In a normal state, human blood is more than 80% liquid, which also contains red blood cells, platelets and leukocytes. However, in some cases (for example, with age-related changes or taking coagulants), blood thickening occurs. This is a dangerous condition that provokes the formation of blood clots, the development of strokes and heart attacks, as well as other disorders of the cardiovascular system. We have prepared the TOP 10 best blood thinners that will restore its rheological properties and help avoid consequences.

There are contraindications. Consult your doctor.

Blood thinners

The need to use blood thinners appears in case of diseases (atherosclerosis, atrial fibrillation, diabetes and a number of others), risk factors (for example, smoking, obesity). They are indicated for the prevention of heart attack, stroke, and pulmonary thromboembolism.

Prescribe antiplatelet agents (Aspirin, Plavix), direct anticoagulants (Heparin, Wessel Due), indirect (Warfarin, Phenilin), new generation (Pradaxa, Xarelto) are recognized as the most effective.

We recommend reading the article about increased blood viscosity. From it you will learn about the reasons for increased viscosity, signs of impairment, the dangers of thick blood, and methods of thinning. And here is more information about the use of Warfarin.

Necessity of application

Blood thinners are necessary to prevent blockage of blood vessels by blood clots - thrombi. Their formation is caused by both diseases and risk factors. The most common pathologies:

• atherosclerosis (formation of cholesterol plaques);
• venous insufficiency (slow blood flow, stagnation, damage to the lining of the veins);
• increased number of platelets in the blood (thrombophilia of congenital origin and in blood diseases);
• malignant neoplasms;
• atrial fibrillation (frequent and ineffective contraction of the atria);
• diabetes;
• hypertonic disease;
• immune disorders causing vascular inflammation;
• bacterial endocarditis (infection of the heart valves);
• severe pain syndrome;
• kidney diseases.

Risk factors for thrombosis include:

• obesity;
• elderly age;
• sedentary lifestyle;
• bed rest;
• injury;
• surgical intervention;
• the use of contraceptive hormonal drugs, for the treatment of menopause, antitumor drugs;
• smoking;
• stress;
• blood transfusion;
• pregnancy, especially with a complicated course - late toxicosis.

Vessel thrombosis
Any of these reasons can lead to blocking of the lumen of the vessel with a thrombus. This is dangerous due to the development of acute circulatory disorders. Depending on where the blood flow stops, the following occurs:

• myocardial infarction;
• ischemic stroke;
• pulmonary embolism;
• infarction of the lung, kidneys, intestines;
• ischemia of the lower extremities with the risk of developing gangrene.

Main groups of drugs

Medicines used to reduce blood viscosity:

• inhibiting blood clotting - direct-acting anticoagulants (Heparin, Fraxiparin and analogues), indirect (Sinkumar, Phenilin, Warfarin);
• preventing thrombus formation and platelet aggregation - antiplatelet agents (Aspirin, Plavix, Curantil).

In case of venous thrombosis (blockage of the veins of the lower extremities), the treatment complex can also include vascular wall strengthening agents - venotonics (Phlebodia, Detralex), angioprotectors (Trental, Pentilin).

Indications for drugs to thin the blood and prevent blood clots

Medicines to thin the blood and prevent thrombosis are indicated for:

• increased risk of blockage of veins and arteries (presence of diseases or provoking conditions, especially with 2-3 risk factors);
• surgery performed on the heart (valve replacement, bypass surgery, stent installation), blood vessels (prosthetics, restoration of blood flow);
• unstable angina (often progresses to myocardial infarction);
• transient attacks of cerebral ischemia (pre-stroke condition);
• suffered thrombosis of the veins of the leg, pulmonary artery;
• extensive surgery (especially in traumatology, on large joints).

Unstable angina - indication for blood thinning

New generation products

New generation medicines include:

• Xarelto,
• Pradaxa,
• Eliquis.

Their advantages:

• no injections required, available in tablets;
• there is a standard dose that does not require frequent monitoring of blood clotting;
• their activity is not affected by food;
• compatible with almost all other medications;
• lower risk of bleeding;
• prevent both arterial and venous thrombosis (heart attack, stroke, pulmonary embolism);
• Xarelto is taken once a day, the rest - twice.

Negative properties:

• high price (from 2000 rubles, 900 hryvnia per month);
• a drug that can be an antidote (neutralizes the effect) is only undergoing clinical trials (andexanet);
• There is no reliable laboratory test (blood test) that can evaluate the effect of the pills.

