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Blood thinners

Category: Medicines

Type

Involuntary

Introduction and description

 

Blood thinners is the common, though not medically correct term for two types of drugs

  • antiplatelet drugs and
  • anticoagulant drugs

Anticoagulants  - reduce blood clotting, or at high doses can prevent the blood from clotting.  Theoretically, they are intended to help people at risk from deep vein thrombosis, pulmonary embolism, or ischemic stroke.  Needless to say, if you use any form of anticoagulant, you have immediately put the person at risk from bleeding to death, if they get any form of wound, as such the decision to use anti-coagulents should not be taken lightly and the dose needs to be extremely carefully monitored.  Oral anticoagulents are used widely as poisons for rodents and are called in this context rodenticides. Furthermore depletion of vitamin K by Coumadin therapy increases the risk of arterial calcification and heart valve calcification, especially if ‘too much’ vitamin D is present.  Since vitamin D is essential to health this seems something of a difficult pay off

 

Antiplatelet drug (antiaggregant) is a member of a class of pharmaceuticals that decrease platelet aggregation.  Thus they are intended to help in preventing clots from forming in the blood stream and have a special use in cases where a stent has been fitted to help prevent clotting round the stent and scar tissue developing.  Again the technical term for this is Restenosis literally meaning the recurrence of stenosis, a narrowing of a blood vessel, leading to restricted blood flow. Restenosis usually pertains to an artery or other large blood vessel that has become narrowed, received treatment to clear the blockage and subsequently become renarrowed.  Generally anti-platelet drugs are not given for longer than a year, as by this time the stent has settled in and any further formation of scar tissue has stopped.

Natural blood thinners

There are a number of foods and natural medicines that have ‘blood thinning’ effects without the side-effects of the pharmaceuticals.  The principle reason side-effects are not experienced is that if one eats a balanced meal and does not drink to excess, it is generally impossible to overdose.

  • Foods and drinks with blood-thinning effects include beer, bilberry, celery, cranberries, garlic, ginger, ginkgo, ginseng, green tea, licorice, onion, turmeric, papaya, pomegranate, red clover, soybean, and foods containing the vitamin niacin.  Nattokinase also has blood thinning effects.  It is an enzyme (EC 3.4.21.62) found in the Japanese food called nattō. Nattō is made from fermented soybeans and has been eaten in Japan for about a thousand years.
    Oxalate-rich plants are also natural blood thinners and plants rich in oxalate include fat hen, sorrel, rhubarb, and buckwheat. Other plants include [in decreasing order], star fruit (carambola), black pepper, parsley, poppy seed, amaranth, spinach, chard, beets, cocoa, chocolate, most nuts, and most berries.  Leaves of the tea plant (Camellia sinensis) contain among the greatest measured concentrations of oxalic acid relative to other plants. However, the beverage derived by infusion in hot water typically contains only low to moderate amounts of oxalic acid due to the small mass of leaves used for brewing.
  • Plant based medicines – there are also a number of plant based medicines that have blood thinning effects including St. John’s wort, red clover, feverfew and willow bark [the basis of aspirin].  Salvia miltiorrhiza (simplified Chinese: 丹参; traditional Chinese: 丹參; pinyin: dānshēn), also known as red sage, Chinese sage, tan shen, or danshen, and highly valued for its roots in traditional Chinese medicine is also a blood thinner.

It should be clear that if pharmaceuticals are being used, then great care must be taken on what one eats and drinks or takes with the drugs.  A curry, for example, with turmeric and ginger, onions and garlic accompanied by a beer could prove quite problematical.

Grapefruit interferes with some anticoagulant drugs, increasing the amount of time it takes for them to be metabolized out of the body

Two observations has been included from Dr Duke providing a list of plants that research has identified as being blood thinning – anti-platelet and anti-aggregate.  The list is extremely comprehensive and very long, but worth perusing.  The plant names are the scientific names, but we have put the common names in the activities section of each observation to make the lists easier to read.

