Antiplatelet vs. Anticoagulant Blood Thinners — 4 Things to Know
Key takeaways:
Antiplatelet and anticoagulant medications are both blood thinners. But they don’t work the same way, and they treat different health conditions.
Antiplatelet medications prevent platelets from sticking together to form clots. This can help prevent clots that cause heart attacks or strokes. They’re often prescribed if you have a history of these conditions.
Anticoagulants are used to treat deep vein thrombosis (DVT), pulmonary embolism (PE), and conditions that can cause them. They work by blocking the formation of clotting factors (proteins) that help form blood clots.
Table of contents
There are many different medications that help prevent unwanted blood clots in the body. They’re all considered antithrombotic medications and are often referred to as “blood thinners.” But they don’t all work the same way or treat the same health conditions.
Antiplatelets and anticoagulants are the two most common types of blood thinners. But what’s the difference between them? And how do you know which one’s best for you? Let’s take a look at four things to consider regarding antiplatelet versus anticoagulant medications.
1. Antiplatelets and anticoagulants work in different ways
There are several types of blood thinners. Two main groups are anticoagulants and antiplatelets. The main difference between these two types of blood thinners is how they work to prevent blood clots.
Antiplatelets
Antiplatelet medications prevent blood cells called platelets from sticking together to form clots. Examples of antiplatelet medications include:
Clopidogrel (Plavix)
Ticagrelor (Brilinta)
Prasugrel (Effient)
Aspirin / dipyridamole (Aggrenox)
Good to know: Low-dose aspirin is also considered an antiplatelet medication. It’s available over the counter (OTC), but you should only take it if your healthcare provider recommends it.
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Anticoagulants
Anticoagulants are prescribed more often than antiplatelet medications. There are several types of anticoagulants, but they all work by interfering with how your body makes clots. They do this by affecting different clotting factors. Clotting factors are proteins made in your liver that work together to help blood clots form.
There are three main types of anticoagulants:
Direct-acting oral anticoagulants (DOACs) work by blocking one of two different clotting factors: factor Xa or thrombin. Examples of DOACs include apixaban (Eliquis), rivaroxaban (Xarelto), and dabigatran (Pradaxa).
Vitamin K antagonists work by blocking the formation of vitamin K. Your body needs vitamin K to make clotting factors. So without it, your body can’t make clotting factors, which prevents the formation of blood clots. Warfarin (Coumadin, Jantoven) is a vitamin K antagonist.
Heparins work by activating a protein called antithrombin. This blocks the formation of both thrombin and factor Xa. Examples include heparin as well as low molecular weight heparin medications, such as enoxaparin (Lovenox) and dalteparin (Fragmin).
2. Antiplatelets and anticoagulants have different uses
Since they work differently, antiplatelets and anticoagulants also have different clinical uses.
Antiplatelet medications are typically used to prevent heart attacks and strokes caused by blood clots. So you may take an antiplatelet medication if you’re at high risk for these conditions or if you’ve had a stroke or heart attack in the past.
Antiplatelet medications can also help reduce the risk of blood clots caused by peripheral artery disease (PAD). This condition narrows the arteries that carry blood to your hands and feet. Smaller arteries are more at risk for the formation of blood clots.
Anticoagulants tend to have a wider range of uses. They’re a first-choice option when it comes to treating and preventing blood clots. This includes clots in the legs, called a deep vein thrombosis (DVT) as well as the lungs, called a pulmonary embolism (PE).
Anticoagulants are often prescribed to prevent these blood clots after surgery. They’re also used if you have a condition that makes blood clots more likely, such as atrial fibrillation (an irregular heartbeat) or a mechanical heart valve.
3. Antiplatelets and anticoagulants have similar side effects
While they have their differences, antiplatelets and anticoagulants have similar side effects to consider. Since both types of medication help prevent blood clots, the most common side effect is an increased risk of bleeding. This can be minor, such as bleeding gums after brushing your teeth. Or it could be serious, such as blood in your urine or stool.
Antiplatelet and anticoagulant medications seem to have a similar risk of bleeding. But you may be at a greater risk if you:
Have a history of bleeding
Have certain health conditions, such as high blood pressure, kidney disease, or diabetes
Take other medications that make bleeding more likely, such as certain antidepressants
Are over the age of 65
4. Antiplatelets and anticoagulants can be combined for certain health conditions
It’s not common, but in some cases your healthcare provider may prescribe an anticoagulant and an antiplatelet medication at the same time. The use of both types of blood thinners is often needed in more complex medical situations.
For example, you might have more than one health condition that raises your risk of blood clots, such as atrial fibrillation and PAD. And since different blood thinners are prescribed for different health conditions, more than one might be needed. Another common example is adding low-dose aspirin to anticoagulant treatment.
Often, healthcare providers rely on scoring tools to help them look at the risks and benefits of prescribing more than one blood thinner. This is because the combination of antiplatelets and anticoagulants has a greater risk of bleeding than either type of medication has on its own.
You should only take more than one blood thinner if your provider tells you to do so. And make sure you provide an updated medication list to all of your healthcare providers, so they know what medications you’re taking. This can help them avoid possible drug interactions with your blood thinner medication.
The bottom line
When it comes to antiplatelets versus anticoagulants, they’re both useful medications for preventing unwanted blood clots. But they work differently and treat different health conditions.
Antiplatelets prevent blood cells called platelets from sticking together and forming clots. They help prevent blood clots that can lead to a heart attack or stroke. And they’re often prescribed if you experience one of these conditions. Examples of antiplatelet medications include clopidogrel (Plavix), ticagrelor (Brilinta), and low-dose aspirin.
Anticoagulants treat and prevent two serious types of blood clots: deep vein thrombosis (DVT) and pulmonary embolism (PE). They’re also prescribed if you have a condition that raises your risk of these clots, such as atrial fibrillation. They work by blocking the formation of clotting factors that lead to blood clots. Examples include apixaban (Eliquis), rivaroxaban (Xarelto), and warfarin (Coumadin, Jantoven).
In some cases, you may take both an antiplatelet and anticoagulant at the same time. But you should only do this if your healthcare provider tells you to do so. Taking more than one blood thinner raises your risk of bleeding-related side effects.
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References
Amaraneni, A., et al. (2023). Anticoagulation safety. StatPearls.
American Heart Association. (2021). What is peripheral artery disease (PAD)?
American Society of Hematology. (2008). Antithrombotic therapy.
Cabral, K. P., et al. (2015). The role of factor Xa inhibitors in venous thromboembolism treatment. Vascular Health and Risk Management.
Iqbal, A. M., et al. (2022). Antiplatelet medications. StatPearls.
Lee, C. J., et al. (2011). Direct thrombin inhibitors. British Journal of Clinical Pharmacology.
Lip, G. Y. H. (2012). HAS-BLED tool – what is the real risk of bleeding in anticoagulation? American College of Cardiology.
MedlinePlus. (2022). Blood thinners.
Melkonian, M., et al. (2017). Bleeding risk of antiplatelet drugs compared with oral anticoagulants in older patients with atrial fibrillation: A systematic review and meta‐analysis. Journal of Thrombosis and Haemostasis.
Palta, S., et al. (2014). Overview of the coagulation system. Indian Journal of Anaesthesia.
Schaefer, J. K., et al. (2019). Association of adding aspirin to warfarin therapy without an apparent indication with bleeding and other adverse events. JAMA Internal Medicine.
Warnock, L. B., et al. (2023). Heparin. StatPearls.
