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Taking Direct Oral Anticoagulants Safely: Care Instructions

Your Care Instructions

Direct oral anticoagulants (DOACs) are medicines that help prevent blood clots. They also help treat problems caused by blood clots. These medicines are also called blood thinners.

Blood thinners don't really thin the blood. They slow down the time it takes for a blood clot to form. They also keep existing blood clots from getting bigger. Blood thinners can help prevent a stroke caused by a heart rhythm problem (atrial fibrillation). This heart rhythm problem can form clots in the heart that can then go to the brain. Blood thinners can also help prevent or treat blood clots in the legs or lungs.

Examples of DOACs include:

  • Apixaban (Eliquis).
  • Dabigatran (Pradaxa).
  • Edoxaban (Lixiana).
  • Rivaroxaban (Xarelto).

Blood thinners can help save lives. But they can also cause problems. They can make you more likely to bleed. It's important to take them right and do everything you can to keep yourself safe.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Take your anticoagulant (blood thinner) exactly as your doctor prescribed them.
  • If you miss a dose, don't take an extra dose to make up for it. Your doctor can tell you exactly what to do so you don't take too much or too little.
  • Ask your pharmacist if you should take your blood thinner with food or without food.
  • Take your blood thinner at the same time every day. Be careful not to run out of them.
  • Ask your pharmacist how to store your blood thinner.
  • Don't take other medicines before talking to your doctor or pharmacist first. This includes prescription medicines, over-the-counter medicines, and natural health products. It also includes aspirin and other pain relievers, such as ibuprofen (Motrin).
  • Tell your doctors, dentist, and pharmacist that you are taking a blood thinner.
  • Wear medical alert jewellery. This lets others know that you take a blood thinner.
  • If you are pregnant, breastfeeding, or trying to get pregnant, tell your doctor. You and your doctor will decide what medicines are safe. If you are not planning on getting pregnant, talk to your doctor about how you can prevent pregnancy.
  • Try to avoid injuries. For example, be careful when you are exercising or playing sports. Make your home safe to reduce your risk of falling.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have a sudden, severe headache that is different from past headaches.

Call your doctor or nurse advice line now or seek immediate medical care if:

  • You have any abnormal bleeding, such as:
    • Nosebleeds.
    • Vaginal bleeding that is different (heavier, more frequent, at a different time of the month) than what you are used to.
    • Bloody or black stools, or rectal bleeding.
    • Bloody or pink urine.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.

Where can you learn more?

Go to

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.