Anticoagulant
Generic and Trade Names:
| Anisindione | Miradon | |||
| Dalteparin | Fragmin | |||
| Danaparoid | Orgaran | |||
| Dicumarol | Dicumarol | |||
| Enoxaparin | Lovenox | |||
| Heparin | Heparin | |||
| Warfarin | Coumadin |
Description:
Anticoagulants or "blood thinners" work in different ways to inhibit blood clotting factors like fibrinogen. They are prescribed in the treatment of thrombosis, myocardial infarction or unstable angina.
Dicumarol stimulates the formation of a vitamin K oxide in the liver, consequently interfering with or inhibiting the role vitamin K plays in coagulation.
Warfarin is classified as a prothrombopenic anticoagulant; it functions to decrease the clotting power of the blood by inhibiting the production of prothrombin.
Low molecular weight heparins are used for prophylaxis or treatment of thromboembolic complications, or certain complications of unstable angina and myocardial infarction. (Facts and Comparisons 1999)
Nutritional Considerations:
Consistent levels of vitamin K are required as vitamin K levels are inversely proportional to the efficacy of certain drugs in this class (Harris, Weibert). Avoid or limit foods high in vitamin K such as : spinach, cauliflower, brussel sprouts, and egg yolk.
Coenzyme Q10 resembles vitamin K and may also reduce the effectiveness of warfarin treatment. (Landbo 1998)(Spigset 1994)
Absorption and activity of Warfarin may be decreased by iron, magnesium, and zinc (Holt). Use of these minerals should be spaced at least two hours apart from the use of anticoagulants.
Patients taking NSAID should consult with their physicians if they have a bleeding disorder, or are taking anticoagulant therapy (Warfarin) before using chondroitin sulfate. (Chavez 1997)
Avoid over 60 gms (2 ozs) onions (which can increase fibrinolytic activity. (Pronsky 1999)
Avoid excess garlic ,ginger and avocado. (Pronsky 1999)
Avoid high dosages of vitamin A, or vitamin E (over 400 IU/day). (Pronsky 1999)
Also, be cautious with over 5 gms (5,000 mg) of vitamin C which may reduce drug absorption. (Pronsky 1999)
Herbal Considerations:
Due to the presence of blood serum platelet aggregation inhibitors, bilberry, cardamom, dong quai, elder, evening primrose, ginkgo, psyllium, red sage and yohimbe, may potentiate the effects of anticoagulant drugs such as heparin.(Brinker 1998)(Newall 1996)(Rosenblatt 1997)
Bladderwrack, fennel, fenugreek, garlic plant, gentian, ginger or skullcap may potentiate the effects of oral coumarin anticoagulants, such as warfarin and dicumarol (Brinker 1998)(Newall 1996)(Rose 1990)
Theoretically Boneset, cascara sagrada, feverfew, agrimony, pokeroot, rhubarb, or senna due to their cathartic activity (i.e. laxative induced increased speed of intestinal emptying), may potentiate anticoagulant therapy. (Newall 1996)
Celery seed, chamomile and lovage may have anti-platelet acitvity . (Newall 1996)
It should also be noted the platelet inhibiting acitivity of cloves may antagonize the effects of other anticoagulants. (Newall 1996)
Due to presence of salicylates, meadowsweet, European poplar, queen of the meadow or willow, may potentiate the effects of other anticoagulant agents, such as heparin. (Newall 1996)
An interaction has been reported between papaya extract and Warfarin. (Shaw 1997)
It is also necessary to be aware of other coagulant herbs (Newall):
Coagulant components Effect
Agrimony Increases human blood coagulation up to 50%
Goldenseal Heparin antagonist
Mistletoe Lectins, agglutinating activity
Yarrow Coagulant, in vivo
Herbs with an anticoagulant effect may potentiate Warfarin medication.
anticoagulant - Effect
Alfalfa - Coumarin constituents
Angelica - Coumarin constituents
Angelica - Inhibits platelet aggregation
Anise /Aniseed - Coumarin constituents
Arnica - Coumarin constituents
Asafoetida - Coumarin constituents
Bogbean - Hemolytic activity
Celery seed or extract - Coumarin constituents
Cassia - Inhibits platelet aggregation
Chamomile, German - Coumarin constituents
Chamomile, Roman - Coumarin constituents
Clove Eugenol - powerful inhibitor of platelet activity
Cumin/Turmeric - Inhibits platelet aggregation
Fenugreek - Coumarin constituents
Feverfew - Inhibits platelet aggregation in vitro
Garlic - Interaction with warfarin reported
Ginger - Inhibition of platelet activity
Ginkgo - Inhibits platelet aggregation
Ginseng - Reduction of blood coagulation 2/Decreases Horse chestnut Coumarin constituents
Horse radish - Peroxidase stimulates synthesis of
Arachidonic acid - metabolites
LicoriceInhibition of platelet activity
Meadowsweet - Salicylate constituents
Melilot - Coumarin constituents
Pau d'arco (Taheebo, Lapacho) - Coumarin constituents
Poplar - Salicylate constituents
Prickly Ash - Coumarin constituents
Quassia - Coumarin constituents
Red clover - Coumarin constituents
Danshen - Anticoagulant
Willow - Salicylate constituents
The German Commission E has also noted the possible anticoagulant effect of bromelain and Cinchona bark.
References
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