Examples

How It Works

Anticoagulants prevent blood clots and keep blood clots from getting bigger. They are also called blood thinners.

Dabigatran keeps thrombin from making a blood clot. Thrombin is a substance (enzyme) in the bloodstream that is needed for blood to clot.

Rivaroxaban blocks a blood clotting factor (Factor Xa) from working. Clotting factors are substances that make blood clot.

Why It Is Used

Anticoagulants are used to lower the risk of stroke and blood clots in people who have atrial fibrillation.¹

Your doctor may recommend an anticoagulant based on your risk of having a stroke. If you are age 55 or older and have atrial fibrillation, you can find your risk of stroke using this Interactive Tool: What Is Your Risk for a Stroke if You Have Atrial Fibrillation?

Dabigatran and rivaroxaban are newer medicines than the anticoagulant medicine warfarin. Warfarin has been used for many years to help prevent stroke in people who have atrial fibrillation. If you are thinking about taking a newer anticoagulant instead of warfarin, talk with your doctor to see if it is right for you.

Reasons why you might take dabigatran or rivaroxaban include:

• You cannot take warfarin safely, such as not being able to keep a safe level of warfarin in your blood (INR).
• You have side effects from warfarin that are hard to live with.
• You do not want to have to get regular blood tests and watch how much vitamin K you eat. Both are needed if you take warfarin.

You cannot take dabigatran or rivaroxaban if you have heart valve disease, an artificial heart valve, or severe kidney or liver disease.

Atrial Fibrillation: Which Anticoagulant Should I Take to Prevent Stroke?

How Well It Works

Dabigatran and rivaroxaban lower the risk of stroke in people who have atrial fibrillation.^{2, 3}

How much your risk for a stroke will be lowered depends on how high your risk was to start with. Not everyone who has atrial fibrillation has the same risk of stroke. It's a good idea to talk with your doctor about your risk.

You will want to weigh the benefits of reducing your risk of stroke against the risks of taking an anticoagulant. Anticoagulants can help prevent stroke. But this medicine also raises the risk of bleeding. Your own risk of bleeding may be higher or lower than average, based on your own health.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

• Usually the benefits of the medicine are more important than any minor side effects.
• Side effects may go away after you take the medicine for a while.
• If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Bleeding

Call or other emergency services right away for signs of serious bleeding:

• You cough up blood.
• You vomit blood or what looks like coffee grounds.
• You pass maroon or very bloody stools.
• You have a sudden, severe headache that is different from past headaches. (It may be a sign of bleeding in the brain.)

Call your doctor right away if you have unusual bleeding such as:

• You have new bruises or blood spots under your skin.
• You have a nosebleed that doesn't stop quickly.
• Your gums bleed when you brush your teeth.
• You have blood in your urine.
• You have heavy period bleeding or vaginal bleeding when you are not having your period.

If you are injured, apply pressure to stop the bleeding. Realize that it will take longer than you are used to for the bleeding to stop. If you can't get the bleeding to stop, call your doctor.

Allergic reaction

Call or other emergency services right away if you have:

• Trouble breathing.
• Hives.
• Swelling of your face, lips, tongue, or throat.

Dabigatran might cause less serious side effects including:

• Stomach upset.
• Stomach pain.

Rivaroxaban does not commonly cause other side effects, such as stomach problems.

Dabigatran and rivaroxaban are newer medicines. So doctors do not yet know if they have any other long-term side effects.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)