Drugs most likely to send you to the ER

blood-thinners-risks-side-effectsIf you’re over the age of 65, the  drug most likely to send you to the emergency room is the blood thinner  Coumadin (warfarin). According to research done by the Centers for Disease Control and published in the New England Journal of Medicine, Coumadin is responsible for 33 percent of emergency room visits among older people. Antiplatelet drugs such as aspirin and Plavix (clopidogrel), which are also prescribed to thin the blood, are responsible for 13 percent of emergency room visits. This means that drugs prescribed to thin the blood in order to prevent blood clots are responsible for almost half of emergency room visits in older Americans.

The reason for these emergency room visits is primarily uncontrolled bleeding caused by blood that is so thin that it won’t clot. The older you are, the greater the risk that blood thinners will kill you instead of help you. If you have an accident that causes trauma such as a bleeding wound, broken bone or bruising, your risk of dying is much higher if you’re taking blood thinners.

The list of dangerous and even deadly side effects and drug interactions for blood thinners is pages long. Their therapeutic window is very small, meaning that even a little bit too small a dose is ineffective, and even a little bit too large a dose can be deadly. Since there are dozens of other medications, foods, beverages, herbs, vitamins and minerals that can affect levels of blood thinners, taking them is pretty much a gamble. Blood thinners do reduce the risk of strokes caused by blood clots, but simultaneously increase the risk of strokes caused by bleeding, as well as the risk of uncontrolled bleeding in stomach ulcers.

Coumadin thins the blood by blocking the action of vitamin K, which is essential for healthy bones, so long term use is almost a guarantee of osteoporosis, especially for women.

What Causes Blood Clots?
Surgery (this is why they get you out of bed and moving ASAP)
Sitting for too long
Prolonged bed rest
Heart damage that causes blood to pool in the chambers
Heart attack
Atrial fibrillation (irregular heartbeat) that causes blood to pool in the chambers
Lack of exercise
Excess estrogen or estrogen dominance
Estrogen replacement (ERT)
Birth control pills
Anemia drugs such as Procrit
Excess sugar and refined carbohydrates in the diet

What Helps Prevent Blood Clots?
Omega-3 fatty acids (e.g. fish oil)
Celery seed

More Information and References

Budnitz DS, Lovegrove MC, Shehab N et al, “Emergency Hospitalizations for Adverse Drug Events in Older Americans,” N Engl J Med Nov 24 2011; 365:2002-2012.

Johnsen SP, Sorensen HT, Mellemkjoer L, “Hospitalisation for Upper Gastrointestinal Bleeding Associated with Use of Oral Anticoagulants,” Thrombosis and Haemostasis: 2001: 86/2 (Aug).

Hirsh J, Dalen JE, Anderson DR et al, “Oral Anticoagulants: Mechanism of Action, Clinical Effectiveness, and Optimal Therapeutic Range,” Chest Journal, January 2001 vol. 119.

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