Anticoagulants or blood thinners are agents that aim to prevent abnormal blood clot formation which is a serious consequence of having atrial fibrillation or venous thromboembolism (VTE). They also address the risk of forming blood clots in patients who have just undergone knee or hip replacement surgery. In the latter case, anticoagulants are prescribed for a limited period once hemostasis has been established, meaning that active bleeding has already stopped.
The market for anticoagulants is quite large. In the US alone, there were more than 3 million people with atrial fibrillation in 2005, and an estimated 7.5 million by 2050. Blood clots that form because of pooling in the heart due to an irregular heartbeat can lead to ischemic stroke, which makes up nearly a quarter of all stroke incidents for people between 80 and 89. VTE on the other hand causes 900,000 adverse events in the US every year.
Blood clots form as a result of a successful coagulation cascade; that is, when the mechanisms for the activation, sticking, and clumping of platelets are in place. Clot formation is an important process for repairing damaged blood vessels, the absence of which will lead to blood loss. Central to the coagulation cascade is the presence of thrombin (factor IIa), which makes it possible for platelets to clump together to form a clot.
Xarelto directly inhibits factor Xa (10-a) of the coagulation cascade, preventing the conversion of prothrombin into thrombin. When there is no thrombin formed, there is no platelet aggregation (clumping); hence, no clot. When administered, Xarelto stays in the body’s system keeping the blood from clotting for up to 12 hours, but it is at its peak strength after two hours or so after taking it. Afterwards, it is eliminated through the kidneys.
When an individual prone to abnormal blood clotting stops taking Xarelto, it increases the risk of clot formation, so it should only be discontinued upon the doctor’s advice except when uncontrollable bleeding occurs. However, the doctor should still be informed about the situation immediately so that the problem of excessive bleeding or other adverse side effects can be addressed.
Currently, there is no guaranteed way to reverse the effects of Xarelto if and when serious bleeding occurs; all that can be done is to wait it out and hope for the best. According to the website of law firm Williams Kherkher, uncontrollable bleeding and the lack of an antidote is main issue brought up in Xarelto litigation. This is a relatively new field, so if you have suffered serious side effects from using Xarelto, consult with a personal injury lawyer with extensive experience in dealing with similar dangerous drugs such as Pradaxa to get the best possible legal representation.