Patient Education Blog

Archive for the ‘warfarin / coumadin’ Category

Eliquis (Apixaban) FDA-Approved for DVT and PE Treatment

| Blood thinners (anticoagulants), Eliquis - Apixaban, Pradaxa - dabigatran, warfarin / coumadin, Xarelto - Rivaroxaban | Comments Off on Eliquis (Apixaban) FDA-Approved for DVT and PE Treatment

Stephan Moll, MD writes…  Apixaban (Eliquis®) was approved by the FDA this week (Aug 21, 2014) for the treatment of DVT and PE.  The approval covers (a) acute DVT/PE management and (b) the longer-term prevention of recurrent DVT/PE. Read the rest of this entry »

Pregnancy, Breast-Feeding: Safety of the Various Blood Thinners

| Arixtra - Fondaparinux, Eliquis - Apixaban, Pradaxa - dabigatran, warfarin / coumadin, Xarelto - Rivaroxaban | Comments Off on Pregnancy, Breast-Feeding: Safety of the Various Blood Thinners

Stephan Moll, MD writes…

The injectable low molecular weight heparins (LMWH; e.g. enoxaparin = Lovenox; dalteparin = Fragmin; tinzaparin = Innohep) are the preferred blood thinners in the pregnant patient. Warfarin is to be avoided as it can cause malformations of the fetus and can lead to bleeding in the unborn.

Regarding breastfeeding:  the low molecular weight heparins (listed above) and warfarin are safe in the woman who is beastfeeding.

Rivaroxaban (Xarelto), dabigatran (Pradaxa) and apixaban (Eliquis) should not be used during pregnancy or while breastfeeding.

A detailed summary about the safety of each blood thinner during pregnancy and while breast-feeding, based on the ACCP 2012 guidelines [ref], can be found here.

Click image above for a detailed summary about the safety of each blood thinner during pregnancy and breastfeeding.

Reference

Bates SM, Greer IA, Middeldorp S et al. VTE, Thrombophilia, Antithrombotic Therapy, and Pregnancy. Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. CHEST 2012; 141(2)(Suppl):e691S–e736S.

 

Disclosure:  I have consulted for Janssen and Boehringer-Ingelheim. 

Last updated: Jan 23rd, 2014

Red Eye – Subconjunctival Bleed on Blood Thinners

| Bleeding, Blood thinners (anticoagulants), warfarin / coumadin | Comments Off on Red Eye – Subconjunctival Bleed on Blood Thinners

Stephan Moll, MD, writes… A subconjunctival bleed (hemorrhage) is a bleed underneath the transparent conjunctiva , and in front of the white (sclera) of the eye ball (see image). The conjunctiva contains many small and fragile blood vessels that easily rupture or break. This leads to blood leaking into the space between the conjunctiva and sclera. Read the rest of this entry »

INR Self-Testing

| INR, warfarin / coumadin | Comments Off on INR Self-Testing

Stephan Moll, MD writes…


INR home testing devices are available to patients. They are often reimbursable by insurance carriers.  Warfarin management through patient self-testing at home is at least as effective and safe as INR testing through a physician’s office or a warfarin clinic, if patients are well-selected.  The well-done large THINRS trial published in 2010 clearly showed this, and a 2011 systematic review of the medical literature confirmed that Read the rest of this entry »

Coumadin Clinics – Finding One Near You

| Blood thinners (anticoagulants), INR, Therapy, warfarin / coumadin | Comments Off on Coumadin Clinics – Finding One Near You

If you are on warfarin (Coumadin®, Jantoven®) you need to be followed in a structured way to optimize your warfarin therapy and minimize the risk for bleeding and clotting. The “thinness” of your blood needs to be determined on a regular basis with a test called INR (International Normalized Ratio; also referred to as PT, protime, or prothrombin time).  While small physician practices may well deliver good warfarin management care, specialized anticoagulation clinics (also referred to as “Coumadin Clinics”) often have the expertise and resources for optimal warfarin management.  If you are trying to find a clinic near you, you can go to the website of the non-profit organization Anticoagulation Forum. You will find a map of the U.S. with the location of and contact information for a number of good Coumadin Clinics – to link to the map click here. Read the rest of this entry »

Warfarin-Induced Skin Necrosis

| Blood thinners (anticoagulants), warfarin / coumadin | 2 Comments »

How common is it?

Warfarin-induced skin necrosis is a rare complication of warfarin (coumadin®, Jantoven®) therapy. It occurs in approximately 1 of 10,000 patients treated with warfarin.

What is it?
“Necrosis” means “dead tissue”. Patients with warfarin-induced skin necrosis develop very painful skin areas, most commonly in the breasts, next commonly in buttocks, thighs and abdomen (see images below). Read the rest of this entry »