A lot is said and written about the need for blood thinning for the treatment and prevention of many serious diseases. In addition, the number of drugs that effectively perform this task has recently increased. It is not recommended to choose them yourself, only a doctor should select them.
But everyone should know which blood thinners without "Aspirin" are used in medicine.
Why thin the blood
With age, many people experience bleeding disorders. The mechanisms of this process are different, some are not fully understood.
What can I take to thin the blood? Strokes, as well as thrombosis and thromboembolism, are pathologies that occur due to the fact that blood clots clog the lumen of the vessel and stop the blood flow in a certain area of our body.
These vascular problems are very dangerous, they never go without a trace: without timelymedical care is either fatal or disabled.
According to the reviews, blood thinners without "Aspirin" are in the first place in the preventive purposes to prevent thrombosis, and therefore, they prevent mortality from cardiovascular diseases.
In addition to prevention, they are also used for the treatment of already formed thrombosis.
Drugs for proper blood thinning
The appearance of clots is activated by many clotting factors found in the blood. Exists:
- Primary platelet hemostasis. Platelets stick together with each other and the vascular wall, thereby clogging the lumen of a small vessel.
- Secondary, coagulation hemostasis. There is an activation of plasma coagulation factors and the formation of a fibrin thrombus.
Accordingly, blood thinning pills without "Aspirin" are divided:
- On antiplatelet agents (prevent the adhesion of platelets, slow down vascular and platelet hemostasis).
- Anticoagulants (block plasma coagulation factors and prevent fibrin clot formation).
Antiplatelet agents
Antiplatelet therapy is indicated in the following situations:
- When the muscles of the heart are damaged, provoked by a deficiency or cessation of blood supply to the myocardium.
- With ischemia of the heart, which occurs with the occurrence of ischemic necrosis of the muscle area.
- For patients with rhythm disturbances.
- Secondary prevention of blood clots in people who have had a stroke.
- After any surgical interventions on the heart and blood vessels.
- Patients with peripheral arterial disease.
Antiaggregants without "Aspirin"
Adverse reactions from drugs containing "Aspirin" forced experts to look for an alternative, more harmless blood thinners with a similar effect.
Subsequently, several drugs without acetylsalicylic acid, which have antithrombotic effects, are now being used in clinical practice.
But it must be remembered that absolutely safe medicines of this group do not exist, each of them has certain limitations, and they are also prescribed only by a doctor. Some modern antiplatelet agents are even prescribed as an adjunct to acetylsalicylic acid.
List of blood thinners without "Aspirin":
- "Dipyridamole" ("Curantil").
- "Ticlodipine" ("Ticlid").
- "Clopidogrel" ("Plavix").
- "Ticagrelor" ("Brilint").
- "Prasugrel" ("Effient").
- Cilostazol (Pletax).
- "Pentoxifylline" ("Trental").
Further antithrombotic drugs for blood thinning without "Aspirin" will bediscussed in more detail.
Dipyridamole
The drug is considered to be a phosphodiesterase inhibitor according to the spectrum of effects, and also has a vasodilating and antiplatelet effect. Its action is slightly weaker than that of "Aspirin", but it is fully justified in case of individual intolerance to the latter.
In addition, "Dipyridamole" is the only antiplatelet drug that is approved for use in pregnant and lactating women. The drug is taken at 75 milligrams four times a day, if necessary, the daily dosage is increased to 450 mg.
Produced "Dipyridamole" in tablet form. The drug with the trade name "Kurantil" will cost more - from 650 to 800 rubles.
Ticlodipine
The drug inhibits platelet aggregation, reduces blood viscosity and prolongs bleeding time. The drug is prescribed at 250 milligrams twice a day. The pharmacological effect of a blood thinner without "Aspirin" is achieved on the fourth day of therapy.
Adverse reactions:
- bleeding;
- thrombocytopenia (a disease characterized by a decrease in platelets below normal, accompanied by increased bleeding and problems with stopping bleeding);
- leukopenia (decrease in the amount of white blood cells in the blood);
- pain in the abdomen;
- diarrhea.
The cost of the medicine is 1600 rubles.
