Risk Of Spinal Or Epidural Blood Clots
People who receive spinal or epidural anesthesia or undergo spinal puncture while taking Eliquis are at risk of developing epidural or spinal hematomas, also known as blood clots. Either type of blood clot can cause long-term injury or paralysis.
Taking Eliquis with other drugs that affect bleeding, such as nonsteroidal anti-inflammatory drugs , platelet inhibitors or other anticoagulant drugs, can increase your risk of developing spinal/epidural blood clots. Spinal surgeries, repeated spinal or epidural punctures and use of indwelling epidural catheters also make these problems more likely. Spinal hematomas have also occurred spontaneously in people taking Eliquis who have not undergone spinal procedures or anesthesia.
If not treated swiftly and properly, a spinal or epidural hematoma can be deadly. While full recovery is possible, hematomas of this nature can result in permanent damage to the brain and long-term disability.
When To Call Your Healthcare Provider
Make sure to let your oncologist know of any symptoms you are having during your chemotherapy treatment, including mouth sores. Some reasons to alert your healthcare team between appointments include:
- Mouth sores that interfere with your ability to eat or drink
- Significant weight loss or signs of dehydration
- A white coating on your tongue, increasing redness, or bleeding that may be a sign of an infection
- A fever. Ask your oncologist what temperature he or she feels is a concern and should prompt you to call
Anticoagulants And Gi Procedures
If you plan to have a GI procedure such as a colonoscopy or upper endoscopy, tell the doctor performing it if you are on blood-thinning medications. Its now considered safe to undergo most GI procedures without stopping aspirin. But if you take warfarin, you will need to tell the doctor who prescribes it that you are having a procedure. He or she will instruct you on when to stop warfarin and if you need to take other medication in its place.
Patients usually need to stop taking other blood thinners two to seven days prior to a GI procedure. You should ask your doctor for specific instructions on when to stop your medications.
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Can Certain Medications Cause Dry Mouth
There are numerous medications on the market that have dry mouth as a side effect, and some medications are more likely than others to cause the condition. Medications that cause dry mouth do so by affecting the sympathetic nervous system and thereby thicken and slow down the production of saliva. According to The American Academy of Oral Medicine, over 1,110 medications have the potential to cause dry mouth.
The American Dental Association says that nearly half of all adults in the U.S. take at least one prescription medication per day, many of which can produce dry mouth. Its estimated that at least 31 million Americans have dry mouth and that 11 million of these cases are due to medications. Dry mouth may seem like its just an uncomfortable condition, but it can actually lead to more serious complications like sore throat, bad breath, problems wearing dentures, tooth decay, oral infections, gum disease, thrush, and mouth sores.
Lets take a look at some of the medications that can cause dry mouth
Medications Causing Gums To Grow
Overgrown or enlarged gum tissue is known as gingival overgrowth. It is sometimes associated with antiseizure medications such as phenytoin, immunosuppressant drugs such as those taken after organ transplantations and calcium channel blockers that are taken by some heart patients. Meticulous attention to cleaning teeth and gums is important for patients with this condition.
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Interactions Of Vitamin K Antagonists
Vitamin K antagonists have a high number of interactions with other substances, including with over-the-counter medications and herbal products. There are warnings of possible interactions with the following:
- Antibiotics such as amoxicillin and ciprofloxacin
- Psychotropic medication such as citalopram and sertraline
- Medication taken against stomach ulcers such as cimetidine and omeprazol
- Herbal products such as gingko, St. John’s wort and ginseng
- Painkillers such as ASA and paracetamol
What Blood Thinners Do
Some blood thinners thin the blood to keep blood cells from sticking together in the veins and arteries. Others prevent blood clots by increasing the amount of time it takes for blood clots to form. These are known as antiplatelet and anticoagulant drugs respectively.
Antiplatelet drugs prevent blood cells from clumping together and forming clots. Examples of antiplatelet drugs are:
Doctors often prescribed medications called anticoagulants to people who have been diagnosed with some forms of heart disease. Coagulate is a medical term that means to clot. These blood thinners prevent blood clots by increasing the amount of time it takes your blood to clot.
Anticoagulants prevent clots from forming. Common anticoagulant blood thinners include:
Newer anticoagulants with less risk of bleeding include:
Your doctor will carefully monitor your dosage of blood-thinning medication. They may occasionally run a prothrombin time test for some medications. This blood test measures your international normalized ratio .
INR is the rate at which your blood clots. An appropriate INR rate varies from person to person according to their medical history. Staying within your INR range can prevent you from bleeding excessively or clotting too easily.
Blood thinners may cause side effects in some people. Excessive bleeding is the most common reaction. It can occur in a variety of ways, including:
- prolonged bleeding from a cut
Other side effects can include:
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Getting Support With Taking Your Medication
It can sometimes take a while to adjust to taking a long-term medication. You will have regular checks while taking blood-thinning medication, and you might need to try different doses or new types of medication before finding whats right for you.
