If you have had a blood clot or are at risk for developing one due to surgery, a certain medical condition, or a medication you are taking, your doctor may prescribe a blood thinner. Warfarin (generic Coumadin) is the most commonly prescribed medication in this class of drugs, but there are several other anticoagulant options available, including Eliquis, Pradaxa, and Xarelto. All these prescription drugs help to prevent blood clots, which can cause heart attacks or strokes.
While blood thinners can help prevent serious medical problems, they also come with their own risks, largely due to the fact that they make it harder to stop bleeding. If you do need warfarin, Xarelto, or any other blood thinner, make sure you are taking the following precautions to avoid side effects and complications.
Tell Your Doctor About All Your Medications
There is a long list of medications and supplements, both prescription and over-the-counter, that interact with blood thinners, so tell your doctor about everything you are taking in order to determine if a blood thinner is safe for you. Relatively common medications to watch out for include St. John’s wort, which makes blood thinners less effective, and NSAIDs like aspirin, which increase your risk for bleeding.
Keep All Doctor’s Appointments
If you are taking warfarin, you will need to get a blood test at least once a month to ensure the drug is working correctly and is still safe for you to use. Newer blood thinners, such as Xarelto, do not require frequent blood tests, but you should still follow your doctor’s instructions for checking in while taking your medication.
Avoid Sharp Objects
Because blood thinners prevent your blood from clotting, even seemingly minor cuts can keep bleeding and become a serious problem. Limit your risks for bleeding as much as possible; use an electric razor, floss and brush your teeth gently, and always wear shoes when you’re outdoors.
Be Careful When Participating in Sports
Bleeding can occur under the skin (this is what causes bruises) or even inside the skull, so it’s best to avoid contact sports while taking a blood thinner. If you are an avid cyclist or skier, be sure to wear a helmet.
Avoid Sudden Dietary Changes
Suddenly changing the types of foods you eat can cause fluctuations in your International Normalized Ratio (INR), a measure of how long it takes for your blood to clot. Be especially careful with foods that are rich in vitamin K—particularly leafy greens—as these can make your medication less effective. It’s still okay to eat foods with vitamin K, but try to eat a consistent amount of these foods on a daily basis. Talk to your doctor about how to maintain a healthy diet without changing the way your blood thinner works.
As with food, suddenly drinking a lot can cause fluctuations in your INR, which puts you at a greater risk for bleeding. If you drink, make sure it’s in moderation.
Wear a Medical Bracelet
Because blood thinners interact with so many other medications and can cause increased bleeding, you should get a medical bracelet engraved with the name of the drug you are using. If you are ever incapacitated and taken to the hospital, this will help your healthcare providers know how to treat you safely.
As with all prescription medications, it’s important to educate yourself about possible risks and drug interactions before you start taking warfarin, Xarelto or any other blood thinner. The more you know about the medication, the better prepared you will be to use it safely.