How Safe Are Anticoagulants?

Anticoagulants are agents designated to prevent or slow down the process of blood clotting

. Although blood clotting is essential to prevent massive blood loss in case of an external or internal injury, when the process is stronger than needed blood clots will form which can block blood vessels and cause heart attack or stroke. Anticoagulants reduce the bloods ability to form clots. However they can only prevent an existing clot from worsening but they cannot dissolve it.

Anticoagulants fall into three categories: inhibitors of clotting factor synthesis, inhibitors of thrombin and antiplatelet drugs. Drugs from the first category inhibit the production of certain clotting factors in the liver like vitamin K. Thrombin inhibitors work by attaching itself to the thrombin, an enzyme responsible for the clotting process and by doing so affecting its ability to clot. Finally drugs from the third category interact with platelets, a type of blood cells to block them from aggregating into clots. Anticoagulants can be used as medications for a series of conditions or in medical devices like blood transfusion bags, test tubs or renal dialysis equipment.

Anticoagulants are normally prescribed for treatment of disorders characterized by abnormal blood clotting like deep vein thrombosis, atrial fibrillation or pulmonary embolism. They can also be used to reduce the chance of clots forming after a heart surgery, bypass surgery or replacement of a heart valve. The medications are available in form of pills or injectable liquids. Normally it takes up to 48 hours for an anticoagulant to work, so if immediate effect is needed patients should receive intravenous heparin.

Although undoubtedly efficient drugs, anticoagulants due to their capacity of interfering with the blood clotting process can also cause massive uncontrollable bleeding and therefore put patients lives in danger. That is why before beginning a treatment or during one, patients should inform their doctors if they are facing a surgery or even a dental procedure.

Lets take for example Pradaxa. The drug based on dabigatran etexilat is an anticoagulant from the thrombin inhibitor class. It was approved in the U.S. in 2010 as a replacement for warfarin, as it needs less supervision from the therapist during treatment. The products label however warns patients regarding the potential side effects. According to the manufacturing company the most common injuries related to the drug are gastrointestinal problems. Patients can suffer from indigestion, burning sensations, stomach upset and pain which in severe cases can lead to internal bleeding. The problems are believed to be caused by the tartaric acid present in the capsules. The substance which lowers the gastric pH is needed for the proper absorption of the drug. So patients who previously suffered from gastric ulcer are advised to avoid taking Pradaxa.

Other serious side effects can be related to allergic reactions towards any of the drugs components. If patients notice during treatment dizziness, headaches, swelling of the face or tongue, difficulty breathing or itching sensations they should contact a doctor as soon as possible.

However the most severe side effects of Pradaxa are related to internal bleeding. The manufacturing company advises patients to ask immediate medical support if they notice any of the following symptoms of severe internal bleeding: frequent nose bleed, bleeding from the gums, vomiting blood, coughing up blood, pink color urine, unusual bruises that get larger or swelling of the feet and ankles. Because of these risks patients with previous kidney problems, bleeding problems, pregnant women or patients older than 70 are advised to avoid taking the medication. However what the drug manufacturing company does not mention is the percent of patients who will be affected by severe bleeding.

Due to proper commercials Pradaxa was largely used by Americans after its approval. Within the first year the drug was prescribed to around 1 million individuals. Surprisingly enough a considerable number of them complained about internal bleeding and there are a couple of hundred death reports filled. The Food and Drug Administration consider the number to high so they decided to start an official search. As the research is still ongoing scientist were able so far to establish that the number of patients who are likely to suffer a heart attack is 30 percent higher for individuals treated with Pradaxa comparing to patients taking warfarin. That means that besides exposing patients to life threatening risks the medication is not efficient as believed to be. So it is not a surprise that some injured patients decided to take the case to court by filing a Pradaxa lawsuit. Although product liability lawsuits can be hard to win, with the support of the right lawyer these people have a chance to recover the costs of their additional treatments and suffering.

by: Cumurciuc Andrea

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