Anticoagulant (Blood Thinner)

An anticoagulant, commonly called a blood thinner, reduces the blood's ability to form clots. Doctors prescribe them for atrial fibrillation (to prevent stroke), deep vein thrombosis, pulmonary embolism, and after some surgeries. Warfarin (Coumadin) was the standard for decades. Newer direct oral anticoagulants include rivaroxaban (Xarelto), apixaban (Eliquis), dabigatran (Pradaxa), and edoxaban (Savaysa). Heparin and its relatives are given by injection.

Blood thinners work by increasing bleeding risk, so the key safety question is how much. The Xarelto prescribing information warns that the drug can cause serious and fatal bleeding, and its boxed warning says premature discontinuation increases the risk of clots, along with a risk of spinal or epidural bleeding in some procedures.

Anticoagulants produced some of the best-known drug litigation of the last decade. Plaintiffs claimed the makers of newer blood thinners understated bleeding risks, marketed them as needing no blood monitoring, and at first lacked a reliable reversal agent for emergencies. In March 2019, the makers of Xarelto agreed to a $775 million settlement of roughly 25,000 lawsuits, without admitting liability. Earlier cases over Pradaxa were also settled.

Other anticoagulant claims involve medical errors, such as wrong dosing, missed drug interactions, or failing to restart or stop a blood thinner around surgery, which are malpractice cases. Never stop a blood thinner without talking to your doctor, since that can cause a stroke. For how drug injury cases are grouped, see what is MDL and class action vs. mass tort. This page is general information, not medical advice.