Watch the video about blood thinners:

For prevention

It is most advisable to use blood thinning medications to prevent blood clot formation. If it has already formed and blocked the vessel, then it can be removed only through surgery or the introduction of clot destroyers - thrombolytics (Urokinase, Streptokinase) directly into the thrombosis zone, high doses into the vein in the first hours.

The relevance of using funds from this group is evidenced by the following facts: every year, 25 million people die in the world from blockage of blood vessels with blood clots. 18 million of them have arterial thrombosis (heart attacks, stroke), and 7 million have venous thrombosis (pulmonary embolism).

Therefore, it is important to start taking medications even if there is an increased risk of acute circulatory disorders:

• increased frequency of angina attacks;
• previous myocardial infarction, ischemic stroke;
• obliterating atherosclerosis of the lower extremities;
• diabetic angiopathy;
• after vascular operations;
• with atrial fibrillation;
• the presence of 2 or more reasons for accelerated thrombus formation (for example, smoking and the use of hormones).

Atrial fibrillation is an indication for taking blood thinners.
It is important to consider that the uncontrolled use of these drugs is dangerous. Therefore, their prescription is carried out only by a doctor (of any specialty), and also during the treatment process you need to take blood tests for clotting.

Release form

The drug is produced in the form of tablets in a white shell, which protects the active substances from the harmful effects of the aggressive gastric environment.

The tablets are produced in the shape of a heart, which helps not to confuse them with other medications. Tablets are packaged in packs of 30 and 100 pieces. Cardiomagnyl is available with a doctor's prescription.

This is indicated in the instructions for Cardiomagnyl. Reviews and analogues are presented below.

"Cardiomagnyl" is prescribed for the following indications:

1. Unstable severity of angina. In this case, the tablets allow you to restore normal functioning of the heart muscle.
2. Prevention of thromboembolism. "Cardiomagnyl" is often prescribed to patients in the postoperative period. As a rule, we are talking about surgical intervention in the walls of blood vessels. The drug reduces the risk of blood clots after coronary artery bypass surgery and angioplasty.
3. Prevention of recurrence of myocardial infarction. You will need to take pills regularly to prevent vascular thrombosis and the development of myocardial infarction.
4. Primary prevention of heart disease. Taking the pills on a regular basis will significantly reduce the risk of developing acute heart failure, as well as blood clots. This prescription is especially relevant for elderly patients, as well as people with excess body weight, smokers and hypertensive patients.

Another area of ​​application for Cardiomagnyl and analogues is diabetes mellitus and hyperlipidemia.

Blood thinner tablets

Antiplatelet agents are produced in tablets for blood thinning, the most inexpensive of them are based on acetylsalicylic acid; for stomach diseases (without aspirin) Dipyridamole, Clopidogrel are used, the others (Ipaton, Brilinta, Disgren, Pletax) are prescribed much less frequently. Blood thinners from the group of antivitamins K (Phenilin, Sinkumar) help with thick blood, but Warfarin is most often used.

Warfarin for blood thinning

Which inexpensive ones to choose

Low-dose aspirin (50-100 mg per day) is the most inexpensive option for preventing thrombosis. It is recommended to prevent the development of a heart attack (with angina) or reduce the risk of recurrence. The drug helps protect the patient from stroke and blockage of the pulmonary artery, the formation of clots in blood vessels after operations.

It is taken for life, but has an adverse effect on the gastric mucosa . Therefore, it is important to take pills from the very beginning of therapy:

• coated with an acid-resistant coating (Trombo ACC, Aspicor, Aspirin Cardio, Sanovasc) or with magnesium (Cardiomagnyl, Magnicor);
• after eating;
• in case of increased acidity of gastric juice and the need for Aspirin, it is combined with antacids (for example, Famotidine, Nexium).

Examples of the cost of the most budgetary blood thinners are given in the table.

Medicines without aspirin

Since almost 5% of those taking acetylsalicylic acid experience inflammation of the gastric mucosa, and 3% develop ulcers, if there is a threat of such complications, medications without aspirin are prescribed: Dipyridamole, Plavix. They, like Aspirin, are antiplatelet agents. Commonly prescribed anticoagulant tablets include Warfarin.

