Blood Thinners: What You Should Know (2023)

Blood thinners are medications used to treat and prevent blood clots. Blood travels through blood vessels in a liquid form to bring oxygen and nutrients to tissues throughout the body. When blood clots form in the body, they block normal blood flow from reaching tissues, and can cause tissue death, such as in heart attack, stroke, and pulmonary embolism.

While blood thinners can be lifesaving medications, they carry a risk of bleeding. This article discusses the types of blood thinners, their medical uses, and side effects.

Blood Thinners: What You Should Know (1)

What Are Blood Thinners?

Blood thinners are medications that treat and prevent blood clots. Blood clots are semi-solid clumps of red blood cells, platelets, fibrin (a type of protein), and other proteins.

Blood clotting is an extremely important function of the body that prevents bleeding. Without blood clotting, a small cut would cause serious, prolonged bleeding.

Thrombus vs. Embolus

Another word for blood clot is "thrombus," but when a blood clot travels to another place in the body, it is known as "embolus." For example, a "pulmonary embolism" is a blood clot that has traveled from the deep veins in the leg to the arteries in the lung.

Blood clots form through two important processes: the coagulation cascade and platelet activation. Blood thinners work by targeting steps in each of these processes.

In the coagulation cascade, damaged tissue sets off a cascade of events that activates several proteins in the blood, called clotting factors. These proteins are activated through a series of steps that, ultimately, activates fibrin. Fibrin is a protein formed during the clotting process that helps stop blood flow.

Another important part of blood clots is platelets. Damaged tissue activates platelets in the blood. Activated platelets attract other platelets, and they stick to each other to plug up the wound and stop the bleeding.

Red vs. White Clots

Blood clots rich in red blood cells and fibrins are known as "red clots," whereas those rich in platelets, which are colorless, are referred to as "white clots." Red clots are found in veins (like the leg veins), whereas white clots are found more in arteries (like the coronary arteries of the heart). The distinction of red vs. white is based on the color and composition of the clots, but all clots contain varying amounts of platelets, fibrin, and red blood cells.

Why Are Blood Thinners Prescribed?

In a broad sense, blood thinners are used to treat blood clots or prevent blood clots from forming when they are dangerous to the body. The following are some specific conditions that could require blood thinners:

  • Deep vein thrombosis (DVT), a blood clot in the leg veins
  • Pulmonary embolism (PE), a blood clot in the pulmonary blood vessels
  • Acute coronary syndrome, a blood clot in the coronary arteries that causes heart attacks
  • Prosthetic heart valves
  • Left ventricular thrombus, a blood clot in the heart
  • Acute limb ischemia, a blood clot in a leg artery
  • Acute mesenteric ischemia, a blood clot in the artery feeding the bowel
  • Atrial fibrillation, an irregular and unusually rapid heartbeat
  • Hypercoagulable state, conditions that cause thick blood
  • Certain pregnancy-related conditions
  • Prevention of blood clots after certain surgeries

How Do Blood Thinners Work?

In general, all blood thinners work by either blocking or inactivating part of the system that forms blood clots. These medications work by binding to proteins that are involved in either the coagulation cascade or to proteins on platelet surfaces.

Anticoagulant medications target the coagulation cascade, whereas antiplatelet medications target platelet activation.

(Video) Blood Thinners - What You Need To Know

Types of Blood Thinners

Anticoagulants

Anticoagulant blood thinners target various proteins in the coagulation cascade. These medications are used for treating red clots, like deep vein thrombosis and pulmonary embolism, as well as preventing strokes in atrial fibrillation and mechanical heart valves.

Anticoagulants are also used during acute blood clotting in arteries (such as heart attacks, acute limb ischemia, and acute mesenteric ischemia). Examples of anticoagulants include:

  • Coumadin (warfarin)
  • Enoxaparin (low molecular weight heparin)
  • Factor X inhibitors, such as Eliquis (apixaban) and Xarelto (rivaroxaban)
  • Direct thrombin inhibitors, such as Acova (argatroban), Angiomax (bivalirudin), and Pradaxa (dabigatran)
  • Tissue plasminogen activators such as Actilyse (alteplase), TNKase (tenecteplase), and Retavase (reteplase)

Antiplatelets

Antiplatelets are medications that target the activation and aggregation of platelets. They are commonly used in the treatment and prevention of stroke and heart attacks.

Antiplatelets are also used to protect stents placed in the heart's coronary arteries and other arteries (such as carotid arteries of the neck and leg arteries in peripheral arterial disease).