Your pharmacist can give you advice and support with taking medicines, such as practical tips for taking tablets, and advice about side effects.
Pharmacy-based support service
In England, you can join the New Medicines Service by asking your local pharmacist. This gives you three appointments with your pharmacist in a private consultation room. The service helps you with getting started, and supports you with solving any problems. The aim is to make it easier to keep taking the medications in the long term.
Risks Involved With Blood Thinners
Please tell your doctor if you are on blood thinners for any reason before beginning treatment for a venous disorder. While it is possible for vein specialists to treat patients who are currently taking blood thinners, your doctor may choose to discontinue them temporarily depending on your clinical situation. Your doctor will work with your primary care physician and/or cardiologist closely in order to choose the safest treatment plan for your specific condition.
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Serious Eliquis Side Effects
Severe allergic reactions to Eliquis cause itching, hives, chest pain, swelling of the face or tongue, labored breathing and dizziness. Consider these reactions a medical emergency. Anyone experiencing these symptoms should call their doctor or 911 immediately.
In clinical trials, major bleeding occurred in 327 of 9,088 people with non-valvular atrial fibrillation. Rare and dangerous side effects such as bleeding within the skull, hemorrhagic stroke and gastrointestinal bleeding have also been reported in patients. People who took Eliquis also experienced abnormal bleeding at surgical sites following hip or knee replacement surgeries.
Serious Eliquis side effects include:
- Joint pain or swelling
- Red or black, tarry stools
- Red, pink or brown urine
- Swelling of the face or tongue
- Severe or uncontrollable bleeding from an injury
- Coughing up or vomiting blood or material that looks like coffee grounds
- Chest pain or tightness
- Wheezing or difficulty breathing
Eliquis is less likely to cause many of these serious side effects than other blood thinners. For example, Eliquis has a lower rate of overall gastrointestinal bleeding than Xarelto , according to an October 2021 study published in the Annals of Internal Medicine
Blood Thinners And Dental Care
Many dental patients are taking blood thinner medications for various medical conditions to prevent the formation of potentially harmful blood clots . However, these medications interfere with the bodys normal clotting mechanism to stop blood flow at a site of tissue injury, which is of concern to dentists for procedures that cause bleeding.
There are two main processes by which the body normally forms a blood clot. The first involves small blood cells called platelets which clump together at the wound to form a plug which slows the flow of blood through the vessel and forms a matrix. The next phase is coagulation when proteins in the blood interact with each other to fill in the spaces between the platelets, stabilize the clot, and make it more solid until bleeding stops.
Antiplatelet medication target the first phase of clot formation by preventing platelets from sticking to each other and to the blood vessel walls. Aspirin does this by creating permanent changes in the platelets which last throughout the lifetime of the platelet which can only be reversed as the body produces new platelets that have not been exposed to the medication.
Some Dental ProceduresScaling and root planning Periodontal surgeryBiopsies
Preparations for dental procedure
QUESTIONS AND ANSWERS ABOUT BLOOD THINNER MEDICATIONS
Additional Information May be Obtained from the American Heart Association
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Effect Of Medications On Teeth And Gums
Some medications, including prescription and over-the-counter preparations, can damage your teeth. Medications can cause gum problems such as inflammation, bleeding or ulcers. Diseased gums can lead to other dental problems, including tooth loss.
Some of the medications that can damage teeth and gums include:
Some medications can cause the gum tissue to thicken and grow over the teeth. This condition is called gingival hyperplasia. Medications linked to an increased risk of gingival hyperplasia include epilepsy medications, cyclosporin , some blood pressure medications and calcium channel blockers.
Medications can also alter the taste in the mouth.
Talk to your doctor, pharmacist or dentist about whether the medications you are taking could harm your teeth. Dont stop taking any prescribed medicine or adjust the dose without your doctors advice.
How To Use Suppositories
Your doctor or pharmacist will tell you how many suppositories to use each day. Some types you use once a day before you go to bed, and others you use several times a day with the last dose before you go to bed. Use them after you do a poo.
Try not to do a poo for at least an hour after using a suppository. This gives the medicine time to work.
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Medicines And Developing Teeth
A childs permanent teeth start to form in the jawbones soon after birth. These developing teeth are vulnerable to certain substances including:
- Tetracycline this antibiotic can give permanent teeth a yellowish or brownish colour.
- Fluoride in measured amounts, this mineral strengthens teeth and is commonly added to water supplies and toothpaste. However, excessive amounts of fluoride can cause white or discoloured spots to form on developing permanent teeth. This is called fluorosis. Young children who often swallow fluoridated toothpaste are at increased risk. Use plain water to gently clean your babys teeth until they are 18 months of age. A low-fluoride childrens toothpaste should be used to clean young childrens teeth. Teach your child to spit rather than swallow toothpaste.
- Antibiotics children who have to take high-dose antibiotics during a period of severe childhood illness can have development defects in the baby and permanent adult teeth which relate to those periods of time.
