“Anticoagulant” refers to a broad category of medications that include a number of different classes. They work to stop blood coagulation and the formation of a clot.
These pharmacological classes include:
(Physicians’ Desk Reference, 70th Ed., 2016)
Serious Side Effects of Anticoagulants
Across these pharmacological classes which encompass anticoagulants, the most serious and common adverse reaction is uncontrolled bleeding, as detailed in British Journal of Clinical Pharmacology “Safety profile of the direct oral anticoagulants: an analysis of the WHO database of adverse drug reactions” (Jan 2017).
Novel Oral Anticoagulants
Novel oral anticoagulants have a faster onset than traditional drugs like Warfarin. Common side effects include:
(Pharmacological Research, “Balancing thromboembolic and bleeding risk with non-vitamin K antagonist oral anticoagulants [NOACs]” January 2017)
Coumarins are vitamin K antagonists. The most famous drug in this class is Warfarin. Side effects can be fatal and include:
Heparin side effects include:
(Clinical Hematology “First-generation agents: aspirin, heparin and coumarins,” Mar 2004)
Synthetic Inhibitors of Factor Xa
Synthetic inhibitors of factor Xa, for instance Fondaparinux, are associated with the following common side effects:
(Cochrane Database Systematic Reviews “Factor Xa inhibitors for acute coronary syndromes,” Jan 2011)
Direct Thrombin Inhibitors
Direct thrombin inhibitors include Hirudin. Side effects include:
(Therapeutische Umschau “New anticoagulants – direct thrombin inhibitors,” Nov 2012)
Understand Your Risks with the Rxight® Genetic Test
Many patients respond well to anticoagulant drugs, but a portion will find side effects – particularly the hematologic side effects – to be severe. This interpatient variability is partly due to genetically encoded differences in the ways drugs are metabolized.
Rxight® DNA testing from MD Labs is designed to allow patients and their prescribers to understand how they might react to a drug – preferably before they begin treatment. Over two hundred prescription and OTC medications are tested based on a process called “SNP genotyping.” All that is required is a simple non-invasive cheek swab of your DNA. After the sample is processed at our labs, your results will be reviewed with you in detail.
How Does Pharmacogenetic Testing Work?
Genetic variations (called polymorphisms) in the genes that code for the enzymes and receptors that interact with anticoagulants can increase the probability of developing adverse effects. Identifying these polymorphisms can therefore reduce the likelihood of patients suffering from side effects. Physicians can prescribe a lower starting dose of the drug given certain alleles, or can move the patient to a different pharmacotherapy altogether.
Contributors to this Article:
Michael Sapko, MD, PhD; Deborah Kallick, PhD, Medicinal Chemistry