Drugs that help reduce blood clotting and strengthen blood vessels

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Author of the article: Marina Dmitrievna

2017.09.15

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Blood analysis

Reduced blood clotting threatens a person with the development of life-threatening pathologies. Various blood clotting factors can provoke the disease. The violation should be dealt with in a timely manner. For this purpose, drugs that increase blood clotting are used.

The principle and mechanism of action of blood clotting drugs

Experts call medications for clotting in the blood coagulants. They can be direct and indirect.

The principle of action of the drugs is based on their ability to stimulate platelet adhesion and the formation of a blood clot in the area of ​​vascular damage. Against the background of this process, bleeding stops and a small blood clot forms at the site of a violation of the integrity of the vascular wall.

Some medications affect not only platelets, but also clotting factors, promoting their rapid formation and transportation to the site of injury. As a result, it is possible to stop the bleeding and prevent the condition from getting worse.

Pharmaceutical companies also offer patients medications that do not have a significant effect on clotting factors and red blood cell adhesion, but help improve the condition of blood vessels, which reduces the risk of severe bleeding.

These medications in most cases reduce the permeability of the vascular wall and strengthen it. Thanks to this, bleeding stops faster, especially when the drugs are used in combination with other drugs that affect platelets and clotting factors.

How to reduce blood thickness

The doctor decides based on test results what measures need to be taken to reduce blood viscosity. Self-medication can lead to internal bleeding, cardiovascular disorders and other health problems.

As the main treatment, special blood thinners are prescribed. Additionally, the doctor may prescribe vitamin-mineral complexes and physiotherapeutic procedures. The patient is required to follow a special diet.

Blood thinners

The pharmacy offers many medications that prevent blood clots. Conventionally, they are divided into two groups:

• Antiplatelet agents - suppress the production of thromboxane, prevent platelet aggregation and the formation of blood clots.
• Anticoagulants - act on blood proteins, preventing the conversion of prothrombin to thrombin.

Each group has its own characteristics, contraindications, and active ingredients. Many medications cannot be taken in combination with painkillers or nonsteroidal anti-inflammatory drugs, so you should consult your doctor before starting treatment. In practice they often use:

Medicines for the elderly

People over the age of 40 should undergo regular medical examinations, even if they do not have any chronic diseases. Gradual aging and weakening of the body often leads to blood thickening. To thin it out, patients over 50 years of age are often prescribed:

• Heparin is a direct-acting anticoagulant. The drug prevents unnatural blood clotting, inhibits the transition of prothrombin to thrombin, and reduces platelet synthesis.
• Exanta is a direct thrombin inhibitor. The drug thins the plasma and prevents the formation of blood clots. When administered orally, the therapeutic effect occurs within 1.5-2 hours.
• Aggregate is an antiplatelet agent. Prevents the development of atherosclerosis, improves the patient's condition after a heart attack and ischemic stroke.
• Cardiomagnyl is an antiplatelet agent. Reduces thromboxane synthesis and blood clotting. Prescribed for the prevention of thrombosis, heart attack, and cerebrovascular accidents.

Blood thinners during pregnancy

During pregnancy, many medications are strictly contraindicated. Medicines to thin the viscous blood are prescribed only in cases where the risk to the mother outweighs the threat to the fetus. Pregnant women may be prescribed:

• Chimes. The effect of the drug helps improve blood flow, strengthens the walls of blood vessels, and prevents the risk of thrombosis.
• Heparin. Used only in hospital settings and in minimal dosages. Heparin injections thin the blood and do not have a negative effect on the fetus, but increase the risk of miscarriage, intrauterine bleeding, and premature birth.

Healthy foods

Nutrition for thick blood should be as balanced as possible. An excess of vitamins C and K increases the number of platelets, so it is necessary to consume foods with these substances in moderation. It is advisable to include foods with amino acids and proteins in your diet:

• lean meats - turkey, skinless chicken, rabbit, beef;
• sea ​​fish and seafood - mussels, oysters, shrimp, salmon, salmon, halibut, herring, mackerel, cod;
• dairy products - cream, sour cream, kefir, yogurt, natural yogurt;
• eggs.

Foods high in omega-3 fatty acids prevent blood cells from sticking together. In addition to sea fish, they contain flaxseed and olive oils. Products such as:

• ginger;
• onion;
• garlic;
• almond;
• cashew nuts;
• beet;
• carrot, apple, pomegranate juice;
• lemon;
• cranberry;
• bitter chocolate.