The drugs

Drugs within this category are classified according to the main mechanism by which they are believed to work.  The mechanism is not explored on our site as it does not help to explain the hallucinations or other experiences, however, Wikipedia has a reasonable explanation of the meaning of each category.  The number of hallucinations, as calculated by the eHealthme website and derived from the ADRs from doctors submitted to the FDA and SEDA, is shown.  The use of a dash [-] indicates that no figures appear on eHealthme under that name.  As drugs frequently get renamed and are marketed under new names on a regular basis, it is possible there are hallucinations, but we do not know the new name.  Furthermore some of these drugs are not sold in the USA, so there will be no figures on eHealthme.  The link takes you to the eHealthme site where all the side effects are listed.  We have also followed the chart by the figures for deaths – the ultimate spiritual experience.

Anticoagulents

Vitamin K antagonists 

Drug name

Number of hallucinations

Coumarins: AcenocoumarolCoumatetralyl*

-

Dicoumarol **

-

Phenprocoumon ***

-

Coumadin

399

Warfarin

309

Jantoven

4

Phenindione

-

 

712

* Acenocoumarol is a derivative of coumarin and is generic, so is marketed under many brand names worldwide
** Dicoumarol was employed as a medicinal anticoagulant drug, but since the mid-1950s should have been replaced
*** Phenprocoumon is marketed under the brand names Marcoumar, Marcumar and Falithrom  and is the standard coumarin used in Germany.  No figures as eHealthme is USA based

Coumadin - On Aug, 24, 2015: 72,242 people reported to have side effects when taking Coumadin. Among them, 2,793 people (3.87%) have Death

Warfarin - On Aug, 18, 2015: 47,495 people reported to have side effects when taking Warfarin sodium. Among them, 1,046 people (2.20%) have Death

Jantoven - On Aug, 24, 2015: 267 people reported to have side effects when taking Jantoven. Among them, 5 people (1.87%) have Death

 

Heparin and derivative substances

 Heparin is a biological substance, usually made from pig intestines. It works by activating antithrombin III, which blocks thrombin from clotting blood.

Drug name

Number of hallucinations

Bemiparin

-

Certoparin [Sandoparin, Embolex]

2

Dalteparin [Fragmin]

7

Enoxaparin [Lovenox, Xaparin and Clexane]

121 + 41 = 162

Nadroparin [Fraxiparine]

-

Parnaparin

-

Reviparin

-

Tinzaparin [Innohep]

8

Fondaparinux [Arixtra]

8

Danaparoid [Orgaran]

-

Sulodexide

-

 

187

 Embolex - On Aug, 24, 2015: 417 people reported to have side effects when taking Embolex. Among them, 8 people (1.92%) have Death

Fragmin - On Aug, 16, 2015: 4,871 people reported to have side effects when taking Fragmin. Among them, 118 people (2.42%) have Death

Lovenox - On Jul, 26, 2015: 19,242 people reported to have side effects when taking Lovenox. Among them, 735 people (3.82%) have Death

Enoxaparin - On Aug, 24, 2015: 8,369 people reported to have side effects when taking Enoxaparin sodium. Among them, 260 people (3.11%) have Death

Innohep - On Jul, 31, 2015: 2,487 people reported to have side effects when taking Innohep. Among them, 48 people (1.93%) have Death

Fondaparinux - On Aug, 2, 2015: 330 people reported to have side effects when taking Fondaparinux sodium. Among them, 7 people (2.12%) have Death

Arixtra - On Aug, 24, 2015: 6,326 people reported to have side effects when taking Arixtra. Among them, 212 people (3.35%) have Death

Orgaran - On Aug, 24, 2015: 489 people reported to have side effects when taking Orgaran. Among them, 11 people (2.25%) have Death

 

 

Direct Xa inhibitor

Some drugs act by inhibiting factor Xa directly (unlike the heparins and fondaparinux, which work via antithrombin activation).