Dipyridamole

It is usually used in combination with Aspirin, less often for independent therapy. Improves cardiac and cerebral circulation, prevents postoperative thrombosis. Flaws:

• you need to drink 3 times a day;
• contraindicated for low blood pressure, arrhythmia;
• impairs tissue nutrition in widespread atherosclerosis (stealing effect - increased inflow through passable vessels impoverishes blood flow in the affected ones).

Analogues of Dipyridamole are Curantil and Persantine, and the combination with aspirin is Agrenox.

Clopidogrel

Under the influence of the drug:

• thrombus formation in the vessels of the brain, myocardium and lower extremities slows down;
• the risk of thrombosis, thromboembolism, stroke and heart attack, as well as their complications in case of existing vascular blockages, is reduced;
• the patency of installed stents and shunts after vascular operations increases.

Often combined with acetylsalicylic acid. Contraindicated in case of liver damage, bleeding, including intracerebral hemorrhage. Trade names of the medicine:

• Plavix,
• DePlatte,
• Zilt,
• Clopidogrel,
• Trombonet,
• Atherocardium,
• Clopidex,
• Lirta,
• Lopirel.

Intracerebral hemorrhage - indication for taking Clopidogrel

Warfarin

Unlike Aspirin and other antiplatelet agents, Warfarin interferes with the action of blood clotting factors and is considered the most prescribed anticoagulant. It is indicated for:

• blockage of the venous network by a blood clot - thrombophlebitis, thrombosis of the veins of the lower limb, pulmonary thromboembolism;
• high risk of arterial thrombosis - atrial fibrillation, inflammatory damage to the heart valves, prosthetic valve apparatus or blood vessels, stenting or bypass surgery on the heart, brain, limbs;
• previous stroke (ischemic), myocardial infarction;
• obliterating atherosclerosis of the lower extremities;
• congenital coagulation disorders - thrombophilia, coagulopathy.

Warfarin is prescribed for atrial fibrillation.
It is not prescribed for severe kidney and liver diseases, peptic ulcers, aneurysm (protrusion of the wall) of the arteries, high blood pressure, which cannot be reduced to normal with medications.
The therapy is carried out under constant monitoring of blood coagulation - the INR indicator is examined. Analogues of Warfarin - Warfarex, Marevan.

Effective products without age restrictions

When recommending drugs to normalize blood viscosity, doctors often take into account the age factor, since over time the tendency for biological fluid to thicken increases. But there are a number of medicines that are used regardless of age.

The most effective blood-thinning drugs for the treatment or prevention of heart and vascular diseases in patients of any age category are: Aspirin, Warfarin, Trental, Aspecard, Pradaxa, Xarelto, Cardiomagnyl.

Blood thinners after 50 years: most effective for older people

Blood thinners are often prescribed after 50 years of age, since during this period complications of atherosclerosis arise - angina pectoris, arrhythmia, cerebrovascular accident, and vascular diseases of the extremities.

Only the doctor chooses medications after blood tests. Some of the most effective for older people include:

After surgery on blood vessels or an acute circulatory disorder in the myocardium, brain and the presence of risk factors, blood thinners from the group of anticoagulants may be prescribed. Warfarin is the most powerful medication, but it also has the highest risk of bleeding. It is not recommended after 65 years of age.

Before prescribing therapy, a complete examination is necessary:

• General blood test and coagulogram;
• biochemical blood test with liver and kidney tests;
• determination of renal filtration rate;
• general urine analysis;
• stool occult blood test;
• gastroduodenoscopy – examination with an endoscope of the mucous membrane of the stomach, duodenum, sigmoidoscopy (large intestine);
• Ultrasound with Dopplerography of the vessels of the heart, neck, brain, limbs;
• fundus examination (performed by an ophthalmologist);
• MRI of the brain (if indicated);
• consultation with a gynecologist for women.

During treatment, monitoring of liver and kidney function, blood pressure and blood clotting is required.

Expert opinion

Alena Ariko

Expert in Cardiology

Antithrombotic therapy helps prevent acute circulatory disorders, but it itself causes serious complications: bleeding, cerebral hemorrhage, hepatitis, blockage of small vessels with parts of destroyed blood clots (purple finger syndrome).

Causes of blood thickening

Normally, blood thickness varies throughout the day. The highest rates are observed in the morning. Therefore, doctors do not advise, especially unprepared people, to engage in sports immediately after getting up.

