Antiplatelets are medications given to patients who are at risk of blood clots. They are also known as blood thinning medications, and there are many different types.
- Prevent the formation of blood clots.
- Are available in different forms.
- Often prescribed in combination with other medications.
If you are concerned about your risk of blood clots and would like to speak to one of our GMC-registered clinicians, they are available for appointments between 9.30am-4.30pm, Monday to Friday via our online video consultation service.
What are antiplatelets?
Antiplatelets are known as blood thinning medications. They are prescribed to prevent blood clots from forming in patients that are thought to be most at risk. Antiplatelets are not the same as anticoagulants, although they perform the same role in terms of preventing blood clots from forming. They are both also known as antithrombotic drugs, which can cause some confusion. In some cases, a combination of antiplatelets and anticoagulants may be prescribed.
What are blood clots?
Blood clots present a very serious risk to health, as they may trigger strokes (blood clots blocking the brain), heart attacks (blood clots blocking the heart) and pulmonary embolisms (blood clots blocking the lungs). Other risks include kidney disease, deep vein thrombosis (DVT) and complications during pregnancy.
Blood clotting is part of the normal healing process. In response to a wound, the body sends out chemical signals to platelets to form a clot around the injury, stopping bleeding and allowing blood vessels to heal. Eventually, the body sends signals to platelets to stop forming, and breaks up the clot when the healing process is complete. Blood clotting does not always work so efficiently, however, with certain conditions leading to them forming in the wrong place or pieces breaking off and blocking blood flow to vital organs.
What symptoms does a blood clot cause?
Symptoms of a blood clot depend on where the clot has formed. In the arms and legs, it may result in swelling, soreness, heat radiating from the area and pain. Blood clots that block the flow of blood to the brain can cause seizures, visual issues, weakness, speech problems and loss of feeling in different parts of the body. Heart symptoms related to blood clots include breathing difficulties, profuse sweating, loss of consciousness, nausea, dizziness and pain that spreads from your chest to your left arm. Blood clots that form in the abdomen are known to cause pain, diarrhoea, vomiting and blood in stools. Blood clots that prevent blood flow to the lungs can cause sharp pains in the chest area, coughing up blood, sweating, problems breathing, dizziness, loss of consciousness, a fever and an increased heart rate.
What are the risk factors for treatment with antiplatelets?
There are several risk factors that may warrant treatment with antiplatelets to prevent blood clots from forming. The most common include obesity, smoking, being over the age of 60, taking oral contraceptives, chronic inflammation, liver problems, cancer, heart conditions, pregnancy, being unable to walk, living a sedentary lifestyle, a family history of blood clots, frequent air travel and bone fractures. One or a combination of these factors may require the use of antiplatelets to lower your risk of blood clots developing.
What you can do to help prevent blood clots
The most effective way to deal with blood clots and the risks they present is prevention, so alongside medications that can manage this risk, lifestyle changes are essential. Managing your weight, particularly if you are obese, may significantly reduce the risk of blood clots forming, as can quitting smoking. Avoiding dehydration is also important, as it can increase the likelihood of a blood clot.
Regular exercise and refraining from leading a sedentary lifestyle are of great benefit for many health reasons, not least the prevention of blood clots. Regular exercise can include something as simple as a brisk walk. Wearing flight socks during air travel is also recommended, and they can usually be purchased at your local pharmacy.
It’s also advisable to refrain from consuming alcohol excessively, as this can lead to the risks associated with dehydration.
It should be noted that antiplatelets are ineffective at treating clots that have already formed, and are used as a preventative treatment only.
If you would like to discuss antiplatelets or blood clots with one of our GMC-registered clinicians, they are available via our online video consultation service, from 9.30am-4.30pm, five days a week. Our registered clinicians can also issue fit notes and referral to specialists for treatment, where suitable.
What side effects can antiplatelets have?
There are many types of antiplatelets available, and side effects may vary depending on the treatment. You should refer to the patient information leaflet that comes with your medication or discuss any concerns you have with your prescribing clinician.
The following information relates to the antiplatelet clopidogrel.
If you experience any of the following symptoms while using this medication, you should seek immediate medical attention: fever, infection, extreme tiredness, yellowing of the skin and/or the eyes, red pinpoint dots, confusion, swelling in the mouth or skin disorders (including itching and blisters of the skin).
