Anticoagulants are a class of drugs that slow down the blood clotting process and, consequently, are used to decrease the risk of stroke and heart attack. They are useful for many patients, but they can also carry a high risk of negative side effects. If you are forced to take them, discuss with your doctor possible drug interactions and any lifestyle changes that could affect your health condition.
Steps
Part 1 of 4: Avoiding Drug Interactions
Step 1. Find alternatives to NSAIDs and aspirin
Non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin are commonly taken to relieve minor pain. However, taking them for patients on anticoagulant therapy may increase the risk of heavy bleeding. So, if you are taking a blood thinner, you may want to look for an alternative to over-the-counter pain relievers.
- Generally, acetaminophen-based drugs pose no health risks when taken with anticoagulants, but should not be taken in high doses, as they could cause liver damage.
- Ask your doctor if you can take acetaminophen instead of aspirin or NSAIDs.
Step 2. Avoid drugs that increase the risk of thrombosis
Some prescription medications promote blood clot formation. Hence, they can cause complications if you are taking anticoagulants to thin the blood and prevent the risk of thrombosis. The most common ones that inhibit the fluidifying effect of anticoagulants include, but are not limited to:
- Carbamazepine (Tegretol): has an anticonvulsant and mood-regulating action.
- Phenobarbital (Luminale): has an anticonvulsant action that also relieves anxiety.
- Phenytoin (Dintoin): has an anticonvulsant action.
- Rifampicin (Rifadin): used to treat tuberculosis (TB).
- Vitamin K: promotes blood clotting;
- Cholestyramine (Questran): lowers cholesterol levels;
- Sucralfate (Antepsin): has an antacid action for the treatment of gastric ulcer.
Step 3. Learn about blood thinning medications as well
Just as some medicines promote blood clotting, so others promote blood thinning and, therefore, can make it even more fluid if you are already taking anticoagulants. So, schedule a series of blood tests with your doctor if you need to take antibiotics, antifungals, or any other medications that cause blood thinning. Among the most common are, but are not limited to:
- Amiodarone (Cordarone): anti-arrhythmic drug used to treat severe heart rhythm disorders.
- Cotrimoxazole (Bactrim): antibiotic.
- Ciprofloxacin (Ciproxin): antibiotic.
- Clarithromycin (Klacid): antibiotic also used to treat some stomach ulcers.
- Erythromycin: antibiotic.
- Fluconazole (Diflucan): antifungal.
- Itraconazole (Sporanox): antifungal.
- Ketoconazole (Nizoral): antifungal.
- Lovastatin (Tavacor): cholesterol medication.
- Metronidazole (Flagyl): antibiotic.
Part 2 of 4: Making Lifestyle Changes
Step 1. Limit foods rich in vitamin K
A diet rich in vitamin K can promote the formation of blood clots and, consequently, decrease the effectiveness of anticoagulants, reducing their fluidifying action and prevention of any thrombosis.
- Leafy green vegetables, including spinach, kale, cauliflower, and lettuce, all have a high content of vitamin K and can alter the effectiveness of blood thinners.
- Cruciferous vegetables, such as broccoli, Brussels sprouts, kale, and asparagus, are all rich in vitamin K and, therefore, should be avoided.
- Other vegetables and legumes to avoid or consume in limited quantities are peas and okra.
- Consult your doctor and / or nutritionist to establish a balanced diet that does not affect the effectiveness of the medications you are taking.
Step 2. Avoid herbal medicines that alter your INR (prothrombin time, which is the tendency for blood to clot)
Some plants act as natural blood thinners. If consumed while taking anticoagulants, they make the blood too thin. This phenomenon can cause bruising and heavy bleeding, but also further complications.
- Avoid herbal teas.
- Avoid taking natural supplements based on (but not limited to) alpha alpha, cloves, echinacea, ginger, ginkgo biloba, ginseng, green tea and St. John's wort.
Step 3. Stop taking alcohol and nicotine
Nicotine can increase the risk of developing thrombosis and cardiovascular disease. Alcohol can compromise the effectiveness of some anticoagulants and also cause gastrointestinal bleeding, which can be aggravated by the use of anticoagulants.
Work with your doctor to design a smoking and alcohol abstention plan if you are a smoker or drink regularly
Step 4. See your doctor about interactions with vitamins and supplements
Many vitamins and supplements affect blood clotting. When taken with anticoagulants, they can cause moderate or severe health complications.]
- If you are on blood thinning therapy, do not take vitamin supplements that contain more vitamins A, E, or C than the recommended daily dose.
- You should avoid fish oil, garlic oil and ginger supplements.
- Onion and garlic extracts are commonly sold in supplement form, but they can compromise prothrombin time and, therefore, are best avoided.
Step 5. Tell your doctor if you have to go on a long trip
Whether traveling by car, bus, train, or plane, people who travel long distances, usually for more than four hours, may be at a higher risk for thrombosis.