Examples of antiplatelets include:

  • Aspirin
  • P2Y12 receptor blockers, such as Plavix (clopidogrel), Effient (prasugrel), and Brillinta (ticagrelor)
  • Phosphodiesterase inhibitors like Aggrenox (dipyridamole) and Pletal (cilostazole)
  • GIIb/IIIa inhibitors, such as Reopro (abciximab), Integrilin (eptifibatide), and Aggrastat (tirofiban)

Side Effects

Unsurprisingly, the main side effect of blood thinners is bleeding. People who take blood thinners will notice that a cut or nick takes longer to stop bleeding and that they bruise more easily. But serious bleeding, such as bleeding in the gastrointestinal tract or brain, can occur. These bleeds can be life-threatening.

Each specific drug has a list of side effects that can range from nausea, constipation, and headache, to shortness of breath and severe allergic reaction.

Natural Blood Thinners

Some foods and supplements are believed to have some blood thinning properties. However, they are not regulated by the Food and Drug Administration (FDA), and the concentration of active compounds in supplements is not consistent.

Always discuss any supplements you're taking or considering with your healthcare provider, as they can interfere with other medications. Supplements should never be taken as a replacement for a prescribed blood-thinning medication.

The following have some evidence of blood-thinning properties:

  • Cranberry
  • Dong quai
  • Fenugreek
  • Feverfew
  • Garlic
  • Ginger
  • Ginkgo
  • Red Clover
  • Turmeric
  • White willow

Summary

Blood thinners are important medications used for treating and preventing blood clots. These include anticoagulant and antiplatelet medications. The benefit of taking blood-thinning medications must always be weighed against their risk of serious bleeding.

A Word From Verywell

If you have been prescribed a blood thinner, it's important to pay attention to signs of bleeding, like red or black colored stool, severe headache, light-headedness, and fainting. If you notice any of these symptoms, seek medical attention right away. Also be sure to discuss any supplements you're taking with your healthcare provider, since many of them can affect how your medications work.

Frequently Asked Questions

  • How long do blood thinners stay in your system?

    This depends on the type of blood thinner, and can range from hours to days. The blood thinning effects of warfarin, aspirin, and Plavix (clopidogrel) can last for days, whereas Eliquis (apixaban) and Xarelto (rivaroxaban) wear off in about a day. Lovenox (low molecular weight heparin) wears off after about 12 hours.

    (Video) Blood Thinners, Everything You Need to Know
  • How long should you be on blood thinners?

    This depends on why your healthcare provider prescribed a blood thinner in the first place. After a heart attack or ischemic stroke, most people can expect to be on at least one blood thinner for life. People who take blood thinners to treat provoked deep vein thrombosis may only need to take them for three months.

  • What pain reliever is safe on blood thinners?

    NSAID (nonsteroidal anti-inflammatory drug) pain relievers such as Advil and Motrin (ibuprofen) and Aleve (naproxen) have blood-thinning properties and should not be combined with blood thinners. This is especially true of aspirin, since these other NSAIDs can compete with the same binding site that aspirin uses and make aspirin ineffective.

    Tylenol (acetaminophen) is generally a safe over-the-counter pain medication to take while on blood thinners.

5 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. MedlinePlus. Blood thinners.

  2. Sugerman DT. Blood thinners.JAMA. 2013;310(23):2579. doi:10.1001/jama.2013.282755

  3. American College of Obstetricians and Gynecologists. Low-dose aspirin use during pregnancy. ACOG Committee Opinion No. 743. Obstet Gynecol. 2018;132:e44–52.

  4. Leite PM, Martins MAP, Carvalho MDG, Castilho RO. Mechanisms and interactions in concomitant use of herbs and warfarin therapy: An updated review. Biomed Pharmacother. 2021;143:112103. doi:10.1016/j.biopha.2021.112103

  5. Reed GW, Abdallah MS, Shao M, Wolski K, et al. Effect of Aspirin Coadministration on the Safety of Celecoxib, Naproxen,orIbuprofen. J Am Coll Cardiol. 2018 Apr;71(16):1741-1751. doi: 10.1016/j.jacc.2018.02.036

(Video) Life on a Blood Thinner: Insights and Advice from an Anticoagulant Specialist

Blood Thinners: What You Should Know (2)

By Angela Ryan Lee, MD
Angela Ryan Lee, MD, is board-certified in cardiovascular diseases and internal medicine. She is a fellow of the American College of Cardiology and holds board certifications from the American Society of Nuclear Cardiology and the National Board of Echocardiography. She completed undergraduate studies at the University of Virginia with a B.S. in Biology, medical school at Jefferson Medical College, and internal medicine residency and cardiovascular diseases fellowship at the George Washington University Hospital. Her professional interests include preventive cardiology, medical journalism, and health policy.