Vegetables are best consumed raw. It is advisable to boil, steam or bake sea fish, seafood and meat without oil. To prevent blood clots from the diet, it is advisable to exclude:

• bananas;
• buckwheat porridge;
• white cabbage;
• nettle;
• chokeberry;
• pork;
• lamb

Indications for use

Blood clotting drugs are prescribed for various conditions that are accompanied by severe bleeding and associated dangerous symptoms.

Main indications for use:

• Bleeding from soft tissues developing against the background of gunshot, cutting or stab wounds, household injuries. In this case, not only local, but also systemic medications are used in the acute period of diseases.
• Bleeding from open fractures with damage to large vessels and small capillaries.
• Internal bleeding, for example, gastrointestinal, which occurs when the vessels of the mucous membrane of the digestive tract are damaged. With such disorders, it is necessary to stop the bleeding within a short period of time to prevent complications.
• Hereditary diseases characterized by a pathological decrease in the number of platelets and clotting factors. In hemophilia, the use of medications may be necessary, even with minimal trauma and capillary bleeding.
• Uterine bleeding of various origins. In case of spontaneous miscarriage or threatened miscarriage, the drugs can be used in long courses.
• The recovery period after surgery on internal organs.
• Heavy menstruation in patients with hormonal imbalance, the presence of uterine fibroids and some other diseases.
• Nosebleeds due to injury or vascular damage as a result of a critical increase in blood pressure.
• Diagnosed thrombocytopenia, characterized by a decrease in the level of platelets in the blood.
• Bleeding from the anus due to hemorrhoids and the formation of anal fissures.

These and other indications are considered reasons for the use of coagulants.

Why does blood clot poorly?

Poor clotting occurs in people who do not have enough substances in their bodies that are responsible for this process. It's a matter of the amount of protein. Their concentration and quality affect the ability of blood to clot.

The disorder occurs due to the presence of hereditary diseases in the human body. Symptoms of pathologies are deterioration of coagulation or its complete absence.

Blood may not clot well due to diseases acquired during life. The list includes:

• Hemophilia. The main sign of pathology is decreased coagulability.
• Von Willebrand's disease. A characteristic feature of the disease is that the body completely or partially lacks protein, without which the blood loses its ability to clot.
• Vitamin K deficiency in the body.
• Liver carcinoma. This is what is called a malignant tumor. Provokes the gradual breakdown of organ cells.
• Infectious pathologies of the liver and other ailments leading to the formation of scars on the organ. Example: hepatitis or cirrhosis.
• Long-term therapy with potent antibacterial agents or drugs that eliminate blood clots. Long-term treatment with blood thinners.
• Lack of calcium in the body. This microelement can provoke the formation of a blood clot.
• Certain types of anemia. These are anemias in which massive and premature destruction of red blood cells occurs. As a result, the body begins to actively produce red cells, stopping the production of platelets.
• Leukemia. A blood disease provokes the formation of all blood cells.
• Damage to blood vessels due to wounds or trauma. Because of this, a lot of blood is lost, and the body does not have time to restore the required volume.

During pregnancy, coagulability worsens due to hormonal imbalance. Hormones negatively affect the functioning of the immune system, which affects the coagulation process. This leads to placental abruption, bleeding after childbirth, premature birth and miscarriage.

Vascular damage

Contraindications

The drugs are not used in cases of diagnosed thrombocytosis and intolerance to the components of a particular medication.

Other contraindications include the following conditions:

• The development of severe hematuria, in which a large amount of blood appears in the urine.
• Tendency to thrombosis.
• Varicose veins, thrombophlebitis and phlebitis at different stages of development.
• Period of anticoagulant therapy.

  
  Anticoagulants are drugs that thin rather than clot blood.

• Acute myocardial infarction. After the disappearance of severe symptoms, medications can be prescribed, but only when an urgent need arises.
• Acute cerebrovascular accident. The drugs are not used for hemorrhagic and ischemic stroke, as they can provoke severe complications.
• Severe kidney pathologies, accompanied by impaired functioning of the organ or failure.
• Atherosclerotic changes in blood vessels, in which there is deposition of cholesterol plaques on their walls.
• Uncontrolled hypertension, in which there is no effect from the use of antihypertensive drugs.

