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ISMP: Most Dangerous Drugs are Blood Thinners

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The prescription drugs most likely to prompt an emergency room visit today are anticoagulants like Xarelto, Pradaxa, Eliquis, and warfarin, according to a recent report published by the Institute for Safe Medication Practices (ISMP).

Based on Centers for Disease Control and Prevention data reviewed by ISMP, almost 22,000 severe injuries and more than 3,000 deaths related to blood thinners in the last year, as reported by patients and health care workers. But because the U.S. Food and Drug Administration (FDA) only tracks voluntary adverse event reports, the actual number of people injured by anticoagulants is likely to be much higher.

According to a CDC study, the annual number of people harmed by blood thinners is estimated to be 10 times greater than the voluntary reports indicate, numbering almost 250,000 people. Adverse events can be reported to the FDA by doctors or patients, and are required to be recorded and shared by drug manufacturers.

Why are Anticoagulants Dangerous?

Blood thinners interfere with the blood clotting process, which is important for treating or preventing medical conditions caused by blood clots, such as strokes, pulmonary embolisms, deep vein thrombosis, and atrial fibrillation. The risk of these types of clots is particularly high after certain types of surgical procedures, such as knee or joint replacement. However, if the blood doesn’t clot in normal circumstances, a patient can eventually bleed out and die if no antidote is available.

To make matters worse, some blood thinners, such as Xarelto and Eliquis, don’t yet have an approved antidote to reverse their anticlotting effects. Warfarin (Coumadin) can be reversed with a dose of vitamin K, and Pradaxa can be reversed with Praxbind, an antidote that was only FDA-approved in 2015, so anyone taking the medication prior to that time was at risk for severe bleeding events.

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