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(Video) Diet considerations when taking blood thinners | Ohio State Medical Center

(Video) Blood Thinners - What They Are, Who Needs Them, Side Effects & More

FAQs

Should I be worried about taking blood thinners? ›

Blood thinning medications do save lives, because they can treat or prevent dangerous blood clots. But, they also pose one possible and very serious side effect: Bleeding. Since blood thinners slow the clotting of blood, unwanted and sometimes dangerous bleeding can occur with the use of these medications.

What are the disadvantages of taking blood thinners? ›

Side effects Anticoagulant medicines
  • passing blood in your urine.
  • passing blood when you poo or having black poo.
  • severe bruising.
  • prolonged nosebleeds (lasting longer than 10 minutes)
  • vomiting blood or coughing up blood.
  • sudden severe back pain.
  • difficulty breathing or chest pain.

Are blood thinners hard on your body? ›

Blood thinners can prevent clotting and stave off growth of existing clots, but they are not without risks. Bleeding is the primary risk associated with blood thinners. This potential side effect can be mild or serious, ranging from bruising to hemorrhagic stroke, bleeding in the brain that requires emergency care.

Can you live a normal life on blood thinners? ›

Life with blood thinners can be overwhelming at first, but eventually, you can still live a very normal life with these medications. Blood thinners do not actually thin your blood, and they do not heal or dissolve blood clots.

Is being tired on blood thinners normal? ›

Aside from bleeding-related issues, there are several side effects that have been linked to blood thinners, such as nausea and low counts of cells in your blood. Low blood cell count can cause fatigue, weakness, dizziness and shortness of breath.

How long is too long to be on blood thinners? ›

Blood thinner treatment for PE is usually advised for at least 3-6 months. Your healthcare provider may advise a longer course depending on why you had the blood clot. Some people at high risk of blood clots may stay on blood thinner indefinitely.

What vitamins should be avoided when on blood thinners? ›

If you are a heart patient who is taking blood thinners, such as warfarin (Coumadin®), you need to be careful not to overdo vitamin K. Blood thinners are often prescribed for people at risk for developing harmful blood clots.

Who should avoid blood thinners? ›

Your doctor likely won't recommend blood thinners if you have:
  • Stomach ulcers or other issues that up your risk for internal bleeding.
  • Uncontrolled high blood pressure.
  • Thrombocytopenia (low blood platelet count)
  • Bleeding disorders (such as hemophilia)
7 May 2022

Can you fly when on blood thinners? ›

If you have a history of blood clots or have recently been treated for them, your risk of developing a PE or DVT while flying may be elevated. Some medical professionals recommend waiting for four weeks after treatment is complete before taking to the air.

Do blood thinners affect exercise? ›

Those individuals taking anticoagulants should avoid high-impact or injury-prone activities, such as hockey, soccer, skiing or football. On the other hand, it is important to stay active to keep your heart and vascular system as healthy as possible.

What can I take instead of blood thinners? ›

Natural blood thinners are substances that reduce the blood's ability to form clots.
...
Some foods and other substances that may act as natural blood thinners and help reduce the risk of clots include the following:
  • Turmeric. ...
  • Ginger. ...
  • Cayenne peppers. ...
  • Vitamin E. ...
  • Garlic. ...
  • Cassia cinnamon. ...
  • Ginkgo biloba.

Do blood thinners make you cold and tired? ›

A blood thinner works by slowing or impairing the blood's ability to clot, Dr. Andersen said, and will not make someone feel colder.

Do blood thinners affect appetite? ›

Common side effects of anticoagulants include stomach upset, loss of appetite, bloating, and diarrhea. If the dosage is too high, blood may be seen in the urine or stool or around the gums, or frequent nosebleeds may occur.

Do blood thinners weaken your immune system? ›

A new study indicates that a newly approved blood thinner that blocks a key component of the human blood clotting system may increase the risk and severity of certain viral infections, including flu and myocarditis, a viral infection of the heart and a significant cause of sudden death in children and young adults.

Is insomnia a side effect of blood thinners? ›

Purpose: Insomnia is an important adverse event of mechanical thromboprophylaxis. This sleep disorder has been reported as one of the commonest adverse events of the new oral anti-Xa anticoagulant darexaban, with similar rates to mechanical thromboprophylaxis in a randomized controlled trial (RCT).

