Popular Names of Blood Thinners And How They Work – Introduction
There are several medicines and drugs that are prescribed to us for our smooth and healthy functioning. Even if these medicines are for your improvement, it is best to know about them and how they function so that we are aware of their mechanism once we intake them.
Blood thinners or anticoagulants work to disrupt the formation of any clots in your bloodstream. They have their distinct mechanism of action, where they work to act on different pathways of the coagulation cascade to make sure that the blood flow remains smooth and without the formation of any clots or ‘thrombi’ that may otherwise pose a risk for the development of any harmful diseases.
In this article, we will review the names and overview of commonly used blood thinner medications. For an enhanced understanding of how they work, we will briefly discuss the steps of the coagulation cascade.
Names of Blood Thinners Used in Common Practice
With the recent advancement in medical sciences, there have been several developments in the field of pharmacology as well.
Now, there are several new medicines that work to perform their jobs better than their former counterparts. And because of this very reason, much advancement has been made for managing certain diseases and conditions in relation to former strategies.
The same could be applied in the case of blood thinners. There are several types of blood thinners available in the markets now that are not only effective but overall safe to be used by older patients as well. (1)
A brief overview of some of the popular blood thinners being used nowadays is given below:
Apixaban, Rivaroxaban, and Edoxaban
The popularly used blood thinner Apixaban is available in markets by the name of ‘Eliquis’. It is a type of blood thinner that is a selective inhibitor of the X-A clotting factor of the coagulation cascade. (2)
Factor X-A is responsible for the final step of the conversion of prothrombin to thrombin, which ultimately leads to the formation of a blood clot. Therefore, when Apixaban is taken to inhibit this very step, there would be no clot formation where it is not needed. It is mostly used for patients whit a diagnosis of atrial fibrillation or deep vein thrombosis. (3)
Rivaroxaban and Edoxaban are other blood thinners that share the same mechanism of action as Apixaban. Rivaroxaban is indicated for the management of deep vein thrombosis, while edoxaban is used for reducing the risk of stroke in patients with atrial fibrillation.
- Side Effects:
Although Apixaban, Rivaroxaban, and Edoxaban are seen to be generally well-tolerated in individuals, it was also seen that there were some side effects of using these drugs.
Bleeding, nausea, hematuria (blood in urine), and bruise formation were some of the rare side effects noticed in some individuals.
See Also: Blood Thinners Side Effects
Dabigatran is another popularly used blood thinner that is available in the markets by the name of Pradaxa. It is a potent and competitive inhibitor of thrombin. Because it is said to be a competitive inhibitor of thrombin, it was seen to bind to both clot-bound and free thrombin, impeding the formation of blood clots. (4)
However, Dabigatran is recommended to be used with extreme caution in patients with a history of hypersensitivity reactions and bleeding risks. (5)
- Side Effects:
The side effects associated with the usage of Dabigatran may include bleeding, black or red-colored stools, stomach discomfort, pain, or blood in the vomit.
Undoubtedly, one of the most popular and commonly used blood thinners is Warfarin. It is such a popularly used drug that it is widely employed for prophylactic purposes in patients with venous thromboembolism and other thromboembolic events. (6)
Warfarin is a competitive Vitamin K antagonist. Vitamin K is used by the liver for synthesizing the majority of the clotting factors involved in the coagulation cascade.
Therefore, when there would be no active Vitamin K present in the body, there would be no clotting factors available. And thus, no clot formation could take place accordingly.
Warfarin has been seen to significantly decrease the risk of death in patients already suffering from myocardial infarction, stroke, or thromboembolic events.
Warfarin is also available as an oral medicine. It is recommended to be taken once daily, and mostly, later in the day just so its dose can be adjusted by the physician. (7)
- Side Effects:
Just like every other blood thinner, Warfarin also has some side effects. The most likely side effects associated with Warfarin are bleeding incidents and hemorrhage. Hemorrhages may occur anywhere in the body, and this is why it might be difficult to manage them when they occur.
Understanding the Coagulation Cascade
- The coagulation cascade is a normal cycle or mechanism performed by the body, where it works to form a clot as soon as an injury to the endothelium (the inner lining of blood vessels) occurs. It works to save you from any significant episode of bleeding and, thus, is helpful under such emergency circumstances. (8)
- However, when a blood clot forms inside the bloodstream in a pathologic fashion caused by certain conditions, doctors indicate blood thinners.
- The coagulation cascade works under the influence of a variety of factors, all of which are activated by their other counterparts. Once activated, each of them has a specific function that helps them reach their final stage of forming a clot.
- The coagulation pathway is divided into two parts – the extrinsic pathway and the intrinsic pathway.
- The intrinsic pathway depends on getting activated by blood coming into contact with a negatively charged surface, usually collagen, which is in the surround of blood vessels. It involves clotting factors XII, XI, IX, VIII, and V.
- The extrinsic pathway, on the other hand, gets activated when the tissue factor comes in contact (gets exposed) with the circulating blood. This pathway mainly involves the tissue factor itself, along with the clotting factor VII.
- Both the extrinsic and intrinsic pathways meet at one common point, where they both work to activate factor X. The clotting factor work to convert prothrombin (or factor II) to thrombin (factor IIA), which ultimately results in the conversion of fibrinogen to fibrin.
- The latter step produces a mesh containing platelets, giving architecture to the newly formed blood clot, impeding blood losses from the blood vessel.
To summarize it all, blood thinners are indeed a life-changing and beneficial option for people who are vulnerable to developing conditions such as venous thromboembolism, heart attack, and stroke.
Blood thinners are widely available in the market by many names, and their mechanism of action differs from one another. The main purpose remains the same, and that is to avoid the formation of any type of blood clots in the bloodstream.
At the end of the day, if you have been declared as someone who is at risk of developing venous thromboembolism or heart attacks, then it is better if you visit a physician and follow the recommendations that best suit your condition to make sure that you live a healthy and happy life in the days to come!
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- Anticoagulation Drug Therapy: A Review – PMC [Internet]. [cited 2023 Apr 11]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307693/
- Agrawal A, Kerndt CC, Manna B. Apixaban. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Apr 11]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK507910/
- Byon W, Garonzik S, Boyd RA, Frost CE. Apixaban: A Clinical Pharmacokinetic and Pharmacodynamic Review. Clin Pharmacokinet. 2019;58(10):1265.
- Ganetsky M, Babu KM, Salhanick SD, Brown RS, Boyer EW. Dabigatran: Review of Pharmacology and Management of Bleeding Complications of This Novel Oral Anticoagulant. J Med Toxicol. 2011 Dec;7(4):281–7.
- Comin J, Kallmes DF. Dabigatran (Pradaxa). AJNR Am J Neuroradiol. 2012 Mar;33(3):426.
- Patel S, Singh R, Preuss CV, Patel N. Warfarin. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Apr 11]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK470313/
- Kuruvilla M, Gurk-Turner C. A review of warfarin dosing and monitoring. Proc Bayl Univ Med Cent. 2001 Jul;14(3):305.
- Palta S, Saroa R, Palta A. Overview of the coagulation system. Indian J Anaesth. 2014 Oct;58(5):515.