Anticoagulants are often referred to as ‘blood thinners’ but they actually work by interrupting the clot-forming process and increasing the time it takes for blood clots to form. This helps prevent blood clots from forming and stops existing clots from growing bigger.
For the prevention and treatment of深静脉血栓形成, where blood clots form in veins deep within the legs and pelvis. From here, the clots can travel to the lungs and cause apulmonary embolism。
The decision about which anticoagulant to use can depend on why it is required and your risk factors. Read more aboutwhich anticoagulant is best for you。
Which anticoagulants are available in New Zealand?
There are several anticoagulants in New Zealand. Some are taken by mouth (orally) as tablets or capsules and some are given by injection.
These are commonly used in hospital. Some people may be given these to inject at home. If you need to do this, your healthcare professional will show you how.
The following animation describes how NOACs such as dabigatran, rivaroxaban and apixaban work in the body.
Source：英国心脏基金会
How long is anticoagulant treatment taken for?
This will depend on what you are taking it for. Some people only need it for a few weeks, such as aftersurgery, or for months such as for deep vein thrombosis.
Other people need to take an anticoagulant for the rest of their lives (people with atrial fibrillation or a mechanical heart valve). Your doctor will advise what is best for you.
What is the risk of bleeding?
Taking anticoagulants means that blood takes longer to form clots, and this can increase your risk of bleeding. The benefits of using anticoagulants usually outweigh the risks of bleeding. If you want more information or have concerns, talk to your doctor.
Before prescribing, your doctor will consider the risk of bleeding for you by considering the following:
your age (risk increases as you get older)
hypertension (high blood pressure) that is not controlled with medication
previous myocardial infarction, ischaemic heart disease or cerebrovascular disease
anaemia
a history of bleeding
the use of other medicines that increase bleeding risk, such as aspirin or other antiplatelet medicines and non-steroidal anti-inflammatory drugs (NSAIDs).
What are the signs of bleeding?
You might bleed or bruise more easily while you are taking anticoagulants.
Be careful when shaving, clipping fingernails, brushing and flossing your teeth, or playing sports.
Avoid new tattoos and piercings as these can cause bruising and bleeding.
如果您跌倒或伤害了头或身体，即使您感觉还好，也要立即进行医疗护理。
严重出血的迹象
有限公司ntact your healthcare provider urgently ifyou have any of the following signs of bleeding:
becoming pale, very weak and tired, or short of breath
any bleeding from your gums
cuts or nosebleeds that won’t stop
凳子上的血液（便便） - 黑色，磨碎的凳子
blood in your urine (pee) – pink, red or brown-coloured urine
heavy periods (menstrual bleeding)
coughing up blood
vomiting up something that looks like coffee grounds.
Oral anticogulants are tablets or capsules that prevent blood clots from forming and stop existing clots from growing bigger. Oral anticoagulant treatment may be needed as a treatment for your condition. There are three funded oral anticoagulants in New Zealand –warfarin,dabigatranandrivaroxaban。
Are there certain medical conditions where one is preferred?
Yes, sometimes there are. This will be something you should discuss with your doctor in more detail.
How long will I need to take the medicine?
The length of time you need to keep taking your medicine for depends on why it's been prescribed. In many cases, treatment will be lifelong.
我多久服用一次药？
Warfarin: You will take 1 or more tablets once a day, usually in the evening. The dose will be adjusted depending on blood test results (see below) and you will be given written instructions about how many tablets to take each day.
达比加特兰: You will take 1 dabigatran capsule twice a day.
Rivaroxaban: You will take 1 rivaroxaban tablet once a day.
Will I need regular blood tests?
Warfarin开始的几周和几个月,你会娘家姓的d frequent blood tests so your doctor can work out the safest dose. After that, most people need to have blood tests every 1–2 months. Some people will need blood tests more or less often than this, and some people are able to test their blood themselves or at a community pharmacy.
达比加特兰: When you first start taking dabigatran, you will need blood tests to check how well your kidneys and liver are working. No regular blood testing to check the level of dabigatran is needed, but you may need to have occasional tests to check your kidneys and liver.
Rivaroxaban: When you first start taking rivaroxaban, you will need blood tests to check how well your kidneys and liver are working. No regular blood testing to check the level of rivaroxaban is needed but you may need to have occasional tests to check your kidneys and liver.
Rivaroxaban：Yes, they can be placed in a blister pack.
我必须改变我的饮食或喝什么吗？
Warfarin: This medicine interacts with many common foods and drinks including alcohol. Seewarfarin and dietfor a list of these. Major changes in what you eat may affect how your body responds to warfarin. If you need to make a major change to your diet, talk to your doctor or pharmacist first.
达比加特兰: There are no known food interactions, but it is best not to drink too much alcohol.
Rivaroxaban: There are no known food interactions, but it is best not to drink too much alcohol.
Will the medicine interact with other medicines I take?
All anticoagulants interact with many other medicines such as ibuprofen, diclofenac, aspirin and herbal supplements such as garlic, ginkgo, ginseng and St Johns Wort. This can mean your medicines won’t work the way they are meant to, or you may have more side effects. Check with your doctor or pharmacist before starting an anticoagulant or before starting any new medicines, including herbal medicines, vitamins and medicines that you buy yourself, such as pain relief medicine. If you already taking any of these when you are prescribed an anticoagulant, tell your doctor or pharmacist.
如果我在吞咽平板电脑或胶囊方面遇到问题怎么办？
Warfarin:如果您无法吞下整个平板电脑，则可以压碎平板电脑。
达比加特兰:胶囊必须吞咽整体，绝对不能被压碎或破碎，因为这会导致严重的不良反应。
Rivaroxaban：如果您无法吞下整个平板电脑，则可以压碎平板电脑。
What about the risk of bleeding?
Taking anticoagulants means that blood takes longer to form clots, and this can increase your risk of bleeding. The benefits of using anticoagulants usually outweigh the risks of bleeding. All anticoagulants have a risk of bleeding and this should be something you discuss with your doctor. Your doctor will consider the risk of bleeding for you by considering a number of factors such as:
your age (risk increases as you get older)
hypertension (high blood pressure) that is not controlled with medication
previous myocardial infarction, ischaemic heart disease or cerebrovascular disease
anaemia
a history of bleeding
the use of other medicines that increase bleeding risk, such as aspirin or other antiplatelet medicines and non-steroidal anti-inflammatory drugs (NSAIDs).
Are the medicines safe during pregnancy and when breastfeeding?
Most anticoagulant medicines aren't suitable for pregnant women. Speak to your GP if you become pregnant or are planning to try for a baby while taking anticoagulants.
如果我需要非紧急手术，包括牙科手术，会发生什么？
It is important to tell anyone treating you, including your dentist, physiotherapist or surgeon, that you are taking an anticoagulant. You should tell them at least a few weeks before your appointment. You may not need to stop taking your medicine, but you might need to have a blood test before the procedure to make sure your blood clots at the right speed. Only stop taking your medicine on the advice of your GP or another healthcare professional.
如果需要在紧急情况下（例如，受伤或紧急手术前）逆转药物的影响会发生什么？
If you have a serious injury or need urgent surgery, you are more likely to have major bleeding because you take an anticoagulant.
Warfarin: A reversal agent is available.
达比加特兰: A reversal agent is available.
Rivaroxaban: There is currently no reversal agent for rivaroxaban available in New Zealand.
To find out more about the risks and benefits of these medicines, talk with your GP or specialist.
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