugs over the old standby, warfarin, for several reasons. However, they also agree that prescribing these newer drugs can be much more complicated than Coumadin. “It’s not a one-size-fits-all choice,” says the Cleveland Clinic’s Bruce Lindsay, MD. Choosing the right blood thinner medication depends on a patient’s overall health and lifestyle.

What are Some Benefits of New Wave Anticoagulants?

Doctors prescribe newer drugs over warfarin for several reasons. First, they require no regular patient monitoring or blood tests. (Warfarin requires at least one blood test and doctor’s visit each month to check its efficacy.) Doctors also like that the newer anticoagulants were designed to avoid warfarin’s risks, including brain hemorrhages and other dangerous bleeding events. Unlike warfarin, the newer blood thinners don’t require any dietary or lifestyle changes, which appeals to doctors and patients alike.

But other aspects concern doctors who hesitate to prescribe these newer anticoagluants. “The good news is you now have an alternative to warfarin,” said Dr. Alan Jacobson. Dr. Jacobson, director of anticoagulation services at the Veterans Administration (VA) in Loma Linda, CA, adds: “The bad news is you can kill a patient as easily with the new drug as you could with the old drug.” If not prescribed properly, these new drugs can cause even more serious problems than warfarin. Worryingly, the side effects are just as extreme.

Side Effects of Anticoagulants

Among newer anticoagulants, doctors may prescribe Pradaxa, Eliquis or Xarelto. Each blood thinner has distinct benefits, though most side effects are the same (with the exception of nausea with Eliquis). The most common newer anticoagulant side effects include:

  • Easy bruising and minor bleeding
  • May cause serious bleeding if it affects blood-clotting proteins too much
  • Unusual pain/swelling/discomfort
  • Prolonged bleeding from cuts or gums
  • Heavy/prolonged menstrual flow
  • Severe headache
  • Dizziness/fainting

However, the most serious complication of all may be that neither Xarelto nor Eliquis currently has an FDA-approved antidote. If an emergency bleed occurs while taking Xarelto or Eliquis, there’s no way to reverse anticoagulation and clot the blood. In other words, severe bleeding events can be fatal. Warfarin has a reversal agent, and Pradaxa is the only newer blood thinner with a current, FDA-approved reversal agent. Because there’s no Xarelto or Eliquis antidote currently available, thousands of patients suffer uncontrollable internal bleeding, blood clots, and other serious conditions.

What You Can Do

If you or a loved one had serious internal bleeding that required hospitalization while taking Xarelto or Eliquis, you may be eligible for compensation. Start your free Xarelto claim review today and an experienced product liability attorney will contact you to discuss your case.

Related: Xarelto vs Warfarin: Comparing Blood Thinner Medications