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Hi, I Need To Be On Blood Thinner But They

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Posted on Tue, 11 Jun 2019
Question: hi, I need to be on blood thinner but they all make me sick. Is it possible that the preservative could be causing this? I see where it is possible to get preservative free heparin, is it possible to get lovenox in preservative free?
doctor
Answered by Dr. Dr. Prasad J (4 hours later)
Brief Answer:
unaware of unpreserved lovenox.

Detailed Answer:
Hi,

Some brands of heparin are available without preservatives; however lovenox which is low molecular weight heparin (different from normal heparin) are mostly available with preservatives. You should discuss with your doctor about changing over to normal heparin (if you need no preservative ones). If the doctors agree, your pharmacist will be able to list the non preservative one like one manufactured by Pfizer.

That being said oral anticoagulants (newer ones) / low molecular weight heparin / heparin are important drugs that prevent blood clotting (thrombus formation). The risks of bleeding is higher with heparin (Heparin > low molecular weight heparin > newer anticoagulants). There is also a need for frequent blood monitoring (PT / INR) with heparin than with others. If you have had previous risks of bleeding, heparin cannot be used.

In a nut shell, though there is preservative free heparin, your doctor will weigh the benefits vs risks of bleeding and frequent monitoring and then decide to use it. You shouldn't change over without advice of your doctor.

Hope this helps. Let me know if you need clarifications.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Prasad J (25 hours later)
I am being told that heparin preservative free is no longer made according to my Drs office.I feel like no one believes me when I tell them the reaction I'm having and how it gets worse with every shot.
I have reactions to tableted meds, fish, beef, white bread, and even mouthwash. I understand the doctors concern since I've had blood clots four times in the last 12 years, but I am pretty much incapacitated when I'm on blood thinner. I have worked for a solution for at least 10 of those years, would you have any thoughts on what I can do?
doctor
Answered by Dr. Dr. Prasad J (16 hours later)
Brief Answer:
Check with your pharmacist...

Detailed Answer:
Hi,

I empathize with your situation. Blood thinner drugs are essential and life saving medications especially when you've had 4 blood clots in the past. Risk of morbidity and mortality is far higher without those blood thinners. Hence as a doctor, it is not going to be right to stop them. There are other alternative forms of medicine - herbal / homeopathy / traditional Chinese / holistic doctors who claim to treat it without regular blood thinner drugs; however as a doctor I don't recommend them.

In this context I can think of two ways to go:
1. Check with a pharmacist. Pfizer, a pharmaceutical industry were making the preservative free heparin sodium few months ago. I think it may still be available. You can discuss with your hematologist / physician if it is still available.
2. List the symptoms (side effects) you have, in the order of its severity and duration. Most patients are on blood thinners without intolerance. If possible, there could be a way to treat symptomatically.

Based on the information available I don't have any more suggestions to the problem especially considering your past blood clots and importance of blood thinners. Let me know what your pharmacists say.

Thank you!!
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Prasad J (5 hours later)
Thank You! I Had an appointment this morning with my primary, he also did not think the no preservative was available, but did mention compounding. I checked with a compounding pharmacy and they told me that a no preservative version of heparin could be attained. I get frustrated by the lack of sharing of knowledge, but I hope I am on the right path. I really hesitated to use your service, but I want you to know it has been really a comfort to me. I will let you know if I am successful with this wild idea of preservative induced reaction. If not, I will be back looking for a new solution.
Thanks again.
Mark
doctor
Answered by Dr. Dr. Prasad J (19 hours later)
Brief Answer:
Sure.. Thank you!!

Detailed Answer:
I am happy you found a solution to the problem through the pharmacy. I hope you get better now.

Good luck !!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Dr. Prasad J

General & Family Physician

Practicing since :2005

Answered : 3701 Questions

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Hi, I Need To Be On Blood Thinner But They

Brief Answer: unaware of unpreserved lovenox. Detailed Answer: Hi, Some brands of heparin are available without preservatives; however lovenox which is low molecular weight heparin (different from normal heparin) are mostly available with preservatives. You should discuss with your doctor about changing over to normal heparin (if you need no preservative ones). If the doctors agree, your pharmacist will be able to list the non preservative one like one manufactured by Pfizer. That being said oral anticoagulants (newer ones) / low molecular weight heparin / heparin are important drugs that prevent blood clotting (thrombus formation). The risks of bleeding is higher with heparin (Heparin > low molecular weight heparin > newer anticoagulants). There is also a need for frequent blood monitoring (PT / INR) with heparin than with others. If you have had previous risks of bleeding, heparin cannot be used. In a nut shell, though there is preservative free heparin, your doctor will weigh the benefits vs risks of bleeding and frequent monitoring and then decide to use it. You shouldn't change over without advice of your doctor. Hope this helps. Let me know if you need clarifications. Regards