If you have atrial fibrillation, taking blood thinners can reduce your risk of stroke. But they do cause other side effects, including serious bleeding.

Atrial fibrillation (AFib) is a heart rhythm condition in which the upper two chambers of your heart beat irregularly. Blood may pool and collect, creating clots that can travel to your organs and brain, increasing your risk of stroke.

Doctors often prescribe anticoagulants, or blood thinners, to thin the blood and prevent clots from forming. Some research suggests that anticoagulants may lower your stroke risk by up to 60%Trusted Source if you have AFib.

Here’s what you need to know about long-term blood thinner use, any side effects you might experience, and what you may want to discuss with a doctor.

Anticoagulants help prevent blood clots by interfering with the blood clotting process. Although they’re often called blood thinners, they don’t thin the blood, according to the United Kingdom’s National Health Service (NHS).

There are several types of blood thinners, which are usually taken orally. These may work in different ways.

Warfarin (Jantoven)

Warfarin is one of the most commonly prescribed anticoagulants. It works by reducingTrusted Source your body’s ability to make vitamin K. Without vitamin K, the liver has trouble making blood clotting proteins.

Doctors have traditionally prescribed warfarin for all people with AFib. However, its current recommended uses are limited to people with AFib who have:

  • a mechanical replacement heart valve
  • rheumatic mitral stenosis

Direct oral anticoagulants (DOACs)

Direct oral anticoagulants (DOACs) work by blockingTrusted Source the blood clotting factors 2a or 10a.

They’re recommended for people with AFib unless the person has moderate to severe rheumatic mitral stenosis or a mechanical replacement heart valve.

DOACs include:

Doctors use a set of guidelines to determine what kind of blood thinner may be best for you.

The most common complication of using blood thinners long term is the increased risk of excessive bleeding. This may cause:

In severe cases, excessive bleeding may lead to complications that affect your organs. People who are taking blood thinners and experience excessive bleeding are three times more likely to die than people not taking the drugs.

As such, it’s important to speak with a healthcare professional before taking blood thinners and to regularly check in with them. Anticoagulants are one of the most common causes of medication-induced hospitalizations.

Some other side effects of taking blood thinners long-term may include:

When it’s an emergency

Call 911 or your local emergency services immediately if you experience any of the following symptoms while on blood thinners:

  • a severe or unusual headache
  • confusion, weakness, or numbness
  • bleeding that won’t stop
  • vomiting blood
  • blood in your stool
  • a fall or injury to your head

These may be symptoms of internal bleeding and could lead to extreme blood loss. Acting fast may save your life.

Antidote medications can stop the effects of warfarin, dabigatran, apixaban, and rivaroxaban, but you’ll need to go to a hospital for treatment.

Some risk factors may increase the likelihood of experiencing excessive bleeding or other complications from taking blood thinners long term. These may include:

The short- and long-term use of blood thinners increases the risk of excessive bleeding, so it’s important to manage the risks. Several lifestyle and dietary changes could help you minimize your risks.

Lifestyle changes

You can do the following things at home to reduce your chances of bleeding from everyday activities:

  • Toss any firm-bristle toothbrushes and switch to ones with soft bristles.
  • Use waxed floss instead of unwaxed, which may damage your gums and cause bleeding.
  • Try an electric razor to avoid nicks and cuts.
  • Use sharp objects, like scissors or knives, with extra care.
  • Talk with a doctor about participating in any activities that might increase your chance of falling or injury, like contact sports. These may also increase your risk of internal bleeding.

Dietary changes

If you’re taking warfarin long term, it’s best to avoid making sudden dietary changes because this could change the medication’s effect on your body.

Warfarin helps prevent blood clots and strokes by reducing the amount of vitamin K your liver produces. However, suddenly eating more foods high in vitamin K could make the drug less effective. These may include foods like:

  • leafy greens, such as spinach, kale, collard greens, and Swiss chard
  • egg yolks
  • liver
  • parsley
  • avocado
  • chickpeas
  • olive oil
  • mature cheese

The United Kingdom’s NHS also recommends not drinking grapefruit or cranberry juice, as these could also affect how the drug works and increase your risk of excessive bleeding.

Similarly, researchTrusted Source suggests that certain high fiber foods and herbal supplements like St. John’s Wort, turmeric, and coumarin may interfere with the effectiveness of select DOACs.

While taking blood thinners, you may require medical monitoring and regular blood tests.

Warfarin

If you’re taking warfarin long term, your medical team will likely monitor you closely to make sure you’re on the right dosage and to minimize the risks of complications.

You may visit the healthcare clinic once every 4 weeksTrusted Source to have a prothrombin time test. This blood test measures how long it takes for your blood to clot.

If you require a medical procedure that involves bleeding, a doctor may also check in with you before to advise you on whether you need to stop taking your medication for a short period.

If you notice the color of your warfarin pill looks different, speak with a doctor. The color represents the dose, so it’s best to monitor the color to ensure you take the right dose.

DOACs

Shorter-acting blood thinners like DOACs don’t usually requireTrusted Source frequent monitoring. A doctor can give you more guidelines for treatment and any changes in the dosage.

If you have concerns about taking blood thinners long term, you may want to speak with a doctor.

It’s important to take your medication at the same time each day. If you miss a dose, contact a doctor to see how you should get back on track.

Some people who remember their missed dose close to when they normally take it may be able to take it a few hours late. Others may need to wait until the following day and double up their dose. A doctor can advise you on the best method for your situation.

Consider setting alarms or using medication reminder apps to avoid missing doses and stay organized.

In many instances, doctors may recommend staying on blood thinners for the rest of your life to reduce the risk of experiencing a stroke.

Blood thinners may cause side effects, including bleeding and bruising. Significant bleeding can be life threatening and requires emergency medical treatment.

Blood thinners may cause side effects like nausea, bleeding, skin rashes, hair loss, and low blood cell counts. They may also increase your risk of significant bleeding.

Doctors may recommend that you continue taking anticoagulant medications for the rest of your life if you have AFib and have a risk of blood clots and stroke. However, if you have AFib, you may be able to stop taking them if you get a Watchman device implantation or an ablation and there is no evidence of AFib.

Taking blood thinners long term can help prevent blood clots and life threatening complications like stroke.

Bleeding is the biggest risk with long-term blood thinner use. Blood thinners may not make you feel better on a daily basis. Still, they’re one of the best measures you can take to protect yourself against stroke if you have AFib.

If you have concerns about blood thinners and their long-term use, speak with a doctor about the risks versus benefits.