Primary Care in Rochester and Kasson

Are you on a blood thinner?

5/10/2021 by Thomas Jaeger, M.D.


Direct-acting oral anticoagulants (DOACs) are a new group of medications used to treat or prevent blood clots. They represent a significant advancement in anticoagulant therapy. They have been available for several years. Over that time, these newer medications have been found to be safe and effective, and much easier to take. 

Previously, warfarin (Coumadin) was the only medication in pill form available to thin the blood. While effective, warfarin requires regular monitoring, as its action is affected by many medications, acute illness and foods containing vitamin K. As a result, the blood can become too thick or too thin, which makes clotting or bleeding more likely. 

Direct-acting oral anticoagulants are different in that their blood thinning actions are much more consistent. They require much less monitoring, and the dose does not need to be adjusted, making them much easier to take. On balance, they are somewhat safer and more effective than warfarin. Like any medicine that thins the blood, bleeding is a risk. However, when taken consistently, this risk is lessened. 

Direct-acting oral anticoagulants cannot be used in some situations. For example, mechanical heart valves still require warfarin to be used for anticoagulation. For many patients, the primary concern to using direct-acting oral anticoagulants is the out-of-pocket cost, as these are new, brand-name medications with no generic equivalents. The cost to the patient will be determined by insurance coverage. Coupons may be available for those not enrolled in a Medicare Part D plan. 

For most patients requiring oral anticoagulant therapy, direct-acting oral anticoagulants are a safe, effective and much more convenient treatment option. Your primary care provider can help determine if one of these medications is a good choice for you. 

Thomas Jaeger, M.D., is medical director of the Primary Care in Rochester and Kasson Anticoagulation Clinic. He is a physician in the Division of Community Internal Medicine, practicing in the Baldwin Building.