If you are taking a blood thinner, your doctor may advise you to change your drug therapy to prevent the risk of thrombosis while traveling
Part 3 of 4: Reduce the Risk of Injury
Step 1. Do not stop taking the drug
During anticoagulation therapy, the risk of bleeding can increase if you injure yourself. However, you must follow it to avoid other serious complications, such as stroke, pulmonary embolism, or myocardial infarction. So, keep taking the drug unless your doctor advises you to stop taking it.
Step 2. Be careful not to hurt yourself
Since anticoagulants slow blood clotting, the risk of heavy bleeding is significantly higher. Therefore, prevent the danger of getting yourself injured by reducing contact with sharp objects and avoiding sports or physical contact activities.
- Be extra careful when using knives, scissors, and razors. Consider using an electric razor to shave your body.
- Be cautious when trimming your fingernails and toenails, avoiding deep wounds when removing cuticles.
- Choose a sport where there is little or no physical contact, such as swimming and walking.
- Consult your doctor before starting a new type of exercise or sport.
- Also try talking to your doctor about various drug options to find one that doesn't put you at too high a risk of bleeding if you have an injury.
Step 3. Use protective equipment
If you are taking blood thinners, you need to be very careful not to get hurt. In other words, you may want to take some precautions when doing home maintenance work or leaving the house.
- Wear a protective helmet every time you skate, skateboard, ride a bike or scooter, otherwise choose a safer physical activity.
- Choose shoes and slippers with non-slip soles to decrease the risk of falls.
- Make sure you bring gardening shoes and gloves whenever you do this kind of work. You can also wear protective gloves when handling sharp tools to avoid injury.
Step 4. Be gentle when brushing your teeth and gums
You probably think brushing your teeth is safe, but if you're taking blood thinners, your gums may start to bleed excessively. Try to take precautions by gently treating your gums and changing the way you clean your mouth.
- Use a soft-bristled toothbrush to decrease the risk of injuring your gums.
- Avoid toothpicks. Instead, clean your teeth using waxed floss carefully.
Step 5. Watch out for overdose symptoms
If you do not have the necessary blood tests and do not undergo regular medical checks, you risk taking too little or too much medication. In the case of anticoagulants, if the dosage is too high, the risk is that of undergoing heavy bleeding and the formation of hematomas.
- Get blood tests regularly if you are taking certain medications, such as warfarin. The laboratory tests will allow you to know if the drug is working properly and also prevent the risk of overdosing or underdosing.
- Bruising, gum bleeding, epistaxis, heavy menstrual flow, and long bleeding from a minor injury are common problems associated with high anticoagulant intake.
- Get regular blood tests and get them checked by your doctor. Let him know if you have any bleeding or bruising.
Step 6. Learn about the risks associated with pregnancy
Some blood thinners are not safe if you are pregnant or if you plan to get pregnant. They can increase the risk of maternal-fetal haemorrhage and fetal malformations. For this reason, doctors usually recommend that women who want to become pregnant take a blood thinner that does not cross the placenta and impairs the development of the fetus. The switch should be done before getting pregnant.
- Warfarin (coumadin), a common blood thinner, carries no risk during pregnancy.
- Heparin, another widely used anticoagulant, does not pass the placenta and, therefore, is considered safe during gestation.
Part 4 of 4: Follow Medical Prophylaxis
Step 1. Go to the doctor regularly
You will need to let him know of any changes you make to your diet or exercise regimen. You should also inform him about the vitamins or supplements you are considering taking before you start taking them.
- Check with your doctor to find out if the activities you plan to undertake may increase the risk of injury.
- Your doctor will also be able to tell you if the vitamins and supplements you would like to take are contributing to the effectiveness of blood thinners.
Step 2. Get your blood tests regularly
If you are taking anticoagulants, you need to systematically check your blood values. The degree of coagulability is calculated on the basis of a particular method of measurement, called the International Normalized Ratio or INR (English acronym for "International Normalized Ratio"). Without regular tests, your doctor will not know if you are taking the right doses of blood thinners.
- Ask your doctor how often you need to do this test. Certain factors, such as travel and food restrictions, can increase the frequency.
- If you are taking the right dose of anticoagulant, your INR will fall between 2, 5 and 3.
- If the index is less than 1, it means that the anticoagulants are not producing any effect. If it is above 5, it is very dangerous and should be reported to your doctor immediately.
Step 3. Update your pharmacist
In addition to informing your doctor, you should also make your health conditions known to your trusted pharmacist. A random mistake in prescribing certain medications can cause serious, sometimes fatal, complications.
- Tell your pharmacist that you are on anticoagulant therapy.
- Check the medications that are prescribed to you from time to time. Make sure they are the right ones and read the package insert to see if any negative interactions with anticoagulants are expected.
Step 4. Warn the emergency room doctors
If a sudden emergency occurs and you are assisted by an ambulance operator or an emergency room doctor, he will certainly not know your medical history. To avoid the risk of negative interactions with the administration of other drugs, you may want to bring a metal plate or bracelet that informs anyone who helps you that you are taking anticoagulants.
