Can you tell me about the new way to thin blood other than aspirin or coumadin (warfarin)?

2 new drugs: The fda has approved 2 new drugs and more are on the way: Pradaxa (dabigatran) and xarelto (rivaroxaban). Key points: they're very expensive, don't require frequent blood samples for dosing, and they have no antidote if serious bleeding occurs. Pradaxa is taken twice a day, xarelto is once daily. If stopped abruptly, there is incr risk of clotting with both. Pradaxa can often cause stomach upset.

2 new drugs: Dr. Werner is absolutely right in his very nice summary. Although expensive, the two drugs he mentioned are still less expensive than the low molecular weight Heparin injections (like lovenox) and they can be taken by mouth. You also don't have to be careful about what you eat when you take them, as you do with coumadin (warfarin)., .

Pros and cons: Pros outweigh cons for most but not all pts 10% pts cannot tolerate the stomach upset of pradaxa. Both increase risk of intestinal bleeding compared with warfarin. Pradaxa increases bleeding overall on those older than 75 c/w warfarin. Both substantially reduce risk of brain bleeding. Pradaxa reduces stroke from atrial fibrillation more than warfarin. Both need dose reduction if kidneys impaired.

Fda approvals: Both new drugs are fda approved only for stroke prevention in atrial fibrillation. However both have evidence that they can prevent and treat blood clots such as deep venous thrombosis or pulmonary embolism. Today however they are not fda approved for those uses.