Blood Thinners and Alcohol: Interactions, Risks, and Side Effects

As many as three million people take blood thinners each year, but some may not be aware of how these medications interact with substances like alcohol. On their own, blood thinners can create a number of health risks and increase the chances of serious bleeding. When combined with alcohol use, however, the risks become much more severe.

What Are Blood Thinners?

Blood thinners are medications that slow your body’s ability to coagulate blood, making your blood less likely to form blood clots. These medications are intended to treat blood clots in people who have them or reduce the risk of them forming. Blood thinners do not actually reduce the size of existing clots, but they can enhance the body’s natural process for eliminating unhealthy blood clots.

The process of blood clotting is very complex, with multiple chains of chemical reactions called the “clotting cascade” that must occur to develop a blood clot. Blood thinners slow parts of this process, making blood clots form more slowly. This helps prevent blood clots from lodging in the heart, causing a heart attack; in the brain, causing a stroke; or in the lungs, causing a pulmonary embolism.

Common Blood Thinner Medications

Different blood thinners work on different parts of the clotting cascade. The specific blood thinner being used will depend on the reason that blood thinners are needed. Commonly used blood thinners include:

• Coumadin (warfarin)
• Xarelto (rivaroxaban)
• Eliquis (apixaban)
• Pradaxa (dabigatran)
• Lovenox (enoxaparin)
• Brilinta (ticagrelor)
• Plavix (clopidogrel)
• Aspirin
• Heparin

Is Alcohol a Blood Thinner?

Alcohol affects how thin your blood will be. Light to moderate alcohol use can make your blood thinner, while heavy alcohol use actually increases the likelihood of forming blood clots. While moderate alcohol use does have a blood-thinning effect, using alcohol specifically to thin your blood or have a healthier heart is not recommended.

Blood Thinners and Alcohol

Mixing alcohol and blood thinners is never recommended. In fact, most blood-thinning medications will specifically advise against mixing them with alcohol. Blood thinners can be dangerous, increasing your risk of severe bleeding during an accident or with an injury. Their use must be carefully monitored to ensure that the blood does not become too thin.

When alcohol is included in the mix, it can alter how thin your blood is and also change how active the medication is. This ultimately affects the delicate balance that doctors hope to achieve while using blood thinners. Depending on how this interaction works, it could cause the blood to become too thin, creating a high risk for bleeding from minor injuries. It could also reverse the effects of the blood thinners, increasing the risk of dangerous conditions like heart attack or stroke.

Risks and Side Effects of Mixing Blood Thinners and Alcohol

There are several risks related to mixing alcohol and blood thinners. Alcohol affects how well your blood clots, potentially negating the effects of the blood thinners or increasing them to a dangerous level. Further, alcohol can affect how long it takes for your body to process blood thinners. This can cause the medication to stay active for longer and have a greater effect than it should. Alcohol can also cause underlying health problems that affect the liver, which plays a vital role in how blood thinners work and how blood clotting occurs. This can further affect blood clotting in the body.

Alcohol and blood thinners interact in different ways that will vary for each individual. This makes it hard to predict exactly what will happen, but it increases the risk of either bleeding or clot-related problems. Alcohol can also increase the risk of injuries, which can bleed more easily while someone is on blood thinners.

If you are taking blood-thinning medications, you should contact your doctor immediately if you have any signs of serious bleeding. These include:

• Excessive or unusual bruising
• Bleeding from your gums or nose that does not stop by itself
• A cut that does not stop bleeding normally
• Blood in your urine or brown urine
• Blood or tar-like substance in stools
• Vomit that is bright red or brown
• Coughing red mucus or blood
• Severe pain, such as headache or stomach ache
• Menstrual bleeding that is much heavier than normal
• Dizziness or weakness

If you are experiencing serious bleeding, it is important for you to tell your doctor all the medications and supplements you are taking and inform them of any food or drink that you have consumed recently. This can help them determine if something is causing an interaction that could lead to serious bleeding.

Can You Drink on Blood Thinners?

