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Monitoring Blood Thinners: Why New Drugs Are Changing the Game
Published: Dec 21, 2023
Blood thinner monitoring has long been a hassle for patients on warfarin. But with new direct oral anticoagulants (DOACs), the testing landscape is changing dramatically.
The Old Way: Warfarin and INR Testing
For decades, patients on warfarin needed frequent blood tests to check their INR (International Normalized Ratio). This test measures how long it takes your blood to clot. Too high, and you risk bleeding; too low, and clots could form. Patients often needed tests every few weeks to keep their INR in the right range.
The New Way: DOACs and Less Testing
DOACs like dabigatran, rivaroxaban, and apixaban work differently than warfarin. They have a more predictable effect on the body, which means most patients don't need regular blood tests to check their clotting levels. This can be a huge relief for many people, eliminating frequent trips to the lab or clinic.
When Might Testing Be Needed?
While routine testing isn't necessary for most people on DOACs, there are some situations where your doctor might want to check your blood. This could include times when you're having surgery, if you're experiencing bleeding, or if there's concern about how well your body is absorbing the medication. Special tests can measure DOAC levels if needed.
The Future of Monitoring
Research is ongoing to determine if any kind of regular monitoring might improve the safety or effectiveness of DOACs. For now, the lack of routine testing is seen as a major advantage. However, it's crucial to take these medications exactly as prescribed and to keep all your follow-up appointments with your healthcare provider.
Frequently Asked Questions
Yes, to check kidney function and baseline clotting.
Current evidence doesn't support routine testing.
Special tests can measure drug activity in the blood.
Not currently, unlike some options for warfarin.
Generally yes, but individual situations may vary.
The Bottom Line
DOACs offer a simpler monitoring approach for many patients, but always follow your doctor's specific recommendations.
References
- Gosselin RC, Adcock DM, Bates SM, et al. International Council for Standardization in Haematology (ICSH) Recommendations for Laboratory Measurement of Direct Oral Anticoagulants. Thromb Haemost 2018; 118:437.
- Dager WE, Gosselin RC, Kitchen S, Dwyre D. Dabigatran effects on the international normalized ratio, activated partial thromboplastin time, thrombin time, and fibrinogen: a multicenter, in vitro study. Ann Pharmacother 2012; 46:1627.
- Garcia D, Barrett YC, Ramacciotti E, Weitz JI. Laboratory assessment of the anticoagulant effects of the next generation of oral anticoagulants. J Thromb Haemost 2013; 11:245.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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