Pharmacist warns patients about this drug — Best Life

Whenever you start taking a new medication, you should always discuss it with a trusted healthcare professional. According Tessa SpencerPharmD, specialist in community pharmacy and functional medicine, this conversation should include the best way to take the medication, how to avoid potential side effects, and what to do if they occur. However, some medications carry an outsized risk, which means your doctor or pharmacist will have important information to consider before starting your new routine. Read on to find out which drug Spencer often finds herself warning patients about and which of its potentially serious side effects should be on your radar.

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Although any drug can have side effects, Spencer notes that certain classes of drugs tend to have more severe side effects than others. “These drugs have what are called ‘black box warnings,’ which are required by the US Food and Drug Administration (FDA) to indicate rare but dangerous side effects,” she explains. Commonly prescribed medications such as antipsychotics, antidepressants, opioid painkillers, blood thinners and others often come with black box warnings, she explains.

“It’s important to note that black box warnings don’t necessarily mean you shouldn’t take the drugs that contain them,” says Spencer. However, you should take extra care to discuss the potential risks of your prescription with your doctor or pharmacist if you see this on the label.

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warfarin blood-thinning habits that increase your risk of stroke

Spencer says the only “black box” drug she finds herself advising patients on “with extreme caution” is the anticoagulant anticoagulant warfarin, also sold under the Coumadin and Jantoven brands. “Warfarin is used to prevent and treat blood clots and to reduce the risk of a heart attack or stroke in some people. Although warfarin is one of the most effective medicines for preventing blood clots, it also comes with a whole series of rules and restrictions for the patient,” she says. “If a patient doesn’t follow these rules, serious side effects can occur.”

Spencer explains, for example, that it is important for those taking warfarin “to have their blood checked periodically to ensure that the time it takes for the patient’s blood to clot is within a small target range. This range target can be affected by many factors; prescribed or over-the-counter medications, when warfarin is taken during the day, dietary habits, alcohol consumption, and illness. All of these could reduce the effectiveness of warfarin or increase the risk of bleeding.


Warfarin requires additional counseling due to its potential to cause internal bleeding, Spencer says. “In the same way that warfarin prevents blood from clotting, it can also cause bleeding. A cut on your hand or a nosebleed can be hard to stop if you’re taking warfarin. But the most serious thing that medical professionals worry about is bleeding inside the body or internal bleeding,” she notes.

She adds that since internal bleeding is not visible, it can go unnoticed until patients begin to develop life-threatening symptoms. “That’s why it’s important to monitor warfarin treatment and perform blood tests on patients taking [the drug]“advises Spencer.

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Spencer says there are now several other blood thinners on the market that can be prescribed to help reduce the risk of heart attack or stroke. These include Eliquis (apixaban), Pradaxa (dabigatran), Xarelto (rivaroxaban), and Savaysa (edoxaban). “Unfortunately, they all have some risk of bleeding due to their ability to thin the blood,” she concedes. However, she adds that “the risk of excessive bleeding is less with these newer drugs and may not be as serious if it occurs.”

What’s more, Spencer says these alternative drugs may also be “more convenient to take because patients don’t need as many blood tests.” Tell your doctor if you have been prescribed warfarin and have any questions about your care, or if you have experienced any side effects while taking it.

Best Life offers the most up-to-date information from top experts, new research and health agencies, but our content is not intended to replace professional advice. Regarding any medications you are taking or any other health questions you have, always consult your health care provider directly.

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