In the past few years, there has been an explosion in the number of patients taking blood thinners.

People with atrial fibrillation now have three additional choices, all of which share a similar mechanism: interrupting the “cascade” of chemical processes that leads to blood coagulation.

These medications are considered game-changers because they don’t require the strict blood monitoring and dietary restrictions of Coumadin.

They also come with bleeding risks, but the risks are less serious than those associated with Coumadin.

• Pradaxa (dabigatran). While this drug has been approved to prevent strokes and blood clots in people with AF, the FDA has received complaints of serious bleeding. The FDA contends it is no more dangerous than Coumadin.

• Xarelto (rivaroxaban). In addition to stroke prevention, Xarelto is approved to lower the risk of blood clots after hip and knee replacements. Along with warnings that are similar to other blood thinners, Xarelto should not be used by people with spinal problems because it can cause a blood clot that could lead to paralysis.

• Eliquis (apixaban). This newest blood thinner is also approved to lower stroke and blood clot risk in people with AF. It carries warnings similar to the other drugs involving bleeding risks.

Cardiologists are being urged to transition their patients off of Coumadin in favor of these newer blood-thinning agents.