Many medications are contraindicated during lactation and pregnancy, but there are drugs approved for such groups of patients. Elderly patients are prescribed medications with extreme caution.

Side effects

Drugs can provoke negative reactions if they are used for blood clotting over a long period of time and the patient violates the instructions. The most common complication is the formation of multiple blood clots in small and large vessels. In this case, the lumen may be blocked and blood circulation may be impaired.

Many patients are bothered by headaches and dizziness, as well as a feeling of nasal congestion. The latter symptom is often associated with a critical increase in blood pressure. With prolonged use of drugs, an increase in the load on the heart muscle is observed, which is associated with an increase in blood viscosity.

Some patients report indigestion, frequent loose stools and loss of appetite. Side effects may affect the urinary system, which manifests itself in the form of increased urination and pain in the kidney area.

Often, the use of medications leads to weakness, drowsiness and decreased performance. In this case, patients note the persistence of symptoms after stopping the use of medications. Some drugs provoke severe allergies, manifested in the form of skin itching, rashes and irritation.

Anti-clotting agents

Blood is the most important component of the body, since its main function is to ensure its normal functioning and protection from various unfavorable factors.
Its movement is ensured by blood vessels. Situations often arise when the blood begins to thicken, which becomes dangerous to health. In this case, specialists prescribe blood thinners. They will be discussed further.

The danger of thick blood

Most people do not attach importance to the fact that disruption of the flow of fluid into the body can provoke various negative consequences. Experts have identified several pathological processes that directly depend on blood viscosity:

• hypertension, characterized by a sustained increase in blood pressure;
• ischemic or hemorrhagic stroke;
• heart attack;
• disruption of the cardiovascular system;
• atherosclerosis;
• varicose veins;
• blood clot formation.

The development of each of these diseases can not only cause disability, but also result in death.

Help of drugs

The prescription of any medication should be carried out only by the attending physician after carrying out diagnostic measures. In addition, throughout the entire treatment period it is necessary to undergo regular tests to monitor your health.

It is important to remember that blood thinners are not blood clot preventers . They are not able to dissolve already formed clots. However, thanks to their properties, it is possible to reduce the viscosity of thick blood and prevent the development of thrombosis.

Which medicine to take and in what dosage is decided by a specialist in each case individually. In this case, it is necessary to take into account the patient’s age category, the severity of the condition and many other factors.

Groups of medicines

All drugs that prevent blood clots are divided into two groups:

1. Antiplatelet agents. They help stop the formation of blood clots, which prevents angina pectoris.
2. Anticoagulants. These are medications that have the property of preventing increased blood clotting and thrombosis in the future.

Medicines of the second type, in turn, are classified into:

• drugs with indirect effects, which are used as prophylaxis after a stroke or myocardial infarction;
• direct action, used when carrying out temporary therapeutic measures under the control of laboratory tests.

All medications aimed at thinning the blood must first be taken to provide first aid to the body. The pathological process itself can only be eliminated by treating the underlying disease.

Who should use it?

It is necessary to take measures to thin the blood only on the basis of appropriate test results or if characteristic symptoms appear. As a rule, depending on the type of laboratory test, indicators may vary.

If the hematocrit value is more than 0.55, the body is in serious danger. When conducting a general blood test for bleeding disorders, an increase in the concentration of red blood cells to 6 or more per liter will be visible. If, when analyzing viscosity, the value of the indicator is higher than four, then we can talk about a threat.

Excessive thickness of the blood fluid will be indicated by corresponding symptoms. These include:

• feeling of dryness in the mouth;
• absent-mindedness;
• increased blood pressure;
• weakness;
• heaviness and coldness in the lower extremities;
• headache.

In addition, one of the main symptoms is tingling and numbness in some areas of the body. When the blood thickens, the patient will experience a constant state of depression.

Effective products for people of any age

The most effective and frequently used blood thinning drugs include the following:

1. Heparin. The same active component is present in the mucus of leeches, which enters the bloodstream during a bite.
2. Dabigatran. It is a thrombin inhibitor. Helps achieve an active level of coagulation.
3. Warfarin. It ranks second in popularity.
4. Trental.
5. Aspecard. Helps control blood clots.
6. Rivaroxaban. Refers to highly selective inhibitors. Relatively new medicine.
7. Aescusan. Helps normalize blood circulation in the veins and strengthens vascular walls.
8. Fenilin. Has an effective effect within a short period of time. Since this remedy has many contraindications, it is used in exceptional cases.
9. Magnesium hydroxide preparations (Cardiomagnyl). Control the thickening of blood fluid.
10. Multivitamins. Helps restore vascular structure and prevent the formation of blood clots.
11. Aspirin.

