12 Commonly Prescribed Blood Thinners
Medically reviewed by Alex Yampolsky, PharmD
Blood thinners are a type of medication that prevents blood clots from forming in the body.
There are two different types: anticoagulants and antiplatelets. They can be taken to treat or prevent blood clots caused by certain conditions. These conditions include:
Deep vein thrombosis (DVT), a blood clot that can partially or completely block a large vein
Pulmonary embolism, a blood clot that has traveled to the lungs and blocks a lung artery
Blood clots caused by atrial fibrillation, an irregular heart rate
This article will review the most commonly prescribed blood thinner medications, how they work in the body, and the differences and similarities between them.
Getty Images / Scott Olson / Staff
Arixtra (Fondaparinux)
Arixtra is taken to prevent blood clotting, which can lead to a pulmonary embolism.
Specifically, this medication is taken to prevent DVT in people who are undergoing:
Hip fracture surgery
Hip or knee replacement
Abdominal surgery
Treatment to reduce the risk of thromboembolism or complications that can arise from thromboembolism
Arixtra is a factor Xa inhibitor. Factor Xa is a clotting protein in the body. Arixtra works by limiting the blood's clotting ability.
Arixtra comes in an injection dosage form. It is administered intravenously (into the vein) in adults and as a subcutaneous (under the skin) injection in adults and children.
Eliquis (Apixaban)
Eliquis is taken to treat or prevent blood clots (such as DVT and pulmonary embolism) from developing. It can also be taken to reduce the risk of stroke for people who experience nonvalvular atrial fibrillation, or an irregular heart rate.
Eliquis is a factor Xa inhibitor. It works by selectively slowing down something called thrombin, a molecule responsible for clotting blood in the body.
Eliquis is available in an oral tablet form. It is available in two strengths: 2.5 milligrams (mg) and 5 mg. Eliquis can be taken by mouth or crushed up if the person taking it cannot swallow the whole tablet.
Fragmin (Dalteparin)
Fragmin is indicated for preventing DVT, more commonly known as a blood clot in a vein, usually in the legs. It can also be taken to prevent complications in people with unstable angina, intended to be taken with aspirin at the same time.
Fragmin is categorized as an anticoagulant, also known as a low-molecular-weight heparin. It works by increasing the ability of a clotting protein in the body, factor Xa.
Fragmin is available only as an injection, and it is administered as an IV.
Heparin
Heparin is taken for:
The prevention and treatment of venous thrombosis
The prevention and treatment of the thromboembolic complications that can arise with atrial fibrillation
Prevention of blood clotting in heart surgery and surgery of the heart’s arteries
Heparin is classified as an anticoagulant. Anticoagulants interact with the proteins responsible for blood clotting (antithrombin III) and stop the clotting factors.
Like Fragmin, heparin is also only available as an injection. It is given to people via IV.
Lovenox (Enoxaparin)
Lovenox is also taken to treat or prevent DVT, particularly in individuals who are undergoing abdominal surgery, knee replacement surgery, or hip replacement surgery or can't move around due to a short-term illness.
Lovenox is classified as a low-molecular-weight heparin. When given, it has antithrombotic properties in the blood, which means that it reduces the formation of blood clots.
Lovenox, like heparin, is available only in injection form. It is usually given once a day for seven to 10 days when taken to prevent blood clots before surgery.
Related: Lovenox (Enoxaparin) vs. Heparin for Blood Clots
Savaysa (Edoxaban)
Savaysa is intended for use to reduce the risk of stroke and systemic embolism in individuals who have atrial fibrillation. It is also taken to treat DVT and pulmonary embolism.
Savaysa is classified as a factor Xa inhibitor. It works by stopping the red blood cells from clotting by inhibiting thrombin, the red blood cells, from forming blood clots.
Savaysa is available in tablet form only. It is available in three different strengths: 60 mg, 30 mg, and 15 mg. It is usually taken once a day. Savaysa may be crushed and mixed into applesauce for individuals who cannot swallow or experience difficulty swallowing.
Xarelto (Rivaroxaban)
Xarelto is intended for:
Treatment of DVT
Treatment of pulmonary embolism
To reduce the risk of getting a stroke and systemic embolism in individuals who experience nonvalvular atrial fibrillation
Like Savaysa, Xarelto is a factor Xa inhibitor. Though Savaysa directly affects platelet aggregation, Xarelto indirectly inhibits platelet aggregation induced by thrombin. Platelet aggregation can be thought of as a group of small cells sticking together that form blood clots. Xarelto decreases the production of thrombin, another molecule responsible for blood clotting.
