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SALEM COMMUNITY HOSPITAL... Use blood thinner medicine safely

September 19, 2010
Salem News

More than 2 million people take blood thinners every day to keep from developing dangerous blood clots.

"Blood thinners reduce the risk of heart attack or stroke by decreasing the formation of blood clots in the arteries, veins or heart," explained Family Practice physician Karl Getzinger, M.D. "Clots can block the flow of blood to the heart muscle and cause a heart attack. They can also block blood flow to the brain, causing a stroke.

"Blood clots occur when the blood hardens and changes from a liquid to a solid. Normally, clots develop to help stop the bleeding after a person has been cut or injured. However, some clots can form inside a person's bloodstream. If this kind of clot breaks loose and gets stuck in a vital blood vessel, it can block the blood flow to important organs in your body, like the heart, brain, or lungs, causing a heart attack, stroke or pulmonary embolism. All of these conditions are serious and can lead to death."

There are several reasons why physicians prescribe a blood thinner. Some of the most common reasons are: an abnormal heart rhythm called atrial fibrillation; heart attack; stroke; deep vein thrombosis or DVT; pulmonary embolism; or after a recent surgery.

Types of Medications

There are two main types of blood thinners, called anticoagulants and antiplatelet agents. Anticoagulants are drugs that are prescribed to prevent a person's blood from clotting. Common names for anticoagulants are "heparin" or "warfarin," which is also called Coumadin.

Antiplatelet drugs prevent the blood cells, called platelets, from clumping together to form a clot. Aspirin is the most common antiplatelet drug, but others used to treat heart disease include Plavix and Ticlid.

Safety Tips

"Always take your blood thinner as directed," Dr. Getzinger added. "For example, some blood thinners need to be taken at the same time of day. Never skip a dose, and never take a double dose. If you do miss a dose, take it as soon as you remember. If you don't remember until the next day, call your doctor for instructions. If this happens when your doctor is not available, skip the missed dose, start again the next day and mark the missed dose on a calendar. A pillbox with a slot for each day may help you keep track of your medicines.

"Because blood thinner medications keep a person's blood from clotting, they also increase the chance of bleeding too much. If you are taking this drug, it is important to be careful in your daily activities that might put you at risk for getting a cut or bruise, as even a small cut can bleed more than normal.

"For patients on warfarin, a regular blood test, called a PT/INR, is needed to be sure you are not getting too much or too little medicine. INR stands for International Normalized Ratio, and indicates the amount of time it takes for your blood to clot.

"Like most medicines, blood thinner medicines can also have side effects. Some of these may include bruising easily or having your gums bleed from brushing your teeth. If you find any unusual bleeding, let your doctor know right away.

"For your own safety, you should also consider wearing a medical alert bracelet or carrying a wallet card to let others know that you are on a blood thinner medication," he suggested. "It is also important not to make major changes in your diet or start a weight-loss plan without first consulting your doctor. The foods and drinks that you consume can affect how well your blood thinner medication works. For instance, you may need to be careful about eating foods or drinking beverages high in vitamin K, because it can interfere with the way some blood thinners work. Vitamin K is found in many green leafy vegetables, as well as other kinds of foods, vitamins and herbal supplements.

"It is also important to tell each of your healthcare providers about the medicines and herbal supplements you are taking or want to take, including those that other doctors prescribe or that you buy over the counter from a neighborhood drugstore or supermarket. Medicines purchased over the counter may interact with your blood thinner. Be especially careful about taking aspirin, as it can further reduce your blood's ability to clot and you can bleed too much."

Following is a list of some common medicines and supplements that you should talk with your doctor or pharmacist about, before using in combination with a blood thinner.

Pain relievers, cold medicines, or stomach remedies, such as:

Advil, Aleve, Motrin, Tylenol, or Excedrin

Alka-Seltzer or Pepto Bismol


Midol or Pamprin HB

Tagamet HB

Vitamins and herbal products, such as:

Centrum, One a Day, or other multivitamins.

Garlic or Ginkgo biloba

Green tea

"In addition, alcoholic beverages may interfere with your medication and its overall effectiveness," Dr. Getzinger concluded. "Don't be afraid to discuss your concerns and ask questions with your physician to help ensure that you take your medicine safely."

Karl Getzinger, M.D., is a board certified Family Practice physician affiliated with Salem Community Hospital's medical staff. His office is located at 166 Vine Street in Salem, 330-337-3500; and at 356 East Lincoln Way in Lisbon, 330- 424-1404.



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