A glass of alcohol and a bottle of blood thinners on a table due to a person with an addiction

Blood thinners are medications that reduce the body’s ability to form blood clots. Blood thinners are used to protect people from harmful blood clots.

For blood to clot when people get a cut or a bruise, the blood requires two critical elements:

  • Platelets: These are a type of blood element that congregates at the site of injury and bind together to form a plug that stops the bleeding.
  • Clotting factors: These are proteins that are mostly produced in the liver and are activated by an injury to form a stringy protein called fibrin. Fibrin forms a tight mesh to begin healing over the bleed.

While blood thinners help protect people from harmful blood clots, they’re a double-edged sword because they also carry a risk of causing bleeding that’s hard to stop. Mixing blood thinners with alcohol may worsen that risk. People who take blood thinners should check with their prescriber if they plan to use alcohol, and should be honest about the extent of their alcohol intake.

What Are Blood Thinners?

There are three types of blood thinners:

  • Anticoagulants: medications that hinder the clotting of blood.
  • Antiplatelets: medications that prevent platelets from congregating and sticking together.
  • Fibrinolytics: medications that break down fibrin, thereby dissolving existing clots.

Antiplatelet drugs and anticoagulants are taken as pills (or sometimes injection) on an ongoing basis to prevent blood clot formation in people who are at high risk for forming blood clots or who have an existing blood clot that could cause catastrophic consequences.

Fibrinolytics are powerful “clot-busting” drugs that are only used in hospitals on a one-time basis in order to dissolve a life-threatening clot, such as a blood clot in the brain that is causing a stroke (a thromboembolic stroke) or during an acute heart attack.

What Are Blood Thinners Used For?

Blood thinners are used to stop the enlargement of existing blood clots in the body that may cause serious problems. They also facilitate the body breaking down the clot and help prevent the clot from traveling elsewhere in the body. The most common example of blood thinner usage is when someone develops a deep vein thrombosis (DVT), which is a blood clot in the veins of the leg. Untreated, a DVT can break off and travel to the lungs through the heart, causing a life-threatening event known as a pulmonary embolism (PE).

Certain people who are at a high risk of developing a DVT may be placed on blood thinners to prevent DVT formation. For example:

  • People who have had orthopedic surgery on their lower limbs may be placed on an anticoagulant for a few weeks
  • People who have had more than one DVT or a PE may be placed on an antiplatelet or an anticoagulant on an ongoing basis
  • People with certain blood-clotting disorders (such as Factor V Leiden) may be put on an anticoagulant

People who may have a high risk of having a heart attack or a thromboembolic stroke (a stroke caused by a tiny blood clot) may be advised by their doctor to take an antiplatelet drug to lower their risk.

People with a heart condition known as atrial fibrillation or atrial flutter may be placed on an anticoagulant to prevent blood clot formation in their heart that could travel to the brain and cause a stroke.

What Medications are Blood Thinners? (H3)

Antiplatetet drugs include:

  • ASA (acetylsalicylic acid) (Aspirin, Asaphen)
  • Clopidogrel (Plavix)
  • Eptifibatide (Integrilin)
  • Ticagrelor (Brilinta)
  • Ticlopidine (Ticlid)
  • Prasugrel (Effient)
  • Dipyridamole
  • Dipyridamole/aspirin (Aggrenox)

Anticoagulant medications include:

  • Heparin
  • Warfarin (Coumadin)
  • Enoxaparin (Lovenox)
  • Edoxaban (Savaysa)
  • Rivaroxaban (Xarelto)
  • Apixaban (Eliquis)
  • Fondaparinux (Arixtra)
  • Dabigatran (Pradaxa)

Fibrinolytic drugs include:

  • Tissue plasminogen activator (tPA)
  • Streptokinase
  • Urokinase

There are also medications that can thin the blood as a side effect but are not used as blood thinners. An example is non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen (Aleve).

Alcohol also has significant blood-thinning effects.

Can You Drink Alcohol While Taking Blood Thinners?

Taking blood thinners and drinking alcohol can be a dangerous combination. It is important that people check with their doctors to ensure that they are aware of any alcohol-related risks.

Alcohol affects the metabolism of the anticoagulant Coumadin, and has been shown to interfere with the ability to maintain the drug in the therapeutic range and to increase the risk of bleeding.

Antiplatelet drugs and the newer anticoagulants (i.e., all except heparin and Coumadin) are not directly affected by occasional moderate alcohol use. However, heavy alcohol use carries a risk of bleeding, so alcohol use should be discussed with the prescriber.

The use of alcohol and aspirin (or other NSAID medications) can increase the bleeding risk, following as few as four drinks.

People who use alcohol more than occasionally should discuss it with their doctor so that their liver function can be checked with a blood test. Impaired liver function from alcohol use can affect how blood thinners are metabolized in the body and can increase bleeding risk independently.

Side Effects of Mixing Alcohol and Blood Thinners

The side effects of blood thinners and alcohol are related to the bleeding risk from the individual effects of alcohol and blood thinners on the blood clotting system.

Some bleeds are of only minor consequence to health, such as easy bruising, nosebleeds or bleeding gums. However, internal bleeding in the stomach or spontaneous bleeding in the brain can be life-threatening and require immediate hospital care.

For people who experience a traumatic event such as a significant fall or a motor vehicle accident, the risk of a significant bleed is greatly increased if they are on a blood thinner and even more so if they also use alcohol regularly.

Is Alcohol a Blood Thinner?

Alcohol is a blood thinner. Alcohol causes anti-clotting effects in several ways:

  • Reduces platelet counts in the blood (thrombocytopenia): This effect affects up to 43% of “healthy” alcohol consumers and 81% of acutely ill alcohol consumers. Alcohol-induced thrombocytopenia usually resolves within one week of stopping drinking.
  • Impaired platelet function (thrombocytopathy): Alcohol impairs platelets from aggregating and plugging bleeds.
  • Breakdown of fibrin (fibrinolysis): Alcohol — depending on the timing of the last drink — can alternately increase breakdown of fibrin, which promotes bleeding, or reduces the breakdown of fibrin, which promotes the formation of potentially deadly blood clots.
  • Liver impairment: This effect impairs the liver’s ability to make the clotting factors that are necessary for the clotting and healing process

If you or a loved one struggle with alcohol use and are concerned about the many health implications of a substance use disorder, contact the Orlando Recovery Center to speak with a representative about how professional treatment can help. Take the first step toward a healthier future, call today.

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Efird, Lydia; Miller, Donald; Ash, Arlene; et al. “Identifying the risks of anticoagulation in patients with substance abuse.” Journal of General Internal Medicine, October 2013. Accessed August 23, 2019.

Gremmel, Thomas; Michelson, Alan; Frelinger, Andrew; et al. “Novel aspects of antiplatelet therapy in cardiovascular disease.” Research and Practice in Thrombosis and Hemostasis, May 27, 2018. Accessed August 23, 2019.

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