How Dangerous Are Blood Thinners?

More than two million Americans are prescribed blood thinners every year. They are prescribed for many reasons and save countless lives, but they also have serious side effects. Can blood thinners do more harm than good?

What Are Blood Thinners?

The term “blood thinner” refers to any drug that slows or prevents unnecessary clots from forming. The most common prescription blood thinner is warfarin (Coumadin). It’s been on the market for several decades and is typically the most affordable option. It is also difficult to dose correctly, requires frequent blood tests, and has many potentially deadly drug and food interactions.

Some newer drugs have fewer side effects that require no lab work and are easy to dose, but they’re usually more expensive (most are only available in the brand name). The most common medications are apixaban (Eliquis), dabigatran (Pradaxa), enoxaparin (Lovenox), rivaroxaban (Xarelto), clopidogrel (Plavix), and ticagrelor (Brilinta).

Why Are Blood Thinners Prescribed?

Blood thinners are prescribed for many reasons, including:

• Heart Disease, like atrial fibrillation or prior heart attack
• Cerebrovascular disease, such as a history of stroke
• To prevent clots on artificial heart valves and stents
• A history of blood clots in the lungs or legs
• To prevent clots after surgery that limits mobility

There is a preferred blood thinner for every situation, but most doctors turn to warfarin when the cost is an issue.

Are Blood Thinners Dangerous?

In short: yes. The real question is, what is the greater danger - the blood thinner or your risk of a deadly clot? The answer isn’t always obvious and is rarely explained to the patient. In fact, many doctors fail to mention that there are two options, so how can you know to question the risks inherent in each choice - take the blood thinner and risk a life-threatening bleed, or don’t take it and risk a life-threatening clot.

The biggest problem with blood thinners is that they prevent blood from clotting. That’s why we use them, but it’s also what makes them so dangerous. Blood clots are typically helpful; they’re the reason you don’t bleed out with every papercut. When we stop the blood from clotting, even small injuries can become deadly. When bleeding happens internally, such as from an undiagnosed stomach ulcer or a minor car accident, many people don’t know there’s a problem until they’ve already lost a substantial amount of blood. Dosing errors and poor monitoring can compound these risks and have horrible outcomes, such as spontaneous bleeding in the brain that can cause permanent brain damage or death. The risks are real and should not be discounted.

Warfarin is particularly problematic because it has a huge number of food, supplement, and drug interactions. Even something simple, like a dentist prescribing a course of antibiotics and ibuprofen, can affect your warfarin levels enough to cause spontaneous, potentially fatal bleeding. The inverse is also true - if you decide to start eating more salads (excessive intake of leafy greens is a significant drug-food interaction), warfarin becomes less effective. A clot could form and cause a heart attack or stroke even though you’re taking your medication “correctly.”

Also, many blood thinners cannot be used during pregnancy. This may not be a problem for most, but it’s a significant concern for women of childbearing age. Pregnant women are five times more likely to develop a blood clot than non-pregnant women, so choosing the correct blood thinner in these situations is crucial.

My Doctor Wants To Prescribe A Blood Thinner. What Should I Do?

Like with any medication, doctors should prescribe blood thinners only if the benefits outweigh the risks. If you have any concerns, don’t be afraid to get a second opinion. It’s also important to understand both choices' potential consequences and determine whether you’re ok with the risks of taking versus not taking a blood thinner.

For example, atrial fibrillation is known to increase your risk of stroke fivefold. Stroke becomes even more of a concern if you’re female, over age 65, have diabetes, or high blood pressure. Blood thinners can be a literal lifesaver for these patients, as it’s been proven that blood thinners can lower the risk of stroke by up to 60 percent and reduce overall mortality by 25 percent. Despite this, whether or not you agree with your doctor to start a blood thinner should be based on where your risk falls. If you’re young, male, and otherwise healthy, your risk of stroke may be significantly lower than the average. Additionally, if you lead an active lifestyle (or are particularly injury-prone), the potential for a blood thinner to cause a serious bleed could outweigh the risk of a stroke.

Lifestyle is often overlooked, but it’s important when deciding whether to start a blood thinner and which one to choose. If your occupation or favorite activity has a high potential for injury and you’re unwilling to change your lifestyle, then a blood thinner might do you more harm than good. At the very least, you want to avoid blood thinners with a higher risk of bleeding, such as warfarin.

If you’re unable to make it to the clinic for frequent blood tests or unable to handle a potentially complex and frequently-changing dosing regimen, then warfarin is probably not for you either. And while one of the newer blood thinners might be the safest option, it won’t do you any good if you can’t afford to pay for it.

I’ve Suffered a Clot or Bleed - Was It Malpractice?

Clots and bleeds are frequently unpredictable and unavoidable. But if you’ve suffered either of these conditions and believe a doctor could have prevented it, then you may have a valid medical malpractice suit. 

Some of the most common examples of blood thinner-related malpractice cases involve improper prescribing, monitoring, or teaching how to safely use warfarin. Perhaps your doctor or pharmacy overlooked a critical interaction with a prescription drug. Or maybe your doctor didn’t monitor your blood levels appropriately (or did not act on it when your numbers went too high or too low). Your doctor or pharmacist may have neglected to inform you of the potential for interactions with supplements or over-the-counter medications that they knew you routinely take. Or perhaps you called your doctor to report excessive bleeding, and they told you not to worry about it and stay home. If any of these situations caused a life-threatening bleed or clot, then you may be entitled to compensation.

Some of these situations will still apply to the newer blood thinners, but they are typically easier to prescribe properly and have far fewer drug interactions. However, if your doctor did not adjust your dose (if indicated) to account for your kidney function, weight, or age, you could be entitled to compensation for any injuries resulting from this improper prescribing. You could also, perhaps, make a case for malpractice if a doctor insisted on prescribing one of these newer medications knowing you couldn’t afford the exorbitant price tag. If you can’t afford a medication and they refuse to change your prescription to an affordable alternative (if there is one indicated for your condition), then it’s no different than them refusing to prescribe anything at all, knowing a blood thinner could save your life.

If any of these situations seem to apply to you, or if you just feel that “this didn’t have to happen,” then find an attorney right away to see if you have a case. In Pennsylvania, there is a two year time limit to file a claim, so it’s important not to delay.

Why Choose Ross Feller Casey?

A good legal team is essential when you’re trying to prove a malpractice case, and the lawyers at Ross Feller Casey are among the best. We have doctors on our legal team, so we understand the medical complexities that can contribute to a malpractice case involving a blood clot or life-threatening bleed. In the past five years alone, we’ve recovered over $1 billion for our clients, including more than 50 $10-million-plus verdicts and settlements. We have the expertise it takes to get the justice and compensation that you deserve. Contact us today for a free consultation. And, as always, you don’t owe us a dime unless you win your case.