Anticoagulant tolerance

Some patients are wary of using anticoagulants. They are worried that by hindering the blood clotting mechanism they are at increased risk in case of an injury or emergency operation and that the risk of internal bleeding is higher. They are also worried about interactions with other medication and foods that could also increase the risk of bleeding.

It is true that the dosage has to be correctly managed for the medicine to be effective without allowing the risk of bleeding to become unacceptably high. In the case of medicines such as Marcumar^® or Falithrom^®, the correct dosage has to be monitored continuously by laboratory tests at short intervals. Novel non-vitamin K dependent oral anticoagulants (NOACs) inhibit coagulation by using individually tailored fixed doses, without the need for relevant dietary interaction or elaborate laboratory monitoring. As a result, tolerance to treatment has improved and treatment has also become more user friendly. NOACs have consequently replaced Marcumar^® as the means of choice (see ESC Guidelines 2016).

Patients should discuss the differences between the various anticoagulants with their doctors so that they receive the treatment that is best suited for them. In the case of injuries, there are methods and means available that can also treat severe bleeding.