Anticoagulants are the drugs affecting blood coagulation factors and used to prevent harmful blood clots, which can cause serious conditions like Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE), or a Stroke.
© Classification of Anticoagulants:
o
Coumarins (Oral)
· Warfarin
· Acenocoumarol
· Dicoumarol
· Ethyl biscoumacetate
· Phenprocoumon
o
Indandiones (Oral)
· Phenindione
· Fluindione
o
Factor Xa inhibitors
· Fondaparinux sodium
· Rivaroxaban (Oral)
o
Heparin
o
Low Molecular Weight Heparins (LMWH)
· Enoxaparin
· Dalteparin
· Tinzaparin
· Bemiparin
· Certoparin
· Nadroparin
· Parnoparin
· Reviparin
o
Heparinoids
· Danaparoid
· Dermatan sulphate
· Pentosan polysulfate
· Suleparoid, Sulodexide
o
Direct Thrombin inhibitors
· Hirudins - Bivalirudin, Desirudin, Lepirudin
· Synthetic Thrombin Inhibitors – Argotroban
· Dabigatran etexilate (Oral)
© Contraindicated Anticoagulant Combinations:
o Antithrombotics + Defibrotide
o Heparin + Telavancin or Oritavancin
o Dabigatran + Itraconazole or Ketoconazole
o NSAIDs (Ibuprofen, Diclofenac, Naproxen, etc)
o Selective serotonin reuptake inhibitors (SSRIs) (Fluvoxamine,
Paroxetine, Vortioxetine, Escitalopram,
Sertraline, Nefazodone, vilazodone)
o Selective Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
(Venlafaxine, Desvenlafaxine, Duloxetine, Milnacipran, Levomilnacipran,
Sibutramine)
o Antiplatelet agents (Aspirin, Clopidogrel, Ticagrelor,
etc)
o Fibrinolytics (Alteplase, Retaplase, Tenecteplase,
Streptokinase, Urokinase)
o Fenofibrate
o Orlistat
o Coenzyme Q10
o St.John's Wort
o Fenugreek
o Ginger
o Anise
o Clove Oil
o Asafetida
o Capsaicin
o Evening primrose oil
o Licorice
o Celery
o Ginkgo
o Garlic
o Papaya
o Chamomile (Matricaria chamomilla)
o
Do
not double the dose to compensate a missed one.
o
Do
not forget to discuss with your surgeon or dentist about the regular use of
Anticoagulant prior to any surgery.
o
Talk
to your Physician or Pharmacist before taking any other medications, including
prescription and OTC (Over-The-Counter) medicines.
o
Contact
your doctor if you develop severe diarrhea, an infection or a fever.
o
Seek
immediate medical advice if there is signs of bleeding such as blood in your
stools or urine, nose-bleeds, bleeding gums, excessive menstrual bleeding or
excessive bruising.
o
Be
careful with knives and try to minimize the risk of falling.
o
Always
adhere to the prescribed dosage schedule.
o
Wear
or carry an identification stating that You are on Anticoagulant.
© Drug interactions can result in significant morbidity and mortality
and thus minimizing the risk for drug interactions should be a goal in drug
therapy.
© The patients with clotting disorders should bring a list of all of
the drugs they are taking including prescription drugs, over-the-counter drugs,
and any supplements, herbal or otherwise, during their visit to the doctor or
pharmacist.
© The risk of adverse effects could be reduced by healthcare
professionals through the screening, education, and follow up on suspected drug
interactions.
© If possible, the patients are recommended to fill all their
prescriptions at one pharmacy.
© Pharmacists can play a crucial role in identifying possible drug
interactions by asking patients on Anticoagulants about their herbal and other
alternative medicine product use.
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