Anti-Platelets and Anticoagulants: How Are They Different?

Anti-Platelets and Anticoagulants: How Are They Different?

What do people with inheritable blood and bleeding disorders need to know about these two types of medications?
Author: Donna Behen

Anticoagulants and anti-platelet drugs are two classes of medications taken by people who either have or are at high risk for heart disease. They are prescribed to help prevent blood clots, which can block blood flow to the heart or brain and cause a heart attack or stroke.

Now that people with hemophilia and other inheritable blood and bleeding disorders are living a lot longer thanks to better treatments for their conditions, many more are facing age-related health risks, including heart disease.

Using anticoagulants or anti-platelet drugs in people who have an inheritable blood or bleeding disorder requires a cautious, collaborative approach between a person’s hematologist and cardiologist, experts say.

Here’s what you need to know about these two kinds of medications and how they differ.

What is an Anticoagulant?

Anticoagulants are commonly called blood thinners, but they don’t actually thin the blood. They work by making it harder for blood clots to form in the heart, veins, and arteries. They also can keep existing clots from growing larger.

These medications are often prescribed for people with atrial fibrillation, deep vein thrombosis, or pulmonary embolism. Examples of anticoagulants include warfarin (Coumadin), apixaban (Eliquis), and rivaroxaban (Xarelto).

What is an Anti-Platelet Drug?

Anti-platelet medications also help to keep blood clots from forming and are prescribed to reduce the risk of heart attacks and strokes. They are also commonly used for a time after a heart stenting procedure to protect the stent until the body can coat it in a layer of its own cells.

Examples of these drugs range from low-dose aspirin to medications called P2Y12 inhibitors, which include clopidogrel (Plavix), ticagrelor (Brilinta), and prasugrel (Effient).

Many people who’ve had a heart attack or stroke are prescribed dual anti-platelet therapy, or DAPT, which consists of aspirin combined with a P2Y12 inhibitor.

Anticoagulants vs. Anti-Platelet Medications

Anticoagulants and anti-platelet drugs both work to prevent blood clots, but they do so in different ways. Anticoagulants work by reducing or blocking natural substances that aid in blood clotting. Anti-platelet medications keep blood clots from forming by keeping blood platelets from sticking together.

In rare cases, anticoagulants may be combined with drugs that work on platelets, such as aspirin or clopidogrel. Combining them increases the risk of bleeding.