Regardless of the type of blood thinner being used, you should generally avoid alcohol while taking a blood-thinning medication. The actual risks to a particular individual are very case-specific and should be discussed with a doctor.

Alcohol Interactions with Anticoagulants and Antiplatelet Medications

There are two main types of blood thinners: anticoagulants and antiplatelets. Anticoagulants affect the chemistry behind how blood clots form, while antiplatelets affect how platelets gather at the site of a blood clot. While there are chemical differences in how these medications work, alcohol should generally be avoided with both types of medications.

Coumadin (warfarin) and Alcohol

Coumadin is one of the most commonly used blood thinners in the U.S., but it carries a 3% to 6% risk of major bleeding. Alcohol should be avoided when taking Coumadin, as it is one of the most serious risk factors for complications with this medication.

Xarelto (rivaroxaban) and Alcohol

The effects of Xarelto can be affected by alcohol, and those taking the medication should limit the amount of alcohol used. While some alcohol may be safe, specific situations should be discussed with a doctor.

Eliquis (apixaban) and Alcohol

Eliquis is a common blood thinner that does not require routine blood tests like some anticoagulants do. However, it cannot be quickly reversed in an emergency. Using alcohol with Eliquis can increase the risk of internal bleeding, so alcohol use should be limited.

Pradaxa (dabigatran) and Alcohol

Alcohol increases the effects of Pradaxa through an unknown mechanism. This increases your risk of bleeding and makes it advisable to avoid mixing alcohol and Pradaxa.

Arixtra (fondaparinux) and Alcohol

Much like Pradaxa, alcohol also increases the effects of Arixtra. This is doubly dangerous, as you are more likely to have an injury while intoxicated and are at higher risk for severe bleeding.

Lovenox (enoxaparin) and Alcohol

The blood-thinning effect of Lovenox is enhanced while using alcohol, increasing the risk of bleeding. You should check with your doctor before mixing Lovenox and alcohol.

Savaysa (edoxaban) and Alcohol

Alcohol use should be limited while using Savaysa because it increases the risk of internal bleeding. While some alcohol use may be permissible in certain situations, you should consult with a doctor or pharmacist about your specific situation.

Brilinta (ticagrelor) and Alcohol

Alcohol use should be limited while using Brilinta. Mixing alcohol and Brilinta could lead to increased dizziness. Someone using alcohol while taking Brilinta should speak with their doctor about the risks that are specific to their situation.

Plavix (clopidogrel) and Alcohol

Plavix increases the risk of stomach bleeding when coupled with daily alcohol use. Alcohol use should be limited while on Plavix, and specific cases should be discussed with a doctor.

Effient (prasugrel) and Alcohol

Alcohol should be limited while using Effient, especially among older adults. Some alcohol use may still be permissible; however, consultation with a doctor is essential to determine the risks for specific situations.

Aspirin and Alcohol

The effects of aspirin are increased by alcohol, making it more likely for the effects to reach a toxic level. Aspirin can also increase the risk of internal bleeding when taken with alcohol. Alcohol use should be limited while taking aspirin, particularly in the two hours before or after using it.

Talk to Your Doctor

Ultimately, anyone who is taking any kind of blood-thinning medication should speak with their doctor before mixing it with alcohol. The different risks that are present will vary based on each individual, and someone who has not spoken with their doctor can have risks they don’t know about. Blood thinners can be dangerous by themselves as well, making it essential to seek medical advice when symptoms or potential concerns arise.

Getting Help for Alcohol Abuse

Avoiding the combination of blood thinners and alcohol is much more difficult for those addicted to alcohol. Even though it could be harmful, people who struggle with alcohol abuse may find themselves combining alcohol and blood thinners even though they know they shouldn’t.

If you or someone you love is struggling with alcohol addiction, professional treatment at a licensed rehab facility can help. The Recovery Village Ridgefield is a premier addiction treatment center in Ridgefield, Washington, that offers detox, inpatient and outpatient programs for alcohol use disorders. Reach out to one of our understanding team members today to learn more about how we can help you achieve a healthier, alcohol-free life in recovery.