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Anticoagulation Therapy (Coumadin®, Pradaxa®, etc.)

An anticoagulant is a blood thinner that helps to prevent the formation of blood clots. Medications have been indicated to prevent and treat blood clots in the legs, lungs and blood vessels throughout the body, thus reducing the risk of heart attack, stroke and pulmonary embolism. Two anticoagulants LIHA physicians use are Coumadin® and Pradaxa®. While both drugs have been proven effective and safe for these uses, the dosage needed for proper blood thinning is different in each patient. Therefore, this must be carefully administered and monitored by a Long Island Heart Associates physician.

How does Coumadin® and Pradaxa® therapy work?

Our bodies naturally respond to injuries by forming clots in the blood to seal off damaged blood vessels. If not for this natural defense mechanism, even the smallest cut could become highly dangerous, as it would continue to bleed indefinitely. Sometimes, however, blood clots can form in the body without injury. When this happens, it can interrupt the flow of blood throughout the body, which can lead to stroke, heart attack or other life-threatening conditions, depending on the location of the clot.


What can I expect from anticoagulant therapy?

Because the body’s response to medicine varies from person to person, careful monitoring by a LIHA physician is needed to ensure proper dosage. The physician will test the blood to determine the degree of anticoagulation, referred to as the international normalized ratio (INR) level. In most cases, an INR value of 2.0 to 3.0 indicates proper dosage. Low INR levels (around 1.0) can indicate that there is not enough Coumadin or Pradaxa in the body, whereas high levels (5.0+) can signal that there is too much, putting the patient at risk for hemorrhaging or other complications related to excessive thinning of the blood.


Anticoagulant therapy typically requires frequent blood testing at first (2-3 times a week, or even daily in some cases) to make necessary adjustments to the patient’s medication as needed. Over time, as a steady dosage schedule is determined and INR levels stabilize; frequent blood testing will not be necessary. At this point, the patient may only need regular Coumadin testing every few months.



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