A lot is said and written about the need to dilute blood for the treatment and prevention of many serious diseases. In addition, the number of drugs that effectively perform this task has recently increased. It is not recommended to choose them yourself, only a doctor should select them.
But everyone should know what blood thinners without Aspirin are used in medicine.
Why thin the blood
With age, many people experience bleeding disorders. The mechanisms of this process are different, some are not fully understood.
What can I take to thin the blood? Strokes, as well as thrombosis and thromboembolism, are pathologies that arise due to the fact that blood clots clog the lumen of the vessel and stop blood flow in a certain area of our body.
These vascular problems are very dangerous, they never pass without a trace: without timely medical assistance it is either a fatal outcome or a disability.
According to reviews, blood thinners without Aspirin come first for preventive purposes to prevent thrombosis, and therefore they prevent mortality from cardiovascular diseases.
In addition to prevention, they are also used to treat already formed thromboses.
Medicines for proper blood thinning
The appearance of clots is activated by many coagulation factors that are in the blood. Exist:
- Primary platelet hemostasis. Blood plates stick together with each other and the vascular wall, thereby clogging the lumen of a small vessel.
- Secondary, coagulation hemostasis. There is an activation of plasma coagulation factors and the formation of a fibrin thrombus.
Accordingly, blood thinners without Aspirin are divided into:
- On antiplatelet agents (prevent gluing of platelets, inhibit vascular and platelet hemostasis).
- Anticoagulants (they block plasma coagulation factors and prevent the formation of a fibrin clot).
Antiplatelet agents
Antiplatelet therapy is prescribed in the following situations:
- With damage to the muscles of the heart, provoked by a deficiency or disruption of the blood supply to the myocardium.
- With ischemia of the heart, which occurs with the occurrence of ischemic necrosis of the muscle area.
- Patients with arrhythmias.
- Secondary prevention of blood clots in people who have suffered a stroke.
- After any surgical interventions on the heart and blood vessels.
- Patients with lesions of the peripheral arteries.
Antiplatelet agents without Aspirin
Adverse reactions from drugs containing "Aspirin", forced experts to look for an alternative, more harmless medicines to thin the blood with a similar effect.
Subsequently, several drugs without acetylsalicylic acid, which have antithrombotic effects, are currently used in clinical practice.
But it must be remembered that absolutely safe medicines of this group do not exist, each of them has certain limitations, and only a doctor prescribes them. Some modern antiplatelet agents are prescribed even as an adjunct to acetylsalicylic acid.
List of blood thinners without Aspirin:
- Dipyridamole (Curantyl).
- "Ticlodipine" ("Ticlid").
- Clopidogrel (Plavix).
- "Ticagrelor" ("Brilinta").
- "Prasugrel" ("Effient").
- "Cilostazol" ("Pletax").
- Pentoxifylline (Trental).
Further, antithrombotic blood thinners without Aspirin will be discussed in more detail.
"Dipyridamole"
The drug according to the spectrum of exposure is considered an inhibitor of phosphodiesterase, and also has a vasodilating and antiplatelet effect. Its effect is slightly weaker than that of Aspirin, but it is completely justified in case of the individual intolerance to the latter.
In addition, "Dipyridamole" is the only antiplatelet agent that is approved for use in pregnant and lactating women. The drug is taken at 75 milligrams four times a day, if necessary, the daily dosage is increased to 450 mg.
Dipyridamole is produced in tablet form. A drug with the brand name Curantil will cost more - from 650 to 800 rubles.
"Ticlodipine"
The drug inhibits the aggregation of blood platelets, reduces blood viscosity and prolongs bleeding time. The drug is prescribed 250 milligrams twice a day. The pharmacological effect of blood thinners without Aspirin is achieved on the fourth day of therapy.
Adverse Reactions:
- bleeding
- thrombocytopenia (a disease that is characterized by a decrease in platelet count below normal, which is accompanied by increased bleeding and problems with stopping bleeding);
- leukopenia (a decrease in the amount of white blood in the blood);
- pain in the abdomen;
- diarrhea.
The cost of the medication is 1600 rubles.
