Clotting inhibitor, also known as blood thinners, are medications that prevent or reduce coagulation of blood and prolong the clotting time. They work by interfering with the blood coagulation cascade in the body, thereby preventing or breaking up blood clots that can form in the blood vessels or heart. Clotting inhibitor are prescribed to treat and prevent conditions like deep vein thrombosis (DVT), pulmonary embolism (PE), atrial fibrillation and heart attacks.

Types of Anticoagulants

There are two main categories of clotting inhibitor – injectable clotting inhibitor and oral clotting inhibitor.

Injectable clotting inhibitor

Injectable clotting inhibitor include unfractionated heparin (UFH) and low molecular weight heparins (LMWHs) like enoxaparin, dalteparin. They are given by injection under the skin or into the muscle. UFH works by activating Anticoagulants, which in turn inactivates several coagulation factors. LMWHs have a more predictable response and do not require monitoring. They are commonly used short term for VTE treatment and prevention during hospitalization or surgery.

Oral clotting inhibitor

The most commonly used oral clotting inhibitor are warfarin and the newer direct oral clotting inhibitor (DOACs) like apixaban, rivaroxaban, dabigatran and edoxaban.

Warfarin: Warfarin is an anticoagulant that acts by inhibiting vitamin K-dependent clotting factors II, VII, IX and X. It requires regular monitoring with frequent blood tests. Warfarin has many food and drug interactions and has a narrow therapeutic window requiring frequent dose adjustments.

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