Sunday, 15 May 2016

Ten Blood Thinners Available On The Market Today


By Michael Monheit

According to BloodThinnerHelp.com, millions of Americans are prescribed blood thinners every year to treat conditions such as clotting disorders and atrial fibrillation. These drugs are also frequently used after knee and hip replacement surgery for the prevention of blood clots. Despite the number of prescriptions written on a daily basis, many are unaware of the potential risks that are associated with the use of blood thinners.

How Do Blood Thinners Work?

Despite the name “blood thinner”, these drugs don’t actually thin the blood. All blood thinners fall into two categories:

Anticoagulants

Drugs that fall into the anticoagulant category work to slow down the speed at which the body forms a blood clot by interrupting the chemical process in the blood which results in a clot. In order to form a clot, the body requires Vitamin K. Anticoagulants actually compete with the Vitamin K, taking its place in the clotting process and disrupting reactions which would normally follow the binding of the vitamin.

Antiplatelets

During the formation of a clot, platelets release thromboxane which acts like a signal to other platelets. This signal results in the platelets sticking together and forming a clot. Antiplatelets work to prevent the release of thromboxane.

The Most Commonly Prescribed Blood Thinners

Drug companies have teams of doctors and scientists who work every day to create new drugs so that doctors will have options when it comes to treating their patients. The most common blood thinners prescribed today include:

Warfarin

Warfarin, which is also known as Coumadin, was first approved for use as a rodenticide in the United States in 1952. It wasn’t until 1954 that the drug was approved for use as a human blood thinner. Reported side effects have included skin necrosis, hair loss, and fatal bleeding events.

Pradaxa

This drug, which falls into the category of antiplatelet, is one of the newer blood thinners on the market. Pradaxa was first approved by the U.S. Food and Drug Administration on October 19th, 2010 for the prevention of stroke and for the treatment of atrial fibrillation. On April 7th, 2014, the drug was also approved for the prevention of deep vein thrombosis (DVT) and pulmonary embolism.

Eliquis

Eliquis, which is also known by its generic name Apixaban, is another one of the newer blood thinners to hit the market. This drug was approved in 2012 for the prevention of stroke and systemic embolism in patients that have been diagnosed with atrial fibrillation. Doctors have reported that adverse bleeding events and spinal hematoma have occurred in patients who have been prescribed the drug.

Plavix

Plavix is an antiplatelet blood thinner. Side effects that have been reported with this drug include nosebleeds, blood in the stool, fever, chest pain, and nausea.

Prasugrel

Prasugrel, also known as Effient, is a platelet inhibitor which is used in combination with aspirin. It is not recommended for patients who are over 74-years-old due to the risk of fatal bleeding. Physicians generally recommend that anyone who is having surgery stop using Prasugrel at least seven days prior to the procedure.

Brilinta

Brilinta, another antiplatelet, is used to prevent strokes and heart attacks. This drug was just recently approved by the FDA on March 30th, 2015.

Cilostazol

This vasodilator is used for claudication - a cramping condition which is often associated with an obstruction of the arteries. Patients using this drug have reported an increase in headaches, swelling in the feet and ankles, fevers, bloody and painful urination, and chest pains.

Aggrenox

This drug, which is actually a combination of aspirin and dipyridamole, is typically prescribed to patients who have previously had a mini-stroke to prevent additional attacks.

Aspirin

Aspirin, which has been around since the 1890’s, is often used to reduce fevers and other pains. It was in the 1960’s that clinical research began to suggest that it could also be used as a blood thinner to prevent strokes and heart attacks.

Xarelto

Xarelto, which has been in the news recently due to the number of lawsuits filed against its manufacturers, is another new blood thinner. Approved in 2011 by the FDA, this blood thinner quickly became popular because the dose used to treat patients was the same for everyone regardless of age, weight, diet, and exercise level. Unfortunately, this drug has also been reported to have a number of serious side effects.

What Is Being Done For Those Who Have Suffered From Side Effects?

One of the most common and arguably most dangerous side effects of any blood thinner is excessive bleeding. Bleeds typically occur in the GI tract, spine, and brain. If the bleed remains uncontrolled, it can be fatal.

In most cases, doctors are able to administer a reversal agent which combats the effects of the blood thinner and allows the blood to form clots. Vitamin K is a reversal agent that is used in many cases. Some drugs, however, like Xarelto, have no known reversal agent and doctors are forced to perform blood transfusions. Sadly, these transfusions don’t work in every case.

This is why it is important to always discuss your lifestyle and any medications you are on with a doctor before beginning a blood thinner. This way, they can identify any risk factors and decide which drug will work best for you. It is also important to pay close attention to any warnings released by the FDA regarding the drug you have been prescribed, like those for the blood thinner Xarelto.

FDA Warnings For Xarelto

In order to provide additional safety information for patients and the medical community, the FDA has also released several warnings regarding Xarelto.

A black box warning was issued informing doctors that patients who discontinued the drug too quickly may suffer from clot formation, DVT, and spinal hematomas.

A second black box warning was issued in March of 2014, which informed the public and medical community that anyone who was scheduled to undergo a procedure involving the spine should wait until the drug was completely out of their system. 

An Adverse Reaction Report was released which informed users that Xarelto could cause thrombocytopenia.

Ongoing Litigation

Many patients who have suffered from side effects such as heart attacks, spinal hematoma, stroke, and excessive bleeding have decided to pursue legal action against the manufacturers of Plavix, Eliquis, and Xarelto. In cases where the patient passed away because of a side effect, their loved ones have pursued a wrongful death complaint.

The largest of these involves more than 5,000 lawsuits which have been filed against Bayer AG and Johnson & Johnson regarding the drug Xarelto. So many complaints have been filed that the Judicial Panel on Multidistrict Litigation decided to consolidate all federally-filed lawsuits into MDL 2592. This consolidation placed the lawsuits in the Eastern District of Louisiana to be overseen by the honorable Judge Eldon E. Fallon. In each of these cases, a plaintiff alleges that the drug Xarelto caused serious harm to a patient to whom it was prescribed.

Did The Manufacturers Conceal Data?

Additionally, a writer for the New York Times published an article which reported that Johnson & Johnson and Bayer Inc may have concealed specific data when their clinical studies were being reviewed by a peer reviewer at the New England Journal of Medicine. The information that was allegedly withheld involved the device used to monitor the blood levels of the patients involved in the clinical trial and the fact that it had been recalled for inaccurate readings.

Plaintiffs are hoping that the combination of their legal efforts and the reviews into how safety testing is done for new drugs will push pharmaceutical companies to change their testing methods.