Anticoagulation treatment – it requires close cooperation between doctor and patient

Deep vein thrombosis, pulmonary embolism, atrial fibrillation – these are some of the conditions in the therapy of which the anticoagulant, i.e. blood clotting treatment, plays a prominent role. However, it is important to know that this requires very close cooperation on the part of both the doctor and the patient, in order to maintain the delicate balance of blood coagulation and bleeding. As to when it is necessary to consult with your doctor, prof. György Blaskó, coagulation specialist of the Thrombosis Center, provides information.

Regular INR testing is required

For older (mainly coumarin-based) products, a blood test is recommended every 6 weeks. The INR value must be between 2-3, otherwise it is recommended to change the dose or switch to another preparation. INR control is not necessary when using the new type of anticoagulants (NOAC), because the mechanism of action of these agents is completely different.

Before surgeries and dental interventions

Major dental/oral surgery treatments, as well as surgeries, can also involve a larger amount of blood loss. If the patient is still using anticoagulants, he may lose life-threatening amounts of blood. That is why, if you are about to undergo such an intervention, it is important to consult your doctor first. After assessing the individual risk, the specialist will decide whether it is advisable to abandon/replace the anticoagulation medication in the days before the operation, or whether it is recommended to switch to another preparation. You will also receive instructions on the prevention of thrombosis in the period after surgery.

Bleeding cases

When taking anticoagulants, the risk of bleeding complications increases, which can even be life-threatening. That is why if you experience symptoms such as frequent nosebleeds, bloody urine, the appearance of unwarranted blue-green spots on the skin, it is important to see your doctor urgently and have your INR level checked! In such cases, it may be necessary to change the dosage or to prescribe another product (e.g. a new type of anticoagulant). But it is also a basic rule for these to see a doctor in case of any bleeding, because they are also anticoagulants!

Family planning

If someone is taking anticoagulants, it is important to consult with your doctor when planning a family, as it is then necessary to modify the therapy! Because then it is necessary to switch to subcutaneous LMWH, because other preparations (coumarin derivatives, NOAC) can cause serious developmental disorders as they penetrate the placenta. In the case of coumarin, the most dangerous period is 8-12 weeks of pregnancy, while with the new types it is forbidden to get pregnant at all times!
It is important that the pregnancy be monitored by a gynecologist experienced in pregnancy pathology due to the thrombosis-increasing effect of pregnancy.

Taking other medicines

It is worth knowing that with coumarin-type anticoagulants, you have to be careful about possible drug interactions, because some antibiotics, NSAIDs (non-steroidal anti-inflammatory drugs), and thyroid drugs increase the effectiveness of the preparation. But Prof. György Blaskó, the blood coagulation specialist at the Thrombosis Center, advises to talk to your doctor before using any new medicine!

“Practically, coumarin anticoagulants are the veterinary horse of drug interactions, because drug interactions with all kinds of outcomes can occur here and there. There are few medicines that are indifferent from this point of view. You also have to pay close attention to dietary supplements, herbal teas, etc. used at the same time, because these can also interact with coumarins with serious consequences! If the patient insists on these drugs, be sure to consult your doctor!”

Longer plane/bus/car journey

Long-term immobilization is considered a serious provoking factor in connection with thrombosis, as the circulation slows down and the chance of blood clots increases. That is why, before traveling longer than 4 hours, or in the case of cast fixation, be sure to see your doctor, who can recommend LMWH therapy. In addition to these, the patient should pay attention to drinking more fluids, wearing compression stockings, wearing comfortable, not too tight clothes, and exercising during the flight.
All of these also apply to bus journeys!

Thrombosis Center