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    Anticoagulants for Coronary Artery Disease

    Anticoagulants for Coronary Artery Disease

    Examples

    Unfractionated heparins

    Generic Name
    heparin

    Low-molecular-weight heparins

    Generic Name Brand Name
    dalteparin Fragmin
    enoxaparin Lovenox

    Coumarins

    Generic Name Brand Name
    warfarin Coumadin

    Direct thrombin inhibitors (only used in the hospital)

    Generic Name Brand Name
    bivalirudin Angiomax
    fondaparinux Arixtra
    lepirudin Refludan

    How It Works

    Anticoagulants are often called blood thinners, but they don't really thin blood. They work by increasing the time it takes for a blood clot to form. This prevents an existing clot from increasing in size, thereby preventing a heart attack or stroke .

    Why It Is Used

    Anticoagulants are not typically used to treat coronary artery disease. But you might take them after having angioplasty or bypass surgery. You might take an anticoagulant if you also have atrial fibrillation or other complications.

    How Well It Works

    Anticoagulants lower the risk of problems caused by blood clots, such as a heart attack or stroke. 1

    Side Effects

    All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

    Here are some important things to think about:

    • Usually the benefits of the medicine are more important than any minor side effects.
    • Side effects may go away after you take the medicine for a while.
    • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

    Allergic reaction

    Call 911 or other emergency services right away if you have:

    • Trouble breathing.
    • Swelling of your face, lips, tongue, or throat.

    Call your doctor if you have:

    • Hives.

    Bleeding

    Call 911 or other emergency services right away if you have:

    • A sudden, severe headache that is different from past headaches. (It may be a sign of bleeding in the brain.)

    Call your doctor now or seek immediate medical care if you have:

    • Any abnormal bleeding, such as:
      • Nosebleeds.
      • Vaginal bleeding that is different (heavier, more frequent, at a different time of the month) than what you are used to.
      • Bloody or black stools, or rectal bleeding.
      • Bloody or pink urine.

    If you are injured, apply pressure to stop the bleeding. Realize that it will take longer than you are used to for the bleeding to stop. If you can't get the bleeding to stop, call your doctor.

    Heparin: Side effects often happen at injection sites. These side effects include:

    • Pain.
    • Irritation.
    • Bruising.

    Warfarin: Other side effects include:

    • Skin rash.

    See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

    What To Think About

    When you take anticoagulants, you need to take extra steps to avoid bleeding problems.

    For more information, see:

    Click here to view an Actionset. Warfarin: Taking Your Medicine Safely
    Click here to view an Actionset. Blood Thinners Other Than Warfarin: Taking Them Safely

    Long-term use of heparin is not typically recommended. It requires one or two injections each day. And long-term use is linked with osteoporosis .

    Taking medicine

    Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

    There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

    Advice for women

    Warfarin

    Do not take warfarin if you are pregnant. Warfarin can cause miscarriage or birth defects. If you are taking warfarin, talk to your doctor about how you can prevent pregnancy.

    If you think you might be pregnant: Call your doctor. If you are pregnant, you will take heparin during your pregnancy.

    If you plan on getting pregnant: Talk with your doctor. You and your doctor will decide which medicine you will take?warfarin or heparin?while trying to get pregnant.

    Heparin

    If you are pregnant: You will take heparin during your pregnancy. Heparin has not been shown to affect the fetus.

    For more information, see Pregnancy and the Increased Risk of Developing Blood Clots.

    Checkups

    Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

    Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

    References

    Citations

    1. Antithrombotic drugs (2011). Treatment Guidelines From The Medical Letter, 9(110): 61?66.

    Credits

    By Healthwise Staff
    Primary Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
    Specialist Medical Reviewer Robert A. Kloner, MD, PhD - Cardiology
    Last Revised August 9, 2013

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