Talk to your dentist for further information on medicines that can affect the development of your childs permanent teeth.
Thrush Or Oral Yeast Infection
Thrush is caused by a fungus called Candida. It appears as white lesions in the mouth and on the tongue.2 An antifungal mouth rinse or lozenge is often prescribed to treat the infection.2
The following medications can cause thrush:2
- some chemotherapy medications.
Fungal infections such as oral candidiasis can also be caused by certain inhaler medications used for patients with asthma. Symptoms can include a sore throat, white patches in the mouth, and irritation to the mouth and tongue.
To prevent infection, patients are usually recommended to rinse their mouth with water and spit after each use of their inhaler.
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Why Blood Clots Are More Common In People With Ibd
Its well known that inflammatory bowel disease is associated with whats called extra-intestinal manifestations: conditions that are related to IBD but arent found in the digestive tract. One of these is the risk of developing blood clots.
The increased risk of blood clots in people with Crohns disease and ulcerative colitis is known to IBD experts but it may not be as well understood by other physicians and by people who have IBD. Its unclear exactly why people with IBD are at risk for blood clots but its thought to have to do with disease activity and changes in the blood that promote clotting.
While the risk of blood clots has been shown to be higher in people with IBD, there are things that can be done to prevent them. Whats vital is that people with IBD understand their personal risk of blood clots and that physicians take steps to avoid this complication when necessary, such as after surgery. People with IBD can also familiarize themselves with symptoms of a blood clot, such as pain, swelling, tingling, and pale skin in one leg.
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About Stroke And Blood Clots
Why does blood clot?
Clotting helps the body to protect itself. When skin or a blood vessel is cut or damaged, a blood clot naturally forms at the site of the injury. This stops the bleeding and helps prevent infection.
Clots and stroke
If a blood clot forms inside a blood vessel or in the heart, it can travel to the brain and cause a stroke or TIA.
Why clots happen
Some of the main ways clots form in the body include:
- Blocked blood vessels: fatty deposits can build up on the inner lining of blood vessels, making them stiffer and narrower. This process is called atherosclerosis. The lining of the blood vessels is damaged, which can cause a clot to form.
- Heart problems: a clot can form inside the heart if you have a heart problem such as atrial fibrillation .
- Arterial dissection: a tear in the lining of a major artery in the neck due to injury or illness. A clot can form in the damaged artery lining, leading to a stroke.
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What Are The Side Effects Or Complications Of These Medications
The most common side effect risk with any anticoagulant is bleeding. Depending on the medication used, other potential risks exist.
Warfarin has a much higher risk of causing bleeding because the dosage must be precise. Other risks and side effects include:
- Skin necrosis. This is a rare complication where warfarin causes clots to form in the blood vessels in your arms and legs, or in surface fatty tissue like breasts, buttocks or thighs. Those clots block blood flow, causing the affected areas of skin to die. This is most often seen in people who have deficiencies in certain blood proteins . Its usually seen within five days after you start warfarin, but is possible as late as 10 days after you start warfarin.
- Blue or purple toe. This is a color change in your toes and feet, especially on the soles of your feet or the sides of your toes. The condition is sometimes painful and usually happens anywhere from a few weeks to two months after you start taking warfarin.
- Congenital disabilities or miscarriages. Warfarin can damage an embryo or fetus, so it shouldn’t be taken during pregnancy. However, warfarin is safe when breastfeeding because it cant be passed through breast milk.
- Complications in patients with lupus. Warfarin dosing is usually higher in people with lupus or similar conditions. People who have lupus will often need to stop taking it before a medical procedure and switch to other medications to avoid bleeding problems.
Heparin and its derivatives
Doubling Up On Blood Thinners
Patients in this study were most likely to take blood thinners for venous thromboembolism, which is a blood clot in a vein, or to prevent a stroke due to existing atrial fibrillation.
But the use of two blood antithrombotics might be increasing some patients risks of GI hemorrhage without further reducing their risk of having a stroke, researchers say.
Many patients may not need to take a medication like aspirin if theyre already taking warfarin, Barnes says. We couldnt find a reason for the second anticoagulant for about 30 percent of the high-risk patients who were on multiple blood thinners. These patients may be able to reduce their risk of GI bleeding simply by stopping one of their blood thinners.
Some appropriate indications for adding anti-platelet therapy to prevent blood clots in patients already taking warfarin, researchers say, include a recent history of coronary artery disease or heart attack, peripheral arterial disease, coronary artery stents, bypass surgery, stroke or mini-stroke , or an autoimmune disorder called anti-phospholipid antibody syndrome.
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Medications And Dental Treatment
If you are scheduled for dental treatment, tell your dentist about any medications you are taking or have recently taken, including prescription, over-the-counter and herbal medications. Some medications, such as aspirin and blood-thinning medications, can increase the risk of uncontrolled bleeding.
Also tell your dentist about your alcohol or smoking intake, as well any drugs you are taking or have recently taken.