Source: //ogomeopatii.ru/sredstva-ponizhajushhie-svertyvaemost-krovi/

Overdose

Independent uncontrolled use of coagulants will certainly provoke an overdose. With the development of this condition, the formation of a large number of blood clots, tachycardia and hypertension are observed. For some, an overdose is accompanied by a hypertensive crisis, during which there is a severe headache and spots flashing before the eyes.

In case of overdose, disorders of the digestive tract and other systems may appear:

• Repeated vomiting during the day, which does not depend on food intake.
• Flatulence and bloating.
• Pain in the stomach and intestines.
• Muscle cramps.
• Peripheral circulation disorders.

In case of overdose, an additional aggravation of the course of chronic diseases is observed, especially in patients who have a tendency to thrombophlebitis.

Precautions and special instructions

Blood clotting medications should only be used as prescribed by a doctor. Self-medication is strictly prohibited. If complications or symptoms of overdose occur, stop use immediately and visit a doctor.

Typically, during a course of therapy, specialists take blood from the patient several times to determine the main indicators of coagulation in the form of prothrombin and platelet count.

If necessary, therapy is canceled if the numbers normalize. During the period of using coagulants, it is important not to exceed the dosage and not to extend the course on your own. This may lead to the development of complications.

The best drugs of the group

Medicines to stop bleeding are available in different dosage forms, which allows you to choose the most suitable medicine in each case. Solutions and tablets are considered the most popular, but sometimes powders are prescribed for preparing solutions. Coagulants are not available in the form of drops, gels or ointments.

Pills

Tablet medications can be used by patients in the absence of acute symptoms. They are easy to use and highly effective when taken correctly.

Vikasol

Tablet medications are prescribed when the bleeding is not life-threatening and does not require immediate stopping.

Solutions

Blood clotting drugs in the form of solutions are prescribed when the patient is unable to take pills, there is a violation of their absorption in the body, or there is a need to immediately achieve a therapeutic result that oral medications are not able to provide.

The most commonly used medications are:

• Aminocaproic acid is used when it is necessary to quickly stop bleeding due to injuries, surgery or pathologies of the digestive tract with damage to the mucous membrane of the intestines and stomach. The product contains the active component of the same name and helps to significantly improve the condition. The patient is given intravenous drips of 100 to 200 ml of the drug per day; treatment usually does not last more than 7 days. The price of the medicine starts from 50 rubles. per bottle.
• Gordox contains aprotinin as the main active substance. This ingredient is of natural origin and is used not only for bleeding, but also for damage to the pancreas. It is prescribed for pancreatitis, liver cirrhosis and some other disorders. The solution is administered 10 ml per day using a dropper, after adding it to 200 ml of sodium chloride. Treatment lasts at least 10 days. The price of the product is from 200 rubles. for 1 ampoule.
• Dicynone contains ethamsylate as the main active component and has pronounced properties. Prescribed for uterine bleeding, during the recovery period after surgery or severe injuries to soft tissues and internal organs. The solution is administered intramuscularly at a dose of 2 ml 3 times a day for 1-2 weeks, depending on the severity of symptoms. Its price is from 30 rubles.

  
  Etamzilate is a cheap analogue of Dicinone, a hemostatic agent for heavy menstruation.

The solutions help to quickly eliminate the symptoms of the disease and prevent severe complications due to heavy blood loss.

Powders

Coagulants can be produced in the form of special powders, which, when dissolved, can produce a solution for external use. Thrombin is considered the most popular drug in this group. It contains the active component of the same name, which has pronounced hemostatic properties.

The drug is used for bleeding during surgery, as well as capillary bleeding due to minor injuries to the skin or mucous membranes. The medication is not used in courses; it is used directly to stop bleeding.

Add 20 to 50 ml of sodium chloride to 1 ampoule of powder. After dissolution, the product is used to soak gauze, which is applied to the affected area for 20-40 minutes. The price of the product starts from 250 rubles.

