Guide Medicinal Product

Anticoagulant: What are the anticoagulants?

Vitamin K antagonists are anticoagulant drugs that thin the blood, or more accurately, that prevent the formation of clots and promote the resorption of those that already exist. But note that there are new anticoagulant treatments that are not antivitamins K, read further what you need to know about what is called NACO.

What is anticoagulant for whom?

These medications may be prescribed in many cases. Here are some of the most common examples:

  • People who have suffered from phlebitis, pulmonary embolism, or those who are at high risk of developing phlebitis;
  • Patients with abnormal heart rhythm such as atrial fibrillation;
  • People who have an abnormality in a heart valve, or who have an artificial heart valve ...

Duration of treatment

The duration of the treatment varies according to the needs of each one: it can go from a few weeks ... to a whole life! In France, 600, 000 people are taking anticoagulant therapy.

These medications must be taken with care and scrupulously respect the dosage prescribed by the doctor. Blood tests should be taken regularly to check the effect of the medication.

Depending on the results obtained, the doctor will adjust the dosage, because the problem here is twofold :

  • a lack of antivitamins K will promote the formation of a clot,
  • but too much AVK may cause bleeding.

To find out if the dose is good, the best way is to regularly take a blood test to analyze an index called INR (International Normalized Ratio).

INR assay

The blood test (which does not require fasting here) is the surest way to know the state of fluidity of the blood. This is called INR.

  • If your INR is less than 2, it means that the blood is not fluid enough. Your doctor should increase the dose of vitamin V antagonists.
  • If your INR is greater than 3, the blood is too fluid and the dose of AVK should generally be reduced.

In general, the higher the INR, the more fluid the blood and the greater the risk of bleeding. A monthly blood test is usually sufficient for patients on long-term anticoagulant therapy.

In the near future, there will certainly be devices to measure oneself at home, the same type as those used by diabetics, as is already the case in Germany.

Optimize your treatment

If treatment with VKAs is effective, say that your INR is in the therapeutic zone: that is, it is most often between 2 and 3.

Unfortunately, today only 50% of patients are in the therapeutic zone because INR can have spontaneous fluctuations or more or less caused by various factors (transient illnesses, medicines, diet ...).

Hence the importance of regular monitoring and blood tests that must be repeated. Physicians have a key role to play in educating patients about INR and how to stay in the therapeutic zone.

Our advice:

> Since July 2008, you can obtain from your doctor, as well as from the pharmacist, the code of conduct of the AVK which will help you to better inform you about your treatment.

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