Can blood thinners cause eye problems? ›

One thing to consider is blood thinners. A lot of patients are on blood thinners, such as Coumadin and Eliquis, and these drugs can make the bleeding and macular degeneration worse if they have the wet type.

What is the safest blood thinner to use? ›

The DOACs — apixaban (Eliquis®), dabigatran (Pradaxa®), edoxaban (Savaysa®), and rivaroxaban (Xarelto®) — are given in fixed doses, do not require INR monitoring, have few medication interactions, do not require dietary restrictions, and carry a lower risk of bleeding compared with warfarin, Dr.

Can you have a stroke while on blood thinners? ›

Unfortunately, the blood thinners used to prevent such blood clots can increase the risk of bleeding in the brain, a cause of hemorrhagic stroke.

What happens if you drink alcohol while taking blood thinners? ›

Both alcohol and blood thinners like warfarin (Coumadin) thin your blood. Taking both together could compound the anticoagulant effect and increase your risk of bleeding. Alcohol might also slow down the rate at which your body breaks down and removes the blood-thinning drug.

Can you take vitamin D with blood thinners? ›

Vitamin D does not interact with your Coumadin. Your INR level (blood thinning level) may be affected by many different things, including the amount of vitamin K in your diet or multivitamins.

What fruit is a natural blood thinner? ›

Natural Aids in Thinning Blood

Meanwhile there are fruits that can aid in blood thinning. These include blueberries, cherries, cranberries, grapes, oranges, prunes, raisins, strawberries and tangerines.

Can you have caffeine while taking blood thinners? ›

Anticoagulant drugs

Health experts advise caution when combining them with coffee, which can also slow blood clotting. Mixing these medications with caffeine can increase the chances of excessive bleeding and bruising, notes RXList.com.

Are there foods to avoid while on blood thinners? ›

Soybeans – These beans are a great source of protein but have too much Vitamin K, over 35% of a person's daily intake. Swiss chard – Is a leafy green vegetable that has a high source of iron but contains too much Vitamin K for someone who is taking blood thinners – over 100% of a person's daily intake.

What are the first signs of a blood clot? ›

Symptoms of a blood clot include: throbbing or cramping pain, swelling, redness and warmth in a leg or arm. sudden breathlessness, sharp chest pain (may be worse when you breathe in) and a cough or coughing up blood.

Can exercise dislodge a blood clot? ›

But exercise can help dissolve blood clots.

Can you feel a blood clot move up your leg? ›

It may feel like you have a charley horse or cramp in your leg. If you have trouble breathing, it could mean that the blood clot has moved from your leg to your lungs. You may cough up blood or feel dizzy.

What activities can you do on blood thinners? ›

Hence be careful with activities of daily living that may put you at risk. However, extreme sports such as football, basketball, soccer, rugby, mountain biking, skiing and so forth put you at high risk of life-threatening bleeding. Such sports are best left alone. Running, walking, stationary biking are safe to enjoy.

Can you lift heavy weights while on blood thinners? ›

Low-impact activities such as walking, biking, yoga, Pilates and strength training are all fine. But if you enjoy higher-risk sports, ask your doctor if they're safe for you, the NBCA advises.

Do you heal slower on blood thinners? ›

Unfortunately, although these medications are helpful to address those medical conditions, they can adversely affect the healing of wounds. Since anticoagulants thin the blood, patients that experience a chronic wound are at risk of excessive bleeding, or their healing process may be slow.

Which fruit is good for blood clots? ›

Citrus Fruit

The antioxidants found in the fruit may help lower inflammation, prevent blood clots, and improve blood circulation.

What is the number one prescribed blood thinner? ›

The most commonly prescribed anticoagulant is warfarin.

Can blood thinners cause blurry vision? ›

Blurred vision. Chest pain. Severe weakness or dizziness. Tingly hands, feet, or face.

Does blood thinner lower blood pressure? ›

An interesting question. I can see where you might think that a blood thinner may also help lower your pressure. But no, there is no medication that substantially does both.

Does eliquis make you pee a lot? ›

Do not be alarmed by the list of side effects. You may not experience any of them. Ask your doctor or pharmacist to answer any questions you may have. frequent need to urinate or pain while urinating • coughing.

Does thin blood make you feel cold? ›

Your blood helps spread the warmth and oxygen throughout your body, and not having enough blood can lead to you feeling cold.

