Blood thinners are life-saving, but improper management can turn these medications into a significant health hazard. Dr Evan Levine, a cardiologist at Mount Sinai Hospital with more than 30 years of experience, is sounding the alarm on what he calls a ‘wave of preventable bleeding’ among patients using blood thinners. Also read | Can aspirin reduce risk of second heart attack? What cardiologist says
In his January 3 Instagram video, he warned that ‘it’s not always the drug, it’s the care plan’. Dr Levine said, “If you’re a patient on a blood thinner… listen up. We are seeing a wave of preventable bleeding, and it’s not always the drug, it’s the care plan. I have the data; here are the four red flags you need to check today.”
He wrote in his caption: “Taking a blood thinner? Four mistakes that might cause a deadly bleed.” Here are the four critical mistakes Dr Levine said patients must avoid:
1. The ‘one-size-fits-all’ dosage trap
According to Dr Levine, many patients were unknowingly ‘overdosing every single day’ because their dosage hasn’t been adjusted for their physical profile. He explained, “First, the dose. According to the FDA label… It’s not the one-size-fits-all. If you meet two of these three criteria — you’re 80 or older, you weigh 132 pounds (59.8 kg) or less, or your kidney function is diminished with a creatinine of 1.5 or higher — you have got to lower the dose. Lower the dose. If not, you’re essentially overdosing every single day.”
2. Dangerous drug interactions
Dr Levine cited a 2024 Medicare study published in JAMA highlighting how common heart medications can cause blood thinner levels to spike dangerously. Dr Levine shared, “Then there are the dangerous drug interactions. A large 2024 Medicare study published in JAMA just proved this. A drug like Cardizem, for example, can spike these blood thinners because it competes with and blocks this pathway called the CYP3A4 pathway that helps metabolise the blood thinner. Now, if you’re on more than 120 milligrams of Cardizem a day, that’s a significant risk.”
3. The ‘double whammy’ aspirin mistake
Dr Levine added that a common but hazardous oversight occured when patients remained on daily aspirin for years following a stent procedure while also taking a potent blood thinner. “Number three, the double whammy, the aspirin mistake. This is a big one, folks. Many patients are left on aspirin for years after a stent when they’re also taking potent blood thinners. And with current guidelines saying this is a no-no for many because of the higher risk of bleeding, you need to have a conversation with your doctor,” he said.
4. Hidden dangers in ‘natural’ supplements
Even ‘healthy’ habits could become lethal when mixed with prescriptions. Dr Levine specifically pointed to high-dose fish oil (omega-3s), which possessed natural anti-platelet effects. Dr Levine concluded: “And finally, the supplements, the natural danger. Even some healthy supplements like high-dose fish oil have anti-platelet effects. And while small doses are usually fine, mixing these high-dose omega-3s with a prescription thinner is an additive effect. It tips the scale from protection to bleeding. Now, if you have any question, call your doctor and ask your pharmacist. I hope that helps.”
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This article is for informational purposes only and not a substitute for professional medical advice.