"Clopidogrel"
The spectrum of action of the drug is similar to "Ticlodipine", but it is more effective and safer. It should be consumed 75 milligrams once a day, regardless of food. The cost of blood thinners without Aspirin varies from 300 to 900 rubles.
Assign "Clopidogrel" in the following conditions:
- In acute coronary syndrome, 300 milligrams is prescribed once.
- As a preventive measure to prevent stent thrombosis after stenting. In the absence of restrictions, it is used in combination with acetylsalicylic acid.
- Coronary heart disease, which occurs with the appearance of ischemic necrosis of the myocardial site.
- Ischemic stroke (impaired microcirculation of the brain with damage to brain tissue, impaired function due to difficulty or cessation of blood flow to a particular department).
- Peripheral arterial occlusion (vascular insufficiency, which develops with impaired patency or clogged vessels, resulting in impaired blood transport to a particular organ, which leads to problems in its functioning).
Ticagrelor
An innovative medication, the spectrum of action is similar to "Clopidogrel." It is produced in tablet form at 60 and 90 milligrams, consumed twice a day. Of the adverse reactions, in addition to bleeding, shortness of breath should be noted. The price of the drug is 4500 rubles.
Complementary Medication
"Prasugrel" is a new drug used in patients with acute coronary syndrome who will undergo stenting. These blood-thinning pills without Aspirin are much more effective than Clopidogrel, but at the same time, adverse reactions occur more often with its use. It is not recommended for patients who have suffered a stroke. The price of the medicine is about 4000 rubles.
"Pletax" has an antiplatelet and vasodilating effect. Well dilates the arteries of the legs. It is used, as a rule, for obliterating lesions of these arteries. Dosage - 100 milligrams twice a day. The price of the drug is 2000 rubles.
Trental combines antiplatelet and vasodilator effects. Reduces blood viscosity, helps improve blood circulation. Both a solution for intravenous administration and tablets are used. The price of the drug varies from 200 to 1500 rubles.
Anticoagulants
These are drugs that inhibit the activity of plasma coagulation factors. They are used in situations where antiplatelet agents alone cannot be dispensed with, for the treatment of thromboembolic complications, and also for prophylactic purposes when the likelihood of complications is very high.
Indications for blood thinners without Aspirin:
- Blockage of the pulmonary artery, which is formed, as a rule, in the large veins of the legs or pelvis.
- A disease in which blood clots form in the veins that interfere with the normal flow of blood.
- Myocardial infarction.
- Ischemic stroke (a violation of microcirculation of the brain with damage to brain tissue, a violation of its functions as a result of difficulty or stopping the flow of blood to a particular department).
- Atrial fibrillation in patients with cardiac ischemia.
- Stroke with atrial fibrillation.
- Prosthetic heart valves.
- A thrombus in the atrium (a natural process in which blood coagulation in vessels or cavities of the heart increases).
- Stent stenosis (narrowing of the artery).
The following groups of these drugs exist:
- Direct anticoagulants that inactivate thrombin in the blood. This is "Heparin" and its various modifications, as well as "Hirudin".
- Indirect anticoagulants block the formation of plasma coagulation factors in the liver (Warfarin, Fenilin, Neodikumarin, Sinkumar).
- New oral anticoagulants.
Direct anticoagulants
Unfractionated heparin is a natural anticoagulant, it is found in many tissues of the body. In the blood, it inhibits thrombin, thereby reducing the ability to form clots.
Heparin is used parenterally in elevated concentrations - to eliminate acute myocardial infarction, limb arterial thrombosis, pulmonary thromboembolism, in small doses - as a preventive measure to prevent thromboembolism. The medication is prescribed with extreme caution under the control of blood coagulation only in a medical facility.
Heparin ointments and gels for local use are also produced (heparin ointment, Lyoton, Venitan, Venolife). They are recommended for varicose veins of the saphenous veins, as well as hemorrhoids.
Low molecular weight heparins are usually administered subcutaneously twice a day. Dispensed in disposable syringes. In most cases, the following drugs are prescribed:
- Dalteparin (Fragmin) - 2,500 micro-units / 0.2 milliliters - there are ten syringes in the package. The cost of the drug varies from 1700 to 2800 rubles.
- "Nadroparin" ("Fraksiparin") - is produced in different concentrations, the cost of the drug ranges from 2000 to 4000 rubles.
