Blood Thinners and Alcohol: How do Both Substances Interact?

Last Updated: April 2, 2021

Authored by Nena Messina, Ph.D.

Reviewed by Michael Espelin APRN

The possible result of the concomitant use of blood thinners and alcohol has always been uncertain. People who take anticoagulants do so to reduce the risk of excessive clotting. Drinking on blood thinners (BTs) may seem harmless, but some effects may become visible over time. What is the relationship between alcohol and blood thinners? Does mixing alcohol with blood thinners have negative health implications? The frequent and combined usage of alcohol and blood thinners may put people at risk of a heart attack or a stroke. While many people do not consider this, alcohol is a drug, too. Like other drugs, it can also interact with the medicines a person takes. That can impact this mechanism.

Since many people drink alcohol in their daily lives, it is crucial to understand how ethanol and BTs interact and affect the body. Should one be drinking on blood thinners? What effect do these drugs have on ethanol? What signs can warn an individual about the adverse impact of their simultaneous use? What should alcoholics do if they need to take this medicine?

Blood Thinners and Alcohol: is It Safe?

Can one take blood thinners and alcohol at the same time? Taking a moderate amount of ethanol with them is not generally harmful. This is because the impact of moderate amounts of ethanol now and then is not enough to cause harm to the body.

Man drinking alcohol with blood thinners feeling unwell.

However, people who binge drink or drink excessively every day are at increased risk of complications because both drugs have a similar clotting outcome.

Taking them together has a synergistic effect in blocking the clotting mechanism of the blood. Without proper clotting mechanisms in place, the body may have an increased predisposition to uncontrollable bleeding. In general, mixing alcohol and blood thinners is not a good idea. It is imperative to understand what BTs are and their functions in the heart and as treatment regimens in the body. BTs are specific medications that inhibit the formation of blood clots in the body.

The most common uses of blood thinners are to prevent deep vein thrombosis (blood clot in the leg or the veins). If this condition is left without treatment, it may develop in a life-threatening event called a pulmonary embolism (PE), caused by fragments of clots passing through the heart.  Certain internal clots that can be attributed to aging can be harmful to health, and BTs are usually recommended to preserve blood fluidity.

Blood Thinners Are of 3 Known Types:

  • Anticoagulants
  • Fibrinolytics
  • Antiplatelets

Anticoagulants: These categories of medications actively inhibit the clotting in the body.

Examples of Anticoagulants Are:

  • Dabigatran (Pradaxa)
  • Warfarin (Coumadin)
  • Heparin
  • Apixaban
  • Edoxaban (Savaysa)
  • Enoxaparin (Lovenox)

Fibrinolytics: Fibrin is an active component in clot formation; hence, Fibrinolytics breakdown fibrin formation, causing the dissolving of clots in the body.

The administration of this medication is usually a one-time management plan.

Some of These Include:

  • Urokinase
  • Tissue plasminogen Activator (tPA)
  • Streptokinase

Antiplatelets:  These are medications (in the form of pills or injections) that prevent blood platelets from converging to form clots.

These Include:

  • Ticagrelor (Brilinta)
  • Dipyridamole
  • Clopidogrel (Plavix)
  • Ticlopidine
  • Dipyridamole/Aspirin (Aggrenox)
  • Acetylsalicylic acid (ASA)( Aspirin, Asaphen)

Having understood how BTs work, it is imperative to understand the likeness with ethanol functions; does alcohol thin your blood?

Does Alcohol Thin Your Blood?

Consuming ethanol can cause severe complications in the long run. Apart from its many disastrous effects on various systems of the body, ethanol also damages the liver and reduces its ability to produce clotting factors.

Clotting factors are necessary for homeostasis, which balances different body functions to ensure everyday living. When clotting factors are reduced, the body cannot heal the numerous micro-injuries it suffers regularly. With enough liver damage, the internal vessels may start bleeding inside the body and cause massive hemorrhage and shock.

Is alcohol a blood thinner? Yes, it is.

Drinking May Cause Anti-Clotting Effects in Many Ways:

  • Alcohol-induced thrombocytopenia – this is an unhealthy reduction in the number of platelets in the body caused by excessive drinking. The condition decreases platelets in plasma below 150,000 microliters. This is below the regular range of 150,000 to 400,000 microliter. Alcohol-induced thrombocytopenia is prevalent in 3 to 43% of persons considered healthy and 14 to 81% of those addicted or dependent on alcohol.
  • Thrombocytopathy – this is the alcohol-based impairment of the aggregating functions of platelets to form clots.
  • Alcohol-induced fibrinolysis – the breakdown of fibrins can be caused by excessive drinking, depending on the time of the last drink. The effects are inconsistent and dangerous blood clots and excessive bleeding.

Although ethanol reduces clotting, it should not be used as a substitute for anticoagulants. Prescription anticoagulants have proper medical methods to track their dosage and effectiveness. This tracking ensures that the balance between clotting and bleeding is maintained. Substituting medications would disrupt this balance as there would be no way to track and manage it.

