Thrombolytics and anticoagulants treat blood clots but in different ways. Thrombolytics are emergency medications that break up blood clots. Anticoagulants prevent blood clots from forming.
Blood clots are a potentially dangerous condition you can prevent or treat with medications. Thrombolytics and anticoagulants are different classes of drugs that can help treat blood clots.
In this article, we’ll contrast thrombolytics and anticoagulants. We’ll explain how they work and discuss when doctors may recommend each type.
Thrombolytics, aka fibrinolytics, are emergency medications people sometimes refer to as “clot busters.” Healthcare professionals use them in emergency medical settings, like hospitals and ambulances, to quickly dissolve dangerous or life threatening blood clots.
Thrombolytics work by activating plasminogen, a protein in your liver. Once activated, plasminogen generates plasmin, a blood enzyme. Plasmin quickly breaks up fibrin, the fibrous proteins that form blood clots.
You might receive thrombolytics intravenously into a vein or through a catheter directly into the clot.
Examples of thrombolytic medications
Thrombolytic medications include:
- tenecteplase (TNKase)
- alteplase (Activase)
- streptokinase (Streptase)
Anticoagulants are medications doctors prescribe to prevent blood clots. People often refer to them as blood thinners or anti-clotting medications. Most anticoagulants are oral medications, meaning you take them by mouth.
Clotting factors in plasma signal your blood to form clots when you’re bleeding. Anticoagulants work by inhibiting the action of these clotting factors.
Unlike thrombolytic medications, anticoagulants won’t dissolve a clot. They do, however, stop blood clots from becoming larger and more dangerous.
Antiplatelets are blood thinners doctors use to prevent blood clots from forming. They work by a different mechanism than anticoagulants do.
Antiplatelets make the platelets (aka thrombocytes) in your blood less sticky. They are microscopic cell fragments that stick together to form blood clots when you are bleeding. Antiplatelets stop platelets from sticking together to form clots.
Aspirin is a commonly used antiplatelet medication.
There is some overlap between the uses for all of these medications. A healthcare professional can explain why they recommend one type over another. In general, these are the usage distinctions between them:
Thrombolytics are emergency medications used in life saving situations. A healthcare professional may give you a thrombolytic medication if:
- you’re having a heart attack
- you’re having a stroke
- you have an acute pulmonary embolism (blood clot in the lung)
Anticoagulants are preventive medications. A healthcare professional may prescribe an anticoagulant if you’re at high risk of blood clots or already have small blood clots that might become larger. You may receive anticoagulants if you have any of these:
- acute DVT (deep vein thrombosis)
- pulmonary embolism
- atrial fibrillation
- structural heart anomalies present from birth
- history of heart valve replacement
- high risk of blood clots after surgery or due to pregnancy or cancer treatment
Doctors often prescribe antiplatelets to prevent heart attacks and strokes. A healthcare professional may recommend this type of blood thinner for you if you have:
What’s the difference between thrombolytics and fibrinolytics?
Fibrinolytic therapy is also known as thrombolytic therapy. They are different names for the same treatment.
What’s the difference between anticoagulants and antiplatelet medications?
Anticoagulants and antiplatelet medications are different classes of blood thinners. Each type stops your blood from clotting but in different ways.
Anticoagulants stop blood clots by altering the effect of clotting factors found in plasma. Antiplatelets do this by preventing platelets in blood from sticking together.
Can you take thrombolytics and anticoagulants together?
Thrombolytics and blood thinners, like anticoagulants and antiplatelets, prevent or dissolve blood clots. The underlying condition that requires treatment, as well as other factors, will help determine which type of medication a healthcare professional recommends.
In an emergency, thrombolytics are usually the medication of choice. Doctors more typically prescribe blood thinners as part of preventive care.