Antiplatelet Drugs

What are antiplatelet drugs?

Antiplatelet drugs are medications that prevent blood clots from forming. They work by stopping your platelets from sticking together. Antiplatelet drugs are used to avoid blood clots, which can cause heart attacks and strokes.

How do antiplatelet drugs work?

Antiplatelets prevent your platelets from clumping together to form a clot.

Blood is made up mostly of:

• Red blood cells, which carry oxygen throughout your body.
• White blood cells, which help fight infection.
• Platelets, which help form blood clots to prevent excessive bleeding.

When your body has an injury, platelets stick or clump together to make a clot. Clots are your body’s natural way of stopping bleeding. For example, when you have a deep cut on your skin, a clot will eventually form to slow and then stop bleeding.

What’s the difference between anticoagulants and antiplatelets?

Both anticoagulants and antiplatelets reduce or prevent clotting. But they work in different ways.

Antiplatelets interfere with the process of platelets binding together. Anticoagulants, also called blood thinners, interfere with proteins in your blood that are involved with clotting.

Examples of anticoagulants include heparin, warfarin, apixaban (Eliquis®) and rivaroxaban (Xarelto®).

Who should use antiplatelet drugs?

Blood clots are an important and natural way your body protects itself. But blood clots in your bloodstream can cause heart attack and stroke. This is more common in people with certain medical conditions, such as:

• Angina.
• Atrial fibrillation.
• Coronary artery disease.
• History of heart attack or warning signs of a possible heart attack in the future.
• History of stroke or warning signs of a possible stroke in the future.
• Peripheral vascular disease (clogged veins and arteries outside of your heart that cause problems with circulation).
• Surgery, such as coronary artery bypass, angioplasty (placement of stents to open arteries) or heart-valve surgery.

What are the types of antiplatelet drugs?

The most commonly used antiplatelet is aspirin, but other kinds include:

• Adenosine diphosphate (ADP) receptor inhibitors (clopidogrel, ticagrelor, ticlopidine, prasugrel) make platelets less sticky.
• Adenosine reuptake inhibitors (dipyridamole) block enzymes involved in clotting.
• Glycoprotein platelet inhibitors (abciximab, eptifibatide, tirofiban) block substances that help clots stick together.
• Phosphodiesterase inhibitors (cilostazol) widen blood vessels and stop platelets from sticking together.
• Protease-activated receptor (PAR-1) antagonist (vorapaxar) blocks a substance on platelets that helps them clot.

How do I take antiplatelets?

Most antiplatelet drugs are pills that you swallow (oral), but some are given intravenously (injected into a vein).

You can take oral antiplatelet medications with or without food. If they upset your stomach, try taking them with food.

If you miss a dose, take it as soon as you remember. But don’t take two doses close together, and never take a double dose.

It’s essential to take antiplatelets exactly as prescribed. Never stop taking the medication (including aspirin) without talking to your healthcare team.

What are the benefits of using antiplatelet drugs?

Antiplatelet drugs are sometimes used to prevent blood clots, heart attacks and strokes, but are primarily used to prevent the recurrence of blood clots after a heart attack or stroke. They can also help relieve symptoms such as chest pain, poor circulation and shortness of breath.

What are the risks of using antiplatelet drugs?

The main risk with antiplatelet drugs is excessive bleeding. The drugs prevent all clots, including ones your body may need. For example, if you have internal bleeding or a wound on your skin, it may bleed so much that it becomes dangerous.

Before you start antiplatelet therapy, talk to your healthcare team about this risk. For example, discuss safety at home so you’re less likely to fall or cut yourself. Carefully review any other medical conditions that can cause bleeding.

Can you overdose on antiplatelet drugs?

If you take too many antiplatelet pills, it can be life-threatening. Never take more than what your healthcare provider prescribed.

What side effects do antiplatelet drugs have?

Common side effects of antiplatelet therapy include:

• Aspirin-induced asthma.
• Shortness of breath.
• Bleeding longer or heavier with cuts or menstrual periods.
• Bruises.
• Hemorrhage.
• Nose bleeds (epistaxis).
• Upset stomach.

Some side effects can be signs of serious problems. If you have any of the following symptoms, contact your healthcare provider:

• Blood in your urine (pee), which may look red, pink or brown.
• Blood in your stool (poop), which may look red or black.
• Chest pain.
• Coughing up or vomiting blood, which may look like blood or coffee grounds.
• Hematoma (a large, raised bruise).
• Ringing in your ears (tinnitus).
• Stomach pain.

What interactions should I watch out for?

Antiplatelet drugs can interact with other medications. Make sure your healthcare providers know about all the medications you take, including:

• Other prescription drugs.
• Over-the-counter medications.
• Vitamins, minerals, herbs, supplements or other natural health products.

If you have questions about antiplatelet drug interactions, talk to your healthcare team, including your pharmacist.

How long should you take antiplatelet drugs?

Most antiplatelet drugs are long-term medications. Never stop taking antiplatelet medication or change the dose without talking to your healthcare provider.

Your healthcare provider may tell you to stop taking antiplatelet drugs temporarily before dental procedures or surgery. You also may have to stop taking them if you’re at risk of falling (for example, if you have balance problems).

Who should not take antiplatelet drugs?

People with certain conditions shouldn’t take antiplatelets, including those who:

• Are planning to have surgery in the next few days.
• Are pregnant, trying to become pregnant or breastfeeding.
• Have ever had bleeding in their brain (brain hemorrhage).
• Have had an allergic reaction to antiplatelets before.
• Have a bleeding disorder, such as hemophilia.
• Have kidney or liver disease.
• Have a stomach ulcer or a history of ulcers.

A note from Cleveland Clinic

Antiplatelets are medications that prevent platelets from sticking together and forming blood clots. They’re a common treatment for people at risk of heart attack or stroke. The major risk with antiplatelet therapy is excessive bleeding. If you’re taking antiplatelet drugs, report any possible bleeding complications to your healthcare provider.