The most prevalent risk associated with this medication is bleeding. This may occur in the stomach, bowels, under the skin (appearing as unusual bruising), nose bleeds, blood in urine, bleeding of the eye and inside the head, lungs or joints. Prolonged bleeding may also occur, with wounds taking longer to heal than usual. If you experience any of these symptoms you should contact a doctor as soon as possible.
Other side effects include:
Common side effects (may affect up to 1 in 10 people): diarrhoea, abdominal pain, indigestion and heartburn.
Uncommon side effects (may affect up to 1 in 100 people): headache, stomach ulcer, vomiting, nausea, constipation, flatulence, rashes, itching, dizziness and a sensation of tingling and numbness.
Rare side effects (may affect up to 1 in 1,000 people): vertigo and enlarged breasts in males.
Very rare side effects (may affect up to 1 in 10,000 people): jaundice, severe abdominal pain, back pain, fever, breathing difficulties, coughing, allergic reactions, swelling in the mouth, blisters of the skin, skin allergies, sore mouth, decreased blood pressure, confusion, hallucinations, joint pain, muscular pain and changes in taste.
The following symptoms have been reported but there is not enough data to suggest their frequency: hypersensitivity reactions, chest pain, abdominal pain and low blood sugar symptoms.
Is it safe to use antiplatelets with other treatments?
Before you start treatment with any antiplatelet you should ensure that your prescribing clinician is aware of any other medication you are currently taking, including supplements. Please refer to the patient information that comes with your medication for its specific contraindications (drug interaction risks).
The following information relates to the antiplatelet clopidogrel, and it may interact with the following medications: oral anticoagulants, medicines used to reduce blood clotting, non-steroidal anti-inflammatory medicines, heparin, ticlopidine, SSRI antidepressants, omeprazole or esomeprazole, fluconazole, voriconazole, efavirenz, carbamazepine, moclobemide, repaglinide and paclitaxel.
Warnings and precautions for treatment with antiplatelets
If you have or are prone to any other conditions, you should inform your prescribing doctor before starting treatment with this medication. In terms of the treatment clopidogrel, this is particularly applicable in the following cases: you have a condition that put you at risk of internal bleeding; you have a blood disorder; you have had recent surgery or are undergoing surgery in the next 7 days (including dental); you have a clot in an artery of the brain; you have kidney or liver disease.
What types of antiplatelets are available?
There are a range of antiplatelets available in the UK, most of which are available on prescription only (with the exception of aspirin). The most commonly used antiplatelets include clopidogrel, aspirin, ticagrelor, dipyridamole and prasugrel.
Is it safe to take antiplatelets if you are pregnant?
Antiplatelets are available in numerous forms, and as such, you should refer to the patient information leaflet that comes with your specific treatment.
Using clopidogrel as an example, it is not recommended that you take this medication during pregnancy. It's important that you inform your prescribing doctor if you are pregnant, thinking of becoming pregnant or suspect you might be pregnant before starting treatment.
It is not advisable to use antiplatelet treatment if you are breastfeeding.
Will antiplatelets affect my ability to drive?
Antiplatelets are unlikely to affect your ability to drive, but there is a small risk of side effects that can impair vision or cause dizziness.
Can I consume alcohol whilst taking antiplatelets?
This may depend on the specific medication involved, but it is not recommended that you consume large amounts of alcohol if you are at risk of blood clots. Consult your prescribing clinician if you are planning on drinking alcohol during treatment.
Should antiplatelets be taken with food?
Some antiplatelets should be taken with food, while others can be taken without it. Read the patient information leaflet provided with your treatment for more information.
Can antiplatelets cause allergic reactions?
It’s possible for anyone to be allergic to any ingredients in any medication. If you have any allergies, you should inform your prescribing doctor before starting treatment.
Some ingredients in certain antiplatelets may also cause stomach upsets, such as clopidogrel tablets, which contain hydrogenated castor oil.
Can I buy antiplatelets over the counter?
Most antiplatelets are only available via prescription, with the exception of aspirin, which you can purchase at your local pharmacy or supermarket.
How can I buy antiplatelets online?
Our GPhC-registered clinicians can speak to you about antiplatelets via our online video consultation service. You can book an appointment with them between 9.30am and 4.30pm, Monday to Friday. They can also provide referral to specialists for treatment and fit notes, where appropriate.
Please note that if we are able to issue treatment for antiplatelets, our prescriber or pharmacist will need to access your summary care record to make sure that you’re already taking it. We can only provide a prescription for antiplatelet treatment if you are already using it.