Drug name

Number of hallucinations

Apixaban [Eliquis]  *

-

Edoxaban [Savaysa, Lixiana] **

-

Rivaroxaban [Xarelto]

-

The development of a number of chemicals in this class has been discontinued

* FDA approvedAugust 21, 2014
** approved by the FDA in January 2015

 

 

Direct thrombin inhibitors

Some drugs in this class have been denied approval by the FDA or have been removed from the market entirely after reports of severe liver damage and heart attacks.

Drug name

Number of hallucinations

Bivalirudin [Angiomax or Angiox]

1

Lepirudin  [Refludan]

-

Argatroban

1

Dabigatran [Pradaxa in Australia, Canada, Europe and USA, Prazaxa in Japan]

35

 

37

 

Bivalirudin - On Aug, 2, 2015: 170 people reported to have side effects when taking Bivalirudin. Among them, 1 people (0.59%) has Death

Angiomax - On Aug, 24, 2015: 1,818 people reported to have side effects when taking Angiomax. Among them, 40 people (2.20%) have Death

Refludan - On Aug, 24, 2015: 547 people reported to have side effects when taking Refludan. Among them, 13 people (2.38%) have Death

Argatroban - On Aug, 1, 2015: 979 people reported to have side effects when taking Argatroban. Among them, 16 people (1.63%) have Death

Pradaxa - On Aug, 24, 2015: 27,044 people reported to have side effects when taking Pradaxa. Among them, 921 people (3.41%) have Death

 

Antithrombin protein therapeutics

 Antithrombin is approved by the FDA as an anticoagulant for the prevention of clots before, during, or after surgery or birthing in patients with hereditary antithrombin deficiency.

Drug name

Number of hallucinations

Defibrotide [Defitelio, Gentium]

-

Ramatroban [Baynas]

-

 

Antiplatelet drugs


Irreversible cyclooxygenase inhibitors

This class of drugs is also to be found in the section on NSAIDs and pain killers as this is their primary function

Drug name

Number of hallucinations

Acetylsalicylic acid/Aspirin

179 + 1019 = 1,198

Aloxiprin

-

Carbasalate calcium

-

Indobufen

-

Triflusal [Disgren, Grendis, Aflen and Triflux]

 -

 

Aspirin - On Aug, 9, 2015: 161,297 people reported to have side effects when taking Aspirin. Among them, 3,623 people (2.25%) have Death

Acetylsalicyclic acid - On Jul, 28, 2015: 37,524 people reported to have side effects when taking Acetylsalicylic acid. Among them, 1,093 people (2.91%) have Death

 

Adenosine diphosphate (ADP) receptor inhibitors

Drug name

Number of hallucinations

Clopidogrel (Plavix)

39 + 23 +402 = 464

Prasugrel (Effient)

5

Ticagrelor (Brilinta)

1

Ticlopidine (Ticlid)

16 + 1 = 17

Cangrelor [Kengreal in the US and Kengrexal in Europe]

-

 

487

 

Clopidogrel - On Jul, 26, 2015: 9,718 people reported to have side effects when taking Clopidogrel. Among them, 198 people (2.04%) have Death

Clopidogrel bisulfate  - On Aug, 24, 2015: 6,012 people reported to have side effects when taking Clopidogrel bisulfate. Among them, 95 people (1.58%) have Death

Plavix - On Aug, 14, 2015: 67,562 people reported to have side effects when taking Plavix. Among them, 2,312 people (3.42%) have Death

Effient - On Aug, 9, 2015: 2,622 people reported to have side effects when taking Effient. Among them, 122 people (4.65%) have Death

Brilinta - On Aug, 24, 2015: 1,035 people reported to have side effects when taking Brilinta. Among them, 38 people (3.67%) have Death

Ticlid - On Aug, 24, 2015: 3,004 people reported to have side effects when taking Ticlid. Among them, 39 people (1.30%) have Death