Vilate is a drug in powder form for the preparation of a solution for intravenous infusion. Contains human clotting factors and has a pronounced hemostatic effect. The medicine is prescribed for severe hereditary diseases accompanied by bleeding disorders. Each bottle of powder comes with a solvent.

After preparing the solution, it is slowly administered intravenously, the procedure is repeated daily for 1-2 weeks, depending on the severity of symptoms. The price of the product is very high and can reach 20,000 rubles. per package.

Such drugs are not used so often, but are highly effective.

Essential Medicines

To get acquainted, it is worth taking a closer look at drugs that increase blood clotting. List of the main potent medications.

"Fibrinogen"

To normalize coagulation, Fibrinogen is prescribed. Available in the form of a porous mass. It is used to have a systemic effect on the body.

The medicine is obtained from the plasma of donor blood. It is injected into the vessel, after which the active substance is converted into fibrin, which forms platelets.

Used in emergency situations when it is necessary to quickly normalize coagulation. The maximum effect of the drug is observed with heavy blood loss, as a result of which a large number of platelets are lost. Often used for gynecological and oncological pathologies.

To increase the blood's ability to clot, the medicine is injected into a vein. To do this, a dropper is placed so that the substance enters the body slowly. Before this, dissolve in a certain amount of water. Can be used in film form. It is applied to the place where bleeding is observed.

"Fibrinogen"

"Thrombin"

The use of a drug that improves blood clotting is most common. It is produced in powder form. Has a direct effect. Used for local therapy.

Dilute before use. This is done as follows: the powder is added to saline solution. As a result, a mixture of prothrombin, calcium and thromboplastin is formed.

For local treatment, the medicine is used in the presence of minor bleeding, bruises, blood loss from parenchymal organs that do not threaten human life. Quite often, Thrombin is used when an organ is damaged during surgery or biopsy.

Dentists practice this to eliminate excessive bleeding from the gums. For this purpose, the hemostatic sponge is impregnated with medication and applied to the site of hemorrhage.

In some cases, it is used internally. Before this, the powder is dissolved in sodium chloride or in the drug Ambien. The indication for oral administration is severe bleeding in the stomach. If blood flows into the respiratory tract, the drug is administered by inhalation.

"Thrombin"

"Vikasol"

This coagulant is menadione sodium bisulfite, which has an indirect effect. It is of a synthetic nature and is considered an analogue of vitamin K. It is produced in the form of tablets or solution. It is used to speed up the process of fibrin clot formation.

The medication itself has no effect on the body. Vitamins that are produced from it restore clotting: vitamin K. The production of vitamins takes time, so the effect is observed after 12 hours. This applies to taking pills. If administered intravenously, the drug acts much sooner.

In most cases, Vikasol is recommended for patients who lack vitamin K in the body or have a low level of prothrombin index. This happens due to the following reasons:

• More than a month of taking vitamin K antagonists and broad-spectrum antibacterial drugs.
• Use of sulfonamide medications.
• Carrying out preventive measures for hemorrhoids in an infant.
• Development of cystic fibrosis.
• Regular diarrhea in children.
• Complications during pregnancy.
• Hepatitis A.
• Heavy blood loss.

Important!!! When taking antagonists together with Vikasol, a decrease in the effect of the last resort is observed.

"Vikasol"

What products are suitable for use during pregnancy and breastfeeding?

Blood clotting medications may be used during pregnancy if there is a risk of miscarriage or premature birth. They help improve the condition and prevent complications.

In most cases, specialists use parenteral dosage forms to eliminate the risk of worsening symptoms due to the use of tablets with a high content of additional components:

• Tranexam in the form of a solution is indicated in the early and late stages of pregnancy. The patient receives 5 ml of the drug intravenously per day; usually therapy does not last longer than 5-7 days. The product does not have a negative effect on the fetus, the mother’s body, or the child. It can be used during breastfeeding, but only as prescribed by a doctor and in the absence of contraindications.
• Contrikal in the form of a solution is not allowed to be used during lactation, in the 1st and 3rd trimester of pregnancy, but if bleeding occurs in the 2nd trimester of gestation, it can be prescribed under the supervision of a doctor. The product contains aprotinin as the main active component, helps stop bleeding and improve the patient's condition. Per day, the patient is given an intravenous drip of 2 ml of a solution previously added to 200 ml of sodium chloride. Treatment lasts no more than 7 days.