- "Enoksoparin" ("Kleksan") - dosing in syringes from 2000 to 8000 units, the price varies from 700 to 3000 rubles.
- "Bemiparin" ("Zibor") - produced in syringes 3,500 micro units of ten pieces, 3900 rubles.
As a rule, low molecular weight heparins are used for prophylactic purposes to prevent thrombosis in patients after surgery. In addition, they can be used by pregnant women with an autoimmune state of hypercoagulation provoked by antiphospholipid antibodies.
"Sulodexide" is an antithrombotic medication that consists of two glycosaminoglycans formed from the mucous membrane of the intestines of a pig. The spectrum of exposure resembles low molecular weight heparins. It is used, as a rule, to prevent microthrombosis in people with diabetes. The advantage of the drug is its good tolerance, as well as the possibility of use not only in injections, but in capsules for oral use. The price of 10 ampoules is 2000 rubles, the cost of capsules is 2700 rubles.
"Warfarin" is almost the only anticoagulant that is prescribed for prolonged use. It is still considered the standard against which all modern medicines with the same effect are compared. In the liver, it blocks the exchange of vitamin K and thereby prevents the formation of several plasma coagulation factors. Subsequently, blood loses its ability to form clots.
With prolonged use, Warfarin reduces the frequency of strokes by 64 percent. But this medication is imperfect, it is inconvenient for frequent use.
The main disadvantages:
- The need for regular laboratory monitoring and constant dosage adjustment.
- Strict adherence to diet.
- Incompatibility with most drugs.
- Frequent bleeding.
Warfarin still remains the most used anticoagulant, mainly because of its affordable cost. The dosage of the drug is selected under the control of a laboratory blood test, sometimes the selection of the optimal concentration of drugs takes a couple of months.
The medicine is produced in tablet form, 2.5 milligrams each. The price of the medicine varies from 70 to 200 rubles, depending on the manufacturer.
New oral anticoagulants are the latest generation of medicines, introduced into medical practice not so long ago, but were quickly accepted by doctors and patients.
All new oral anticoagulants can be divided into two groups:
- Direct thrombin inhibitors (Dabigatran).
- Direct inhibitors of factor Xa ("Rivaroxaban", "Apixaban", "Endoxaban").
Their effect can be compared with Warfarin, but it is more convenient to work with them both for a medical specialist and for a patient. The main advantage is that they do not require general laboratory control. The main disadvantage is their high price.
Dabigatran inhibits thrombin, thereby preventing the conversion of fibrinogen to fibrin. It is well absorbed from the gastrointestinal tract. Its influence is also comparable to Warfarin. Adverse reactions are rare, and use is much more convenient.
"Dabigatran" is made in capsules of 75, 110 and 150 milligrams, used twice a day, the daily dosage is selected by the doctor depending on the purpose of the appointment. It is forbidden to use the drug for bleeding, as well as a recent hemorrhagic stroke, severe renal failure, pregnancy. Laboratory monitoring is usually not required.
The cost of the drug is 1900 rubles.
"Rivaroxaban", "Apixaban", "Edoxaban" inhibit both free and thrombus-related factor Xa. Trade Names:
- Rivaroxaban - Xarelto.
- Apixaban - Elikvis.
- Endoxaban - Lixiana.
Indications for use are the same as that of Warfarin. All three drugs are rapidly absorbed from the gastrointestinal tract.
The differences are that you need to use Xarelto tablets with food, the rest - regardless of the meal. "Elikvis" - twice a day, the rest - once.
Folk remedies for blood thinning without Aspirin
Preparations have many limitations, so you should look at other natural medicines (herbs, fruits, berries) and other grandmother's recipes:
- Plants that help thin the blood are white willow bark, sweet clover, roots of the Caucasian dioscorea, hazel bark and leaves, horse chestnut, medunica, ginkgo biloba leaves.
- Due to the pharmacological properties of sodium bicarbonate (baking soda), patients manage to get rid of the increased acidity of the stomach and thick blood.
- Cranberries are filled with a huge amount of vitamins. The increased content of ascorbic acid has a positive effect on the wall of blood vessels, making it stronger, which reduces the likelihood of blood clots.