Ticlopidine hydrochloride - On Aug, 24, 2015: 1,376 people reported to have side effects when taking Ticlopidine hydrochloride. Among them, 8 people (0.58%) have Death

Phosphodiesterase inhibitors

Drug name

Number of hallucinations

Cilostazol (Pletal)

18 + 28 = 46

Dipyridamole (Persantine)

3 + 1 = 4

 

50

 

Pletal - On Aug, 24, 2015: 5,360 people reported to have side effects when taking Pletal. Among them, 118 people (2.20%) have Death

Cilostazol - On Aug, 24, 2015: 2,417 people reported to have side effects when taking Cilostazol. Among them, 53 people (2.19%) have Death

Persantine - On Aug, 24, 2015: 1,623 people reported to have side effects when taking Persantine. Among them, 49 people (3.02%) have Death

Dipyridamole - On Aug, 24, 2015: 3,454 people reported to have side effects when taking Dipyridamole. Among them, 77 people (2.23%) have Death

 

Protease-activated receptor-1 (PAR-1) antagonists

Drug name

Number of hallucinations

Vorapaxar (Zontivity)

-

 

Glycoprotein IIB/IIIA inhibitors (intravenous use only)

Drug name

Number of hallucinations

Abciximab (ReoPro)

-

Eptifibatide (Integrilin)

-

Tirofiban (Aggrastat)

-

 

ReoPro - On Aug, 24, 2015: 4,432 people reported to have side effects when taking Reopro. Among them, 114 people (2.57%) have Death

Integrilin - On Aug, 24, 2015: 2,470 people reported to have side effects when taking Integrilin. Among them, 90 people (3.64%) have Death

Aggrastat  - On Aug, 11, 2015: 1,821 people reported to have side effects when taking Aggrastat. Among them, 50 people (2.75%) have Death

 

How it works

The mechanism by which the hallucinatory experiences work is not hard to fathom.  If you thin the blood too much [overdose] you decrease the supply of oxygen to the brain, the system starts to shut down in a controlled manner,  starting with memory and reason,  reverting to core functions.  This same mechanism we have seen a number of times with quite a few drugs.

In effect they work via hypoxia.

As we saw above, a number of foods also help to thin the blood.  If you thus combine these foods with the drugs, this too will be an overdose.  This paper outlines some other interactions that may be contributing.

 

Int J Cardiol. 2005 Jan;98(1):1-14. Cardiovascular pharmacotherapy and herbal medicines: the risk of drug interaction. Izzo AA, Di Carlo G, Borrelli F, Ernst E
Use of herbal medicines among patients under cardiovascular pharmacotherapy is widespread. In this paper, we have reviewed the literature to determine the possible interactions between herbal medicines and cardiovascular drugs. The Medline database was searched for clinical articles published between January 1996 and February 2003. Forty-three case reports and eight clinical trials were identified.

  • Warfarin - Warfarin was the most common cardiovascular drug involved. It was found to interact with boldo, curbicin, fenugreek, garlic, danshen, devil's claw, don quai, ginkgo, papaya, lycium, mango, PC-SPES (resulting in over-anticoagulation) and with ginseng, green tea, soy and St. John's wort (causing decreased anticoagulant effect).
  • Digoxin - Gum guar, St. John's wort, Siberian ginseng and wheat bran were found to decrease plasma digoxin concentration;
  • Aspirin - aspirin interactions include spontaneous hyphema when associated with ginkgo and increased bioavailability if combined with tamarind.
  • Statins - Decreased plasma concentration of simvastatin or lovastatin was observed after co-administration with St. John's wort and wheat bran, respectively.
  • Diuretics - Other adverse events include hypertension after co-administration of ginkgo and a diuretic thiazide
  • Antihypertensives - hypokalemia after liquorice and antihypertensives
  • Phenprocoumon - anticoagulation after phenprocoumon and St. John's wort.

Interaction between herbal medicine and cardiovascular drugs is a potentially important safety issue. Patients taking anticoagulants are at the highest risk.
PMID: 15676159

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