{"id":48345,"date":"2022-02-03T10:00:38","date_gmt":"2022-02-03T15:00:38","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=48345"},"modified":"2022-01-25T12:35:04","modified_gmt":"2022-01-25T17:35:04","slug":"new-blood-thinners","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/new-blood-thinners\/","title":{"rendered":"Are new blood thinners better than Coumadin?"},"content":{"rendered":"

Blood thinners are a class of medications, also known as <\/span>anticoagulants<\/span><\/a>, that have one main purpose: to keep your blood flowing smoothly through your veins and arteries. They do so by preventing blood clots from forming initially, and keeping existing blood clots from getting any bigger. Blood clots are dangerous because they can move through your bloodstream, lodge somewhere\u2014like your heart, lungs, or brain\u2014and prevent essential blood flow. Blood thinners are part of the treatment plan for many cardiovascular conditions, from <\/span>atrial fibrillation<\/span><\/a>, or irregular heart rhythm, to <\/span>deep vein thrombosis.<\/span><\/a>\u00a0<\/span><\/p>\n

Historically, there was one main oral blood thinner\u2014Coumadin (warfarin)\u2014that could prevent these life-threatening issues. But, it came with some drawbacks. If you\u2019ve watched any TV lately, you\u2019ve likely seen advertisements for the new blood thinners that were created to fix those issues, like <\/span>Xarelto and Eliquis<\/span><\/a>. Read on to learn everything you need to know about these alternatives to Coumadin.<\/span><\/p>\n

The problem with Coumadin<\/span><\/h2>\n

Coumadin (warfarin)<\/span><\/a> is one of the oldest cardiac medications, first popularized when President Dwight D. Eisenhower had a heart attack while in office. It\u2019s very effective at preventing clots by inhibiting vitamin K, a vitamin your body uses to create the proteins it needs to clot your blood. The drawback is that changes in certain diet and eating habits\u2014like consuming varying amounts of foods rich in vitamin K (rather than eating a consistent amount) or <\/span>drinking alcoholic beverages<\/span><\/a>, can affect the blood\u2019s ability to clot. Excess vitamin K can make the blood more likely to clot. This is why healthcare providers recommend patients who take warfarin eat a consistent amount of foods rich in vitamin K. On the other hand, alcohol can thin the blood. People taking Coumadin need frequent blood tests to check their status and constant dose adjustments to achieve the perfect balance between bleeding too much or forming clots.\u00a0<\/span><\/p>\n

What are new blood thinners?<\/span><\/h2>\n

Between 2010-2015 a series of new blood thinners hit the market,<\/span> each deemed either more or equally effective compared to warfarin for clot prevention by the U.S. Food and Drug Administration (FDA).\u00a0\u00a0<\/span><\/p>\n

    \n
  1. Pradaxa (dabigatran)<\/span><\/a>, initial approval 2010<\/span><\/li>\n
  2. Xarelto (rivaroxaban)<\/span><\/a>, initial approval 2011<\/span><\/li>\n
  3. Eliquis (apixaban)<\/span><\/a>, initial approval 2012<\/span><\/li>\n
  4. Savaysa (edoxaban)<\/span><\/a>, initial approval 2015<\/span><\/li>\n<\/ol>\n

    These drugs were initially referred to as novel oral anticoagulants (NOACs). Now that they have been around for over five years, the <\/span>preferred term<\/span><\/a> is direct-acting oral anticoagulants (DOACs). \u201cWith the first, Pradaxa, out since 2010, they\u2019re not so novel anymore,\u201d explains <\/span>Frank Dorsa, MD<\/span><\/a>, a cardiologist with the NewYork-Presbyterian Medical Group Hudson Valley in New York. Savaysa, the last to be approved, has never captured as large a market share as Eliquis or Xarelto as it did not offer any significant advantage over the other three DOACs.<\/span><\/p>\n

    How do new blood thinners work?<\/span><\/h2>\n

    Blood thinners don\u2019t actually make the blood thin, explains <\/span>Raman Mitra, MD<\/span><\/a>, a cardiologist and director of the electrophysiology laboratory at <\/span>North Shore University Hospital<\/span><\/a> in New York. There are a dozen or so proteins in the blood that collaborate in clotting, and if any one of those elements is impeded, blood takes longer to clot, and therefore the chance of a stroke is lessened. Instead of inhibiting vitamin K, each of the new blood thinners interferes with a key step in clot formation.\u00a0<\/span><\/p>\n

    The result is a more reliable clotting effect. Meaning, the dosage doesn\u2019t need to be constantly tinkered with, and your diet doesn\u2019t affect how well it works. It\u2019s less of an impediment to a person\u2019s life.<\/span><\/p>\n

    What makes new blood thinners better than Coumadin?<\/span><\/h2>\n

    Warfarin has two clear strengths the DOACs don\u2019t have. First, it is the only option for those with a mechanical heart valve, says Dr. Mitra. Also, warfarin is by far the least expensive. However, warfarin alternatives are a better choice in almost every other way. According to Dr. Mitra and Dr. Dorsa, new blood thinners:\u00a0<\/span><\/p>\n