Clopidogrel
The drug is similar in spectrum to "Tiklodipin", but more effective and safer than it. It should be consumed at 75 milligrams once a day, regardless of food. The cost of blood thinning pills without Aspirin varies from 300 to 900 rubles.
Prescribe "Clopidogrel" under the following conditions:
- For acute coronary syndrome, 300 milligrams once.
- For prophylactic purposes to prevent stent thrombosis after stenting. Used in combination with acetylsalicylic acid unless restricted.
- Ischemic heart disease, which occurs with the appearance of ischemic necrosis of the myocardium.
- Ischemic stroke (impaired microcirculation of the brain with damage to brain tissue, disruption of its functions due to difficulty or cessation of blood flow to a particular department).
- Peripheral arterial occlusion (vascular insufficiency that develops when the patency or blockage of blood vessels is impaired, as a result of which blood transport to a particular organ is disrupted, which leads to problems in its functioning).
Ticagrelor
Innovative drug, the spectrum of action is similar to "Clopidogrel". Produced in tablet form of 60 and 90 milligrams, used twice a day. Of the adverse reactions, in addition to bleeding, shortness of breath should be noted. The price of the drug is 4500 rubles.
Additional medicines
Prasugrel is a new drug being used in patients with acute coronary syndrome who are about to undergo stenting. These blood thinning pills without Aspirin are much more effective than Clopidogrel, but at the same time, adverse reactions appear when it is used more often. It is not recommended for use in patients who have had a stroke. The price of the medicine is approximately 4,000 rubles.
"Pletax" has antiplatelet and vasodilating effects. Well dilates the arteries of the legs. It is used, as a rule, for obliterating lesions of these arteries. Dosage - 100 milligrams twice a day. The price of the drug is 2000 rubles.
"Trental" combines antiplatelet and vasodilating effects. Reduces blood viscosity, helps improve blood circulation. Apply as a solution for intravenous administration, and tablets. The price of the drug varies from 200 to 1500 rubles.
Anticoagulants
These are drugs that inhibit the activity of plasma coagulation factors. They are used in situations where antiplatelet agents alone are indispensable, for the treatment of thromboembolic complications, as well as for prophylactic purposes, when the likelihood of complications is very high.
Indications for blood thinning pills without "Aspirin":
- A blockage in the pulmonary artery, which usually occurs in large veins in the legs or pelvis.
- A disease in which the veins formblood clots that interfere with normal blood flow.
- Myocardial infarction.
- Ischemic stroke (impaired cerebral microcirculation with damage to brain tissue, disruption of its functions as a result of difficulty or cessation of blood flow to a particular department).
- Atrial fibrillation in patients with cardiac ischemia.
- Has had a stroke with atrial fibrillation.
- Prosthetic heart valves.
- Atrial thrombus (a natural process that increases blood clotting in the vessels or cavities of the heart).
- Stent stenosis (narrowing of the artery).
There are the following groups of these drugs:
- Direct anticoagulants that inactivate thrombin in the blood. These are "Heparin" and its various modifications, as well as "Hirudin".
- Indirect anticoagulants block the formation of plasma coagulation factors in the liver ("Warfarin", "Phenylin", "Neocoumarin", "Sinkumar").
- New oral anticoagulants.
Direct anticoagulants
Unfractionated heparin is a natural anticoagulant found in many body tissues. In the blood, it inhibits thrombin, thereby reducing the ability to form clots.
"Heparin" is used parenterally in high concentrations - to eliminate acute myocardial infarction, thrombosis of the arteries of the extremities, pulmonary embolism, in small doses - as a preventive measure to prevent thromboembolism. The medication is prescribed withspecial care under the control of blood clotting only in a medical facility.
Heparin ointments and gels for local use are also produced (heparin ointment, Lyoton, Venitan, Venolife). They are recommended for varicose veins, as well as hemorrhoids.
Low molecular weight heparins are usually injected subcutaneously twice a day. Released in disposable syringes. In most cases, the following drugs are prescribed:
- "D alteparin" ("Fragmin") - 2500 microunits / 0.2 milliliters - a total of ten syringes in a package. The cost of the medication varies from 1700 to 2800 rubles.
- "Nadroparin" ("Fraksiparin") - produced in different concentrations, the cost of the drug ranges from 2000 to 4000 rubles.