Among the pathological causes of blood thickening, the following should be highlighted:

• heart diseases;
• fluid deficiency;
• hormonal imbalance;
• diabetes;
• improper functioning of the spleen;
• lack of zinc, selenium, vitamin C or lecithin in the body;
• taking certain medications;
• poor nutrition.

Blood thinners are the safest for the stomach

Blood thinners often cause stomach pain; the safest are those that do not contain aspirin:

• Dipyridamole,
• Clopidogrel,
• Trental.

Warfarin, used to thin the blood, does not have a direct damaging effect on the mucous membranes, but in the presence of a stomach ulcer in the acute stage it causes severe gastric bleeding.

It is important to know that there cannot be effective medications for blood clots that can be used continuously without side effects. All drugs are dangerous if taken uncontrolled, as they interfere with the entire blood coagulation system. By preventing thrombosis, they thereby stimulate bleeding.

Properties of mucolytic drugs

Medicines that dilute pathological secretions are prescribed in accordance with certain symptoms of the disease. Mucolytics are usually prescribed for dry cough. They help to effectively liquefy and also reduce the viscosity of mucus. In addition, medications facilitate the elimination of sputum and reduce the symptoms of the disease.

When exposed to special enzymes, the functioning of the bronchial mucosa is stabilized. Medicines for thinning sputum in adults are presented in tablet form (Bromhexin, Mucaltin), as well as in the form of solutions and mixtures for inhalation (Berodual), powders and dragees for making hot drinks (ACC). It is possible to purchase medications without a prescription from a medical specialist.

When treating a wet cough, doctors prescribe a combination of medications to dilute the pathological secretion. In case of complications, medications for sputum of reflex action are used. They help to increase the urge to cough, which leads to faster elimination of mucus. As a rule, Mucaltin anti-sputum tablets are often prescribed, as well as syrups from marshmallow or licorice root.

Injections to thin the blood

The following injections are used to thin the blood:

• Heparin,
• low molecular weight heparin – Tsibor, Fraxiparine, Clexane;
• Wessel Due F;
• thrombolytics – Actilyse, Streptokinase, Urokinase.

Heparin is administered subcutaneously or intravenously in hospital settings. Before administration, the patient's blood clotting time is measured and the dose is adjusted. Indicated in the acute period of myocardial infarction, with blockage of the arteries of the lower extremities, the pulmonary vascular system.

Low molecular weight analogues of heparin do not require such caution; it is enough to administer them by injection 1 or 2 times a day. More often they are recommended after operations to prevent increased thrombus formation.

Wessel Due F is similar to the previous group, it is prescribed for:

• diabetic angiopathy;
• recovery period after stroke and heart attack;
• weakening of memory and thinking abilities against the background of vascular diseases, decreased patency of the arteries of the brain;
• suffered thrombosis of blood vessels of the lower extremities;
• thrombophilia (propensity to form blood clots).

The drug is contraindicated in case of bleeding and pregnancy.

Injections of thrombolytics (Streptokinase and analogs) are used only in the acute period (preferably the first hours) for:

• myocardial infarction;
• acute arterial thrombosis;
• thromboembolism of pulmonary vessels;
• obliterating endarteritis (damage to the arteries of the legs);
• heart valve replacement;
• blockage of the veins of the pelvis, extremities, subclavian, internal organs.

It is used exclusively in a hospital for intravenous, intra-arterial administration, including directly into a blocked artery (for example, a coronary artery during a heart attack).

Thrombolytic injections are prescribed for obliterating endarteritis

What is possible during pregnancy

Pregnant women are prescribed Curantil in tablets and Heparin in injections with caution; they must be used under the supervision of a gynecologist. A drug such as Aspirin is contraindicated, since in the early stages it can cause miscarriage and fetal development abnormalities.

In the third trimester, acetylsalicylic acid is dangerous for weak labor and severe bleeding after childbirth. In this case, even small doses are harmful. In the fetus against the background of medication:

• pressure in the lungs increases;
• the ductus arteriosus closes prematurely;
• there is severe renal dysfunction.

How does it affect the blood?

Acetylsalicylic acid and aspirin-containing drugs belong to the group of non-steroidal anti-inflammatory drugs. These substances reduce the formation of prostaglandins in the body, which, among other effects, promote platelet aggregation and sedimentation of blood clots on the walls of blood vessels.

There is an opinion that taking “acetyl” lowers cholesterol levels in the blood and inhibits the progression of atherosclerosis. This confusion is due to the fact that blood clots, the formation of which aspirin blocks, often form on atheromatous plaques. The medicine does not have a direct effect on cholesterol levels in the body.