What are some potential problems with thin blood? ›

Thin blood presents problems with clotting, wound healing, and bruising. On the other hand, thick blood can increase the risk of blood clots and thrombosis, which can be life threatening.

Are blood thinners hard on your stomach? ›

For some patients on blood thinners, gastrointestinal bleeding caused by those medications is an adverse event that can be disabling or even fatal. New research highlights two strategies to potentially reduce the risk.

Is Covid worse for people on blood thinners? ›

- High-dose blood thinners result in little or no difference in death rate and increase minor bleeding compared to low-dose blood thinners for people hospitalised with COVID-19.

How do blood thinners affect the brain? ›

A new study shows that people who take the commonly used blood thinning drug warfarin may have larger amounts of bleeding in the brain and increased risk of death if they suffer a hemorrhagic stroke.

Can you get your teeth cleaned on blood thinners? ›

Dental prophylaxis, or teeth cleaning, is a common dental procedure that dentists can most likely provide while a patient is on blood thinners. While bleeding can occur, there are many techniques in dental care to staunch or slow bleeding.

Do I really need blood thinners? ›

Who needs blood thinners? Blood thinners are prescribed for people who have an increased risk of heart attack or stroke due to an irregular heart rhythm, heart or blood vessel disease, deep vein thrombosis (DVT), or prior heart attack or stroke.

Who should avoid blood thinners? ›

Your doctor likely won't recommend blood thinners if you have:
  • Stomach ulcers or other issues that up your risk for internal bleeding.
  • Uncontrolled high blood pressure.
  • Thrombocytopenia (low blood platelet count)
  • Bleeding disorders (such as hemophilia)
7 May 2022

Why would I be on blood thinners? ›

They're given to people at a high risk of getting clots, to reduce their chances of developing serious conditions such as strokes and heart attacks. A blood clot is a seal created by the blood to stop bleeding from wounds.

Can I skip a day of blood thinners? ›

Never skip a dose, and never take a double dose. If you miss a dose, take it as soon as you remember. If you don't remember until the next day, call your doctor for instructions. If this happens when your doctor is not available, skip the missed dose and start again the next day.

Can you fly when on blood thinners? ›

If you have a history of blood clots or have recently been treated for them, your risk of developing a PE or DVT while flying may be elevated. Some medical professionals recommend waiting for four weeks after treatment is complete before taking to the air.

What can you do instead of taking blood thinners? ›

Natural blood thinners are substances that reduce the blood's ability to form clots.
...
Some foods and other substances that may act as natural blood thinners and help reduce the risk of clots include the following:
  • Turmeric. ...
  • Ginger. ...
  • Cayenne peppers. ...
  • Vitamin E. ...
  • Garlic. ...
  • Cassia cinnamon. ...
  • Ginkgo biloba.

Are there foods to avoid while on blood thinners? ›

Soybeans – These beans are a great source of protein but have too much Vitamin K, over 35% of a person's daily intake. Swiss chard – Is a leafy green vegetable that has a high source of iron but contains too much Vitamin K for someone who is taking blood thinners – over 100% of a person's daily intake.

What vitamins should be avoided when on blood thinners? ›

If you are a heart patient who is taking blood thinners, such as warfarin (Coumadin®), you need to be careful not to overdo vitamin K. Blood thinners are often prescribed for people at risk for developing harmful blood clots.

What is the safest blood thinner to use? ›

The DOACs — apixaban (Eliquis®), dabigatran (Pradaxa®), edoxaban (Savaysa®), and rivaroxaban (Xarelto®) — are given in fixed doses, do not require INR monitoring, have few medication interactions, do not require dietary restrictions, and carry a lower risk of bleeding compared with warfarin, Dr.

What happens if you drink alcohol while taking blood thinners? ›

Both alcohol and blood thinners like warfarin (Coumadin) thin your blood. Taking both together could compound the anticoagulant effect and increase your risk of bleeding. Alcohol might also slow down the rate at which your body breaks down and removes the blood-thinning drug.

Do blood thinners affect urination? ›

Blood thinners often lead to blood in urine severe enough to require medical help, new study finds.

Do blood thinners make you feel cold? ›

A blood thinner works by slowing or impairing the blood's ability to clot, Dr. Andersen said, and will not make someone feel colder.

› ... › Cardiovascular Health ›

The two main types of blood thinners are anticoagulants, which include warfarin and heparin, and antiplatelet drugs, such as aspirin. Common blood thinner medic...

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