- "Enoxoparin" ("Clexane") - dosing in syringes from 2000 to 8000 units, the price varies from 700 to 3000 rubles.
- "Bemiparin" ("Cibor") - available in syringes of 3500 microunits, ten pieces, 3900 rubles.
As a rule, low molecular weight heparins are used prophylactically to prevent thrombosis in patients after surgery. In addition, they can be used in pregnant women with an autoimmune hypercoagulable state provoked by antiphospholipid antibodies.
"Sulodexide" is an antithrombotic drug,which consists of two glycosaminoglycans formed from the intestinal mucosa of the pig. The spectrum of action resembles low molecular weight heparins. It is used, as a rule, to prevent microthrombosis in people with diabetes. The advantage of the drug is its good tolerance, as well as the possibility of using not only in injections, but in capsules for oral use. The price of 10 ampoules is 2000 rubles, the cost of capsules is 2700 rubles.
"Warfarin" is almost the only anticoagulant that is prescribed for prolonged use. It is still considered the standard against which all modern drugs with the same effect are compared. In the liver, it blocks the metabolism of vitamin K and thereby prevents the formation of several plasma coagulation factors. Subsequently, the blood loses its ability to form clots.
With continued use, Warfarin reduces the incidence of strokes by 64 percent. But this medicine is not perfect, it is inconvenient for frequent use.
Main cons:
- The need for regular laboratory monitoring and constant dosage adjustments.
- Strict adherence to the diet.
- Incompatible with most drugs.
- Frequent bleeding.
Warfarin continues to be the most widely used anticoagulant, mainly because of its affordable cost. The dosage of the drug is selected under the control of a laboratory blood test, sometimes the selection of the optimal concentration of drugs takes a couplemonths.
The drug is produced in tablet form of 2.5 milligrams. The price of the medicine varies from 70 to 200 rubles, depending on the manufacturer.
New oral anticoagulants are the latest generation of medicines introduced into medical practice not so long ago, but were quickly accepted by doctors and patients.
All new oral anticoagulants can be divided into two groups:
- Direct thrombin inhibitors ("Dabigatran").
- Direct factor Xa inhibitors (Rivaroxaban, Apixaban, Endoxaban).
Their effect can be compared with "Warfarin", but it is more convenient to work with them for both the medical specialist and the patient. The main advantage is that they do not require general laboratory control. The main disadvantage is their high price.
"Dabigatran" inhibits thrombin, thereby preventing the conversion of fibrinogen to fibrin. Well absorbed from the gastrointestinal tract. Its influence is also comparable to Warfarin. Adverse reactions are rare, and the use is much more convenient.
Dabigatran is produced in capsules of 75, 110 and 150 milligrams, used twice a day, the daily dosage is selected by the doctor depending on the purpose of the appointment. It is forbidden to use the remedy for bleeding, as well as a recent hemorrhagic stroke, severe renal failure, pregnancy. Laboratory control is not usually required.
The cost of the drug is 1900 rubles.
"Rivaroxaban", "Apixaban", "Edoxaban" inhibit both free and thrombus-associated factor Xa. Trade names:
- Rivaroxaban - Xarelto.
- "Apixaban" - "Eliquis".
- "Endoxaban" - "Lixiana".
Indications for use are the same as for "Warfarin". All three drugs are rapidly absorbed from the gastrointestinal tract.
The difference lies in the fact that you need to use Xarelto tablets with food, the rest - regardless of food intake. Eliquis - twice a day, the rest - once.
Folk remedies for blood thinning without "Aspirin"
Medications have many limitations, so you should look at other natural medicines (herbs, fruits, berries) and other grandmother's recipes:
- Plants that help thin the blood - white willow bark, medicinal sweet clover, Caucasian Dioscorea roots, hazel bark and leaves, horse chestnut, lungwort, ginkgo biloba leaves.
- Due to the pharmacological properties of sodium bicarbonate (baking soda), patients can get rid of hyperacidity of the stomach and thick blood.
- Cranberries are full of vitamins. The increased content of ascorbic acid has a positive effect on the wall of blood vessels, making it stronger, which reduces the likelihood of blood clots.