The drug acts as a thinner, preventing platelet aggregation and slightly dilating blood vessels, which reduces the risk of blood clots. This is the antiplatelet property of the drug. The effect after taking a simple aspirin tablet occurs within an hour and lasts 24-48 hours.

In addition, long-term use of non-steroidal anti-inflammatory substances causes a decrease in the number of leukocytes and other blood cells, which the doctor must take into account when prescribing tablets.

dietary supplements

Dietary supplements may be recommended for patients who do not require medication. They will have a slight effect on the risk of blood clots, but side effects are less common. It is strictly forbidden to replace prescribed medications with dietary supplements or combine them with anticoagulants and antiplatelet agents.

Blood thinners include:

Expectorants for children

You should approach the selection of any medications for your child responsibly, since all drugs differ in composition, dosage and method of action on the body. Let's look at some options that the doctor may prescribe for your baby:

• Gedelix. The product contains ivy leaf extract and contains no dyes or preservatives. Available in the form of drops and syrup. It can even be used by children under one year of age. For infants, the drug should be diluted in water.
• Doctor Mom is a syrup that consists of 11 medicinal herbs. Prescribed for the treatment of cough in children aged three years and older.
• Mucaltin - tablets. Use before one year is not recommended.
• Syrup with licorice root extract. Due to the ethyl alcohol it contains, children under 6 years old should dilute the product with water.
• Bromhexine medicine is a potent medicine that is prescribed even for the treatment of pneumonia.
• Alteyka syrup contains extracts of medicinal herbs, as well as amino acids, fatty acids, pectins, minerals, provitamin A, which improve the functioning of the bronchial glands and improve coughing.
• Berodual is an effective remedy that acts on muscles and reduces spasms.
• Ascoril is a combination cough medicine that contains 3 substances - salbutamol, bromhexine and guaifenesin. The drug should not be used for more than one week and should not be combined with antitussives.

Contraindications

Each drug has its own contraindications for use, general restrictions for antithrombotic therapy:

• liver failure;
• decreased filtration of urine by the kidneys;
• decreased number of platelets in the blood;
• high risk of bleeding (peptic ulcer, vessel aneurysm, dilated veins of the esophagus, trauma);
• severe hypertension;
• previous hemorrhagic stroke, pulmonary or renal bleeding.

Hemorrhagic stroke is a contraindication for antithrombotic therapy

Possible complications

The most dangerous and common complication of taking blood thinners is bleeding. In addition, it is possible:

• abdominal pain, diarrhea;
• nausea, vomiting;
• disturbance of blood composition - decrease in platelets, red blood cells, increase in eosinophils;
• itching, rashes;
• hair loss;
• kidney stones, nephritis;
• bile stagnation, signs of liver damage;
• numbness of the limbs;
• dizziness;
• constant headache;
• frequent appearance of bruises on the skin.

Measures to prevent side effects

To reduce the risk of bleeding and other side effects of blood thinners, you should:

• undergo examination before starting treatment;
• periodically monitor test results during therapy (once a week if there is a high risk of bleeding);
• in old age and childhood, as well as with kidney and liver diseases, it is necessary to start taking it with low doses, and then, under the control of a coagulogram, gradually increase the dosage to the desired effect;
• It is prohibited to drink alcohol or take other medications on your own; they may be incompatible with antiplatelet agents and anticoagulants;
• maintain blood pressure at 130-140/80-85 mmHg. Art.;
• do not change the drug without the consent of your doctor, even to an analogue with one active ingredient.

We recommend reading the article about cerebral hypertensive crisis. From it you will learn about the causes of development, symptoms of a high blood pressure crisis, the consequences of a crisis and therapy. And here is more information about the drug Trombopol.

Blood thinners are used to prevent venous and arterial thrombosis - pulmonary thromboembolism, stroke (ischemic), myocardial infarction. Main groups: antiplatelet agents (Aspirin, Clopidogrel), direct anticoagulants (Heparin, Clexane, Wessel Due F), indirect (Warfarin).

They are prescribed for diseases (atherosclerosis, atrial fibrillation), risk factors (obesity, smoking). Contraindicated in patients with a tendency to bleeding, severe liver and kidney diseases. To reduce the risk of adverse reactions, monitoring of blood tests and a complete preliminary examination is required.