Risks of Simultaneous Consumption

People who are occasionally using blood thinners and alcohol are not at much risk. Occasional drinking works fine with anticoagulants. However, heavy drinkers may be at risk of severe complications like excessive bleeding and death.

If anticoagulants are taken with a massive amount of ethanol, they may cause excessive blood thinning due to the synergistic effect. Moderate alcohol consumption thins the blood. However, medical professionals do not recommend drinking as a blood thinner.

Man sitting on the couch with alcohol and blood thinners on the table and in hands.

Drinking regularly might make the blood too thin, so gums, minor cuts, and incisions will bleed much more than they usually do. Old people are especially susceptible to injuries and bleeding. Excessive drinking on blood thinners in these people can easily cause massive plasma loss and death.

Drinking contributes to blood-thinning; however, the type of ethanol, frequency, and amount also matters. Research has not specified if red wine, beer, or any other alcoholic beverage has a higher capacity to cause deep vein thrombosis (blood clot on a deep vein, usually the leg). However, liquor was implicated as a risk factor in the development of deep vein thrombosis. This could be due to the higher volume of ethanol in liquor and the tendency for abuse. Either way, binging on any form of ethanol while using BTs can expose one to DVT.

Dangerous Signs for Doctor’s Consultation

There are numerous side effects of blood thinners and alcohol. Drinking on blood thinners will result in a large amount of bleeding.

Dangerous Signs Include:

  • bruises on skin
  • skin discoloration
  • bloody urination, vomiting, or stool
  • excessive bleeding from an injury
  • drop in blood pressure
  • dizziness
  • headache
  • fainting
  • nausea and vomiting
  • abdominal pain
  • shortness of breath
  • chest pain
  • confusion
  • altered level of consciousness

If any of these signs are noticed, the person experiencing them should be rushed to the nearby hospital’s emergency department. Often, these signs are subtle and easy to miss. A person might be bleeding internally and would not realize it. Therefore, people taking both drugs simultaneously should be actively looking out for these signs to prevent dangerous complications.

Effect of Alcohol on Cardiovascular System

Alcohol has many effects on the cardiovascular system. Low-to-moderate use is associated with a reduced risk of developing factors that cause atherosclerosis, narrowing of vessels, and inflammation. Despite that, the harmful effects of its consumption are numerous, ranging from serious physiological effects, mitochondrial dysfunction, inflammatory response, oxidative stress, programmed cell death, and anatomical damage to the cardiovascular system.

Ethanol immediately increases blood pressure and can cause chronic hypertension in the long run.

Woman with hypertension measuring blood pressure.

Hypertensive people taking anticoagulants should actively avoid alcohol as it may cause bleeding in the brain due to its effect on clotting and blood pressure. Moderation in the consumption of alcohol is key to a healthy heart.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the Moderation of Alcohol Intake Can Aid the Cardiovascular System in the Following Ways:

  • Low heart attack risk
  • Reduced risk of developing diabetes
  • Low risk of heart disease and other alcohol-based health issues that lead to the high mortality rate
  • Reduced risk of ischemic stroke

Reports show that women who drink excessively are more vulnerable to heart disease than men. Scientific research, however, showed that males who used 5.1 to 30 grams of ethanol daily had a reduced 29% risk of developing fatal heart disease or a non-fatal myocardial infarction. This is evident that ethanol consumption at moderate levels may reduce the risk of coronary heart disease. In another research that recorded 87,526 females, the risk of coronary heart disease was just 10% higher in women categorized as former drinkers than women who were abstainers. Active drinkers had a 40% higher risk. Even though moderation is an effective way to ensure that the heart is in good condition, complete abstinence is usually the best option.

Options for Alcoholics

If someone has a history of drug abuse or family members who have an ethanol addiction, they should explore alcohol abuse resources or contact a medical professional. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) is an exceptional resource consolidating everything related to ethanol addiction. NIAAA helps heavy drinkers to reduce their consumption to moderate levels, which is difficult to achieve without help. In addition to that, people who have been living in a family of drinkers and an increased risk of becoming alcoholics themselves can find help and guidance from ACOA (Adult Children of Alcoholics).

So, to sum up, a moderate amount of drinking reduces clotting but cannot be substituted for prescribed anticoagulants. Simultaneous blood thinners and alcohol use can cause internal bleeding in heavy or regular drinkers due to their synergistic effects. People taking anticoagulants should reduce ethanol consumption for the sake of their health or contact a rehabilitation center in case of an addiction to ethanol. They should also be on the lookout for signs of internal bleeding. Alcoholics with anticoagulant prescriptions should actively seek help in rehab institutions. Professional medical treatment will help to reduce their risk of developing severe health complications.

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Published on: December 10th, 2019

Updated on: April 2nd, 2021

About Author

Nena Messina, Ph.D.

Nena Messina is a specialist in drug-related domestic violence. She devoted her life to the study of the connection between crime, mental health, and substance abuse. Apart from her work as management at addiction center, Nena regularly takes part in the educational program as a lecturer.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.