  
  Contrical in ampoules

• Etamsylate can be used during pregnancy and breastfeeding. The product contains the active ingredient of the same name, is considered quite effective and helps to quickly eliminate bleeding. It is administered intramuscularly, 2 ml 2-3 times a day for 10 days. Longer courses are indicated if the need arises.

The use of medications during pregnancy and lactation should be agreed with a doctor.

Fibrinogen

To increase blood clotting, many doctors also prescribe a medication such as Fibrinogen. It is produced in the form of special bottles in the form of a porous mass.

Fibrinogen has a systemic effect on the entire body.

Sometimes it is obtained from blood plasma from a donor. Quite often it happens that the active component of this medicine can turn into fibrins, which increases the risk of blood clots.

The product is characterized by a number of features in use:

1. Fibrinogen is used mainly for emergency therapy.
2. With heavy bleeding, the highest activity in the body of this drug is observed.
3. Fibrinogen is especially important in gynecology in case of bleeding due to placental abruption, when a woman needs to save not only her life, but also try to save the child.

There are also cases of its use for severe bleeding of internal organs, when a fibrin film is applied to the bleeding area. In order to begin introducing the drug into the body, it must first be dissolved in water. Fibrinogen is administered only intravenously or intravenously, but always very slowly.

List of the best drugs for heavy periods

Many women suffer from heavy menstruation, which causes blood complications due to severe blood loss. To reduce blood volume, it is allowed to use medications in tablet form, which do not often cause complications and are effective:

• Dicynone.
• Vikasol.
• Tranexam.
• Etamzilat.

• Ascorutin.

Such remedies additionally have a positive effect on the vascular wall, which helps improve its condition and prevent complications. The drugs are usually started 2-3 days before the start of menstruation and continued for 3 days after the end. The dosage for each patient is determined individually.

Vikasol and Phytomenadione

Vikasol is a coagulant that can be bought at almost any pharmacy. It is usually sold in the form of an injection solution or tablets. Vikasol belongs to indirect coagulants. It is of synthetic origin and is considered an analogue of vitamin K. It is dissolved in water. This drug is used to accelerate the formation of fibrin blood clots.

Vikasol itself has virtually no effect. The effects on the body are caused by the vitamins that are synthesized from it, especially vitamin K. Therefore, the results after taking such a medicine will be noticeable no earlier than 12 hours. However, with intravenous administration, the result can be seen within half an hour.

Most often, Vikasol is prescribed in case of a lack of vitamin K in the body or when the prothrombin index is low.

Causes of vitamin K deficiency:

• long-term use of vitamin K antagonists;
• use of sulfa drugs;
• long-term therapy with broad-spectrum antibiotics;
• preventive measures taken to eliminate hemorrhagic pathology in infants;
• presence of cystic fibrosis;
• frequent diarrhea in children;
• pregnancy complicated by certain systemic diseases;
• hepatitis affecting clotting;
• severe bleeding;
• preparatory stage before operations.

Phytomenadione is also used to increase blood clotting.

It can be administered intravenously. The ampoule contains 1 ml of this medicine. This product can also be used in tablet form. The product is of synthetic origin.

Phytomenadione is prescribed in the following cases:

• long-term use of anticoagulants;
• sulfonamide therapy;
• ulcerative colitis;
• antibiotic therapy;
• hemorrhagic syndrome;
• preparation for heavy surgical operations.

What can be used to stop nosebleeds?

Capillary bleeding, which includes nosebleeds, is stopped by using a special hemostatic sponge. It is a dry, homogeneous compressed mass, which is in sterile packaging. The size of each can be 50x50 mm or 100x100 mm.

After removing the sponge from the sterile bag, it should be inserted into the nasal passages. Over the course of 3 minutes, it is saturated with blood and adheres tightly to the mucous membranes, preventing further bleeding.

The drug is not used in courses; it is indicated only if it is necessary to provide emergency assistance to a patient with nosebleeds of various origins. It is recommended to visit a doctor after receiving assistance.

Drugs designed to accelerate blood clotting are used quite often in various fields of medicine. They are effective, but if used incorrectly they can cause various complications. That is why it is important to first consult with a specialist who will determine the advisability of prescribing a particular remedy.