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A component of the Canadian Medication Incident Reporting and Prevention System (CMIRPS).

SafeMedicationUse Newsletter

What You Need to Know about Your Blood Thinners


Examples of newer blood thinners:

  • apixaban
    (brand name Eliquis)
  • dabigatran
    (brand name Pradaxa)
  • edoxaban
    (brand name Lixiana)
  • rivaroxaban
    (brand name Xarelto)

Blood clots can be dangerous. They can travel to the legs (causing leg pain), the lungs (causing chest pain or trouble breathing), the heart (causing a heart attack), or the brain (causing a stroke). If you are taking a blood thinner, it means you are at risk for getting blood clots. While blood thinners are helpful to prevent clots, they can also cause the opposite problem, namely bleeding. Making sure you get the right dose of a blood thinner, neither too much nor too little, is very important.

For many years, people who needed a blood thinner were given a prescription for warfarin (brand name Coumadin). Over the last decade, several newer blood thinners have become available. These medications are more convenient than warfarin to use because they do not require regular blood tests. However, unlike warfarin, it is not as easy to reverse their effects if dangerous bleeding occurs or if you need emergency surgery. has the following advice for consumers who need blood thinners:

  • Ask your doctor about the pros and cons of warfarin compared with the newer blood thinners to help decide which medication is right for you. Use the 5 Questions to start the discussion.
  • Blood thinners interact with many medications as well as non-prescription and natural health products. Check with your pharmacist before taking any of these products.
  • Bleeding can be a warning of a problem with your medication. Unexplained bruises, frequent nosebleeds, or dark and sticky bowel movements are some signs of bleeding. If you notice any of these signs, contact your doctor or go to the emergency department of your hospital.
  • Some of your regular activities (e.g., sports, massage treatments) might need to be stopped or modified while on a blood thinner. Talk to your doctor or pharmacist.
  • If you need an operation of any kind, including dental surgery, tell your doctor or dentist about your blood thinner. For some surgeries, the doctor or dentist may want you to stop the blood thinner for a few days beforehand.

Medication safety bulletins contribute to Global Patient Safety Alerts

This newsletter was developed in collaboration with Best Medicines Coalition and Patients for Patient Safety Canada.

Recommendations are shared with healthcare providers, through the ISMP Canada Safety Bulletin, so that changes can be made together.

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