Reducing the Risks of Taking Anti-clotting Medications

Advice for those taking anti-platelet or blood thinning medications

Blood platelets help clot blood. Anti-platelet medications are often prescribed to reduce the platelet levels in people for whom blood clots present a risk, like those who are susceptible to heart attacks or stroke.

This treatment, however, carries a risk for people who may develop bleeding gastro-intestinal (G.I.) ulcers, like those who have had GI bleeding in the past and those taking medications known to occasionally induce it, for example non-steriodal anti-inflammatory medications (Motrin, etc), aspirin, the anti-depressant sertraline (Zoloft), anti-platelet medications, and blood thinners like Heparin.

The American College of Gastroenterology and the American Heart Association have recently made a series of suggestions to minimize the risk of bleeding:

1) patients with a history of ulcers or GI bleeding or who take more than one anti-clotting medication should be considered for treatment with medication that reduces stomach acid, specifically a proton pump inhibitor (PPI) like Nexium, Prevacid, Prilosec and others.

2) patients without such a history who are taking only one anti-clotting medication should be considered for PPI treatment if they are over 60, using steroids, or have GI discomfort or reflux.

3) patients who have a history of ulcers should be tested for Heliobacter and, if positive, treated for it before starting anti-platelet therapy.

Bhatt et all Report of American College of Cardiology Clinical Expert Task Force: Reducing GI risks of anti-platelet therapy. Circulation:2008 Oct 28, 118:1894