Age and Anticoagulants: Choosing Appropriate Medications

physician-with-senior1-199x300.jpgOlder adults who require anticoagulant medications may want to have a discussion with their doctors about the most appropriate medications they should use. A new study in the British Medical Journal suggests  individuals who are over the age of 75 should be cautious when selecting anticoagulant medications.

Anticoagulants are often prescribed for people who have had or are at risk of atrial fibrillation and stroke. Anticoagulants help to thin blood and in turn reduce the risk of blood clots. Sometimes, however, excessive bleeding can result from decreasing the blood's ability to clot. This can be particularly dangerous when there is bleeding in the gastrointestinal tract.


There are many factors that go into the decision as to which of various medications to prescribe for a condition. A new article in the BMJ has identified one such factor that doctors should consider when selecting an anticoagulant for patients over the age of 75.

Entitled "Comparative risk of gastrointestinal bleeding with dabigatran, rivaroxaban, and warfarin; population based cohort study," the article was published online on April 24, 2015.  This retrospective study focused on new users of three anticoagulants - dabigatran, rivaroxaban, and warfarin. By examining records for several thousands of atrial fibrillation patients who were prescribed these medications, researchers were able to compare how the risk of gastrointestinal bleedings may have differed among the three groups.

Of the three medications examined, warfarin is the oldest, having been around and used since the 1950s. Dabigatran and rivaroxaban are newer. Compared to the newer drugs, warfarin lasts for a longer period of time after administration, and it is recommended that patients on warfarin have their blood tested on a regular basis. The newer anticoagulants do not require this kind of regular blood testing.

The study found that patients over the age of 75 who are using one of these two newer drugs have a significantly higher risk of developing gastrointestinal bleeding.  For patients under 65, however, there is LESS of a chance of this complication with the newer medications.

As stated, there are lots of factors that must be considered, which is why doctors must give careful attention to individual needs; however, this study suggests that the age of the patient may need to be considered when weighing all of the considerations.

These results come from one retrospective study, so the conclusions are by no means definitive; however, exercising a little special care and just bringing this up with one's doctor may be a good idea.​

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