Anticoagulants: Uses, most common brand names, and safety information

Medically reviewed by  Jamie Winn, PharmD

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Anticoagulants are medications that are also commonly referred to as blood thinners.  They are used to treat, prevent, and lower the likelihood of blood clots breaking off and traveling to vital organs in the body.

This reduces the chance of serious illnesses like strokes and heart attacks in individuals that have an increased risk of developing blood clots.

A blood clot is a seal formed by blood to prevent bleeding from wounds. When they form in the wrong place, however, they can block blood vessels and limit blood flow to vital organs like the brain, heart, or lungs.

Let’s learn more about anticoagulants including the most common brand names, uses, and essential safety information.

The list below includes the most common types of FDA-approved anticoagulants and pricing.

List of anticoagulants

What are anticoagulants?

Anticoagulants are a class of drugs that reduces your body’s ability to clot. They can dissolve existing clots or prevent new ones from developing.  Anticoagulants are used to treat and prevent serious diseases caused by blood clots, such as strokes, heart attacks, and pulmonary embolisms.

Some of the earliest approved blood thinners, heparin and warfarin have been around for over half a century.  Some of the newer medications such as Pradaxa and Xarelto have made it more convenient for the patients as they don’t require the same frequent monitoring and regular blood tests as warfarin. Anticoagulants come in different forms, including injections under the skin, intravenous (IV) drugs, and oral medications.

How do anticoagulants work?

The clotting process is a complex reaction of your body to blood vessel damage. Anticoagulants disrupt this clotting process at different points depending on the class of medication.

What are the classes of anticoagulant drugs?

Vitamin K antagonist

Warfarin is the only vitamin k antagonist available in the US. It works by limiting the availability of vitamin K, a vitamin that is necessary for the blood coagulation pathway to produce certain clotting factors. This decreases the blood’s ability to clot. Warfarin interacts with numerous other prescription medications and supplements and is also affected by how much vitamin K you get from the foods you eat. It also requires frequent blood tests to monitor your INR to make sure your dose doesn’t need adjusting.

Factor Xa inhibitors

These medications include Eliquis and Xarelto and they decrease the activity of factor Xa, which leads to less thrombin and as a result, less clotting. Factor Xa inhibitors can affect factor Xa within the blood and also within a pre-existing clot. They do not require routine monitoring, unlike some other anticoagulant medicines.

Heparins

This group, consisting of unfractionated heparin and low molecular weight heparins (LMWH), inhibits thrombin and factor Xa, factors necessary in the blood clotting cascade. These medications can be injected intravenously or under the skin. Heparin is typically used as an inpatient medicine as it requires daily monitoring. LMWH such as Lovenox does not require daily monitoring and can be administered by the patient or caregiver.

Direct Thrombin inhibitor

By binding to the clotting protein thrombin, medicines such as Pradaxa inhibit its clotting activity. Frequent monitoring is not required with these medications.

Platelet inhibitors

Platelets circulating in the bloodstream also play an important part in clot formation. By decreasing platelet activity, medications such as aspirin, Plavix, and Brilinta help reduce the formation of clots.

What are anticoagulants used for?

Anticoagulants are used to treat or prevent a variety of conditions such as:

• Deep vein thrombosis (DVT)
• Blood clots in the venous or arterial systems
• Heart attack (myocardial infarction)
• Stroke
• Atrial fibrillation
• Pulmonary embolism
• Transient ischemic attack (TIA)

Anticoagulants are also used in individuals with an increased risk of blood clots including those with:

• Artificial heart valve
• Joint replacement such as hip or knee
• Family history of excessive blood clotting

Note that indications may vary amongst products so speak with your healthcare provider for medical advice on which drug will work best for your medical condition.

Are anticoagulants safe?

Anticoagulants are considered safe when it is used as indicated for the recommended amount of time. However, they can cause some serious side effects such as:

• Major bleeding or hemorrhage
• Spinal hematoma
• Thrombocytopenia (decreased platelets in the blood)
• Increased risk of clotting if discontinued before completion of therapy (Factor Xa inhibitors)

Who shouldn’t take anticoagulants?

Because these medications can increase your risk of bleeding, it is not recommended for use in the following conditions:

• Hemophilia or other bleeding disorder
• Active major bleeding
• Stomach ulcers, especially with aspirin
• Previous allergy or adverse reaction
• High risk of bleeding in the brain
• Caution should be taken if pregnant
• Severe or uncontrolled high blood pressure
• Caution should be taken if you are undergoing or recently had surgery

Can you take anticoagulants while you are pregnant or breastfeeding?

The use of anticoagulants in pregnancy is something important to consider. During pregnancy, the risk of venous thromboembolism (VTE) is approximately five to 10 times higher than during non-pregnancy, and after giving birth the risk is 15 to 20 times higher.

Most anticoagulants have not been studied in pregnant patients and must be used with caution and only if the benefits outweigh the possible dangers to the fetus.

Warfarin specifically should be avoided during pregnancy unless it is absolutely necessary. It can however be used while breastfeeding.

Common anticoagulant side effects

The most common side effects of anticoagulation include:

• Bleeding
• Bruising
• Nose bleeds and bleeding from the gums
• Dizziness
• Shortness of breath
• Injection site reactions
• Anemia
• Nausea/vomiting
• Headache
• Fatigue
• Chest pain

Serious and sometimes life-threatening side effects can occur and include:

• Hemorrhage
• Skin or tissue damage
• Kidney or liver damage
• Increased risk of fracture with long-term use
• Arrhythmia

This is not a complete list of side effects and we encourage you to consult with your healthcare professional for a complete list of side effects.

How much do anticoagulants cost?

You can purchase certain anticoagulants for $49 per month from NiceRx if eligible for assistance. Prices at the pharmacy vary by your location, strength, and quantity, as well as your insurance coverage or coupons available.

Related information on anticoagulants

• Blood thinner basics. WebMD
• Different types or classes of anticoagulants. MedicineNet
• What are anticoagulants? Drugs.com
• Anticoagulation during pregnancy. ASH Clinical News
• How do anticoagulants work? RxList