Unlike the other blood thinners discussed, Xarelto has two different dosage forms: oral tablet and oral liquid. Xarelto is available in four different strengths of tablets: 2.5 mg, 10 mg, 15 mg, and 20 mg. It also comes in pre-flavored oral suspension, which is 1 mg/milliliter (mL) strength.
Related: Xarelto vs. Eliquis: What You Need to Know
Warfarin
Warfarin’s intended use is for:
Prevention and treatment of venous thrombosis and pulmonary embolism
Prevention and treatment of complications that can arise from a blood clot from a condition that is related to pulmonary embolism and or for individuals who have had a heart valve replacement
Reducing the risk of death, recurrent heart attack, and complications such as stroke or systemic embolism after a heart attack
Warfarin is a vitamin K antagonist. Vitamin K antagonists work by stopping vitamin K clotting factors in the blood. While taking warfarin, it's important to be aware of your diet. Foods rich in vitamin K can affect how well your medication works.
Warfarin only comes in oral tablet form. It is commercially available as a tablet in nine different strengths.
Plavix (Clopidogrel)
Clopidogrel, known by its brand name, Plavix, is classified as a P2Y12 inhibitor, which is an antiplatelet agent. It is taken for acute coronary syndrome (ACS), which refers to any of three conditions that can cause any sudden life-threatening reduction of blood flow to the heart. It is often taken with aspirin.
Plavix can help lower the risk of heart-related complications in people who have had a recent heart attack, stroke, or severe chest pain.
Plavix is taken as an oral tablet. It comes in two strengths: 75 mg and 300 mg.
Effient (Prasugrel)
Effient (prasugrel), like clopidogrel, is also a P2Y12 platelet inhibitor. Effient is taken to reduce any blood clots from forming in the heart. This includes individuals who have had stents surgically added to their heart.
Like Plavix, Effient is often taken along with aspirin.
Effient is available in tablet form to be taken by mouth. It comes in strengths of 5 mg and 10 mg.
Brilinta (Ticagrelor)
Ticagrelor, more commonly known by its brand name, Brilinta, is also classified as a P2Y12 inhibitor. It is indicated for use to reduce the risk of cardiovascular death, heart attack, and stroke in people with ACS.
Brilinta comes in 60 mg and 90 mg tablets.
Related: Brilinta (Ticagrelor) vs. Plavix (Clopidogrel): Which Is Better?
Aspirin
Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that also works as a blood thinner. It is considered an antiplatelet agent.
People ages 40 to 59 who are at a high risk of developing heart disease and have no increased risk of bleeding may benefit from taking daily low-dose aspirin to prevent heart issues. However, it's best to consult your healthcare provider before starting this regimen.
If taken together, aspirin can interact with certain blood thinners by enhancing bleeding risk. Therefore, if you are on other blood thinning medications, talk to your healthcare provider before starting aspirin.
What's the Difference Between Anticoagulants and Antiplatelets?
Though anticoagulants and antiplatelets may seem to have the same functions and features, they do not.
Anticoagulants and antiplatelets both work in different places in the process of blood clotting. Anticoagulants prevent the blood clots from forming completely, whereas antiplatelets reduce the likelihood that platelets in the blood will clump up or clot.
P2Y12 inhibitors, a type of antiplatelet medication, are usually prescribed with daily aspirin therapy. Anticoagulants, on the other hand, are usually never taken with aspirin unless approved by your provider.
Choosing the Right Blood Thinner for You
When deciding which blood thinner is the best choice for you, your provider will consider your existing medical conditions.
Antiplatelet drugs are mostly given to people who have atherosclerosis. Atherosclerosis is a type of heart disease wherein plaque builds up in the arteries' valves.
Anticoagulants are mostly taken by those with atrial fibrillation, venous thromboembolism, or technical heart valves.
In people who have atherosclerosis as well as a high risk of blood clots, both an antiplatelet and an anticoagulant may be prescribed
When deciding which one is right for you, it is important to note your individual conditions and discuss them with your healthcare provider. Based on your conditions, they will determine which blood thinner is best.
Summary
Several anticoagulants and antiplatelet drugs are commonly prescribed to help prevent or treat the formation of blood clots. These medications may differ in their specific indications and whom they would benefit most.
Blood thinners are usually taken for a range of conditions associated with blood clots, such as DVT, pulmonary embolism, and atrial fibrillation.
The wide range of blood thinners available gives healthcare providers multiple options to choose for their patients. It is important to discuss all your medical conditions with them so they can appropriately prescribe the blood thinner that suits you best.
The author would like to recognize and thank Sakina Yasmin Naqvi for contributing to this article.
Read the original article on Verywell Health.
