Deep Vein Thrombosis medications & treatments
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Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one of the deep veins in your body. They most commonly occur in your lower legs and thighs, but can also occur in other parts of your body. It is estimated that 1 to 3 out of every 1,000 American adults develop a deep vein thrombosis or pulmonary embolism (when the blood clot travels to the lungs) each year. Approximately 10% to 30% of those people will die within 1 month of diagnosis. It is the 3rd most common vascular disease in the US and more than half of all DVTs happen as a result of being hospitalized for surgery or illness.
What is deep vein thrombosis?
Deep vein thrombosis (DVT or venous thrombosis) happens when a thrombus (blood clot) develops in a deep vein in your body, usually in the lower extremities. This usually occurs if your vein is damaged to injury or the blood flow within them slows down or stops. Although DVTs are not immediately life-threatening, they can cause serious complications if they break loose, travel through your bloodstream, and cut off the blood flow to the lungs. This condition called a pulmonary embolism (PE), can be fatal. When a DVT and pulmonary embolism are 2 parts of a condition called venous thromboembolism (VTE).
Even if the blood clot doesn’t break free, you can have long-term complications due to the damage the clot does to the veins. These complications are called post-thrombotic syndrome (PTS) and include swelling, pain, and in severe cases, ulcers in the affected part of the body.
Deep vein thrombosis causes
DVTs are due to clots forming, so anything that can affect your blood flow can increase your risk of DVTs, including the following risk factors:
- Being over age 60
- Family history of DVT or PE
- Varicose veins
- Birth control pills or hormone replacement therapy
- Being pregnant or having recently given birth
- Autoimmune diseases such as lupus or inflammatory bowel disease
- Not moving for long periods of time (long car trips, bed rest from surgery, or a medical condition)
- Heart failure
- Certain medications
How is deep vein thrombosis diagnosed?
To properly diagnose deep vein thrombosis, your doctor or healthcare professional will look at your symptoms, review your medical history, perform a thorough physical exam, and run some diagnostic tests.
Deep vein thrombosis symptoms
Symptoms of DVT can include:
- Swelling of your leg, arm, or affected area
- Pain, tenderness, or warmth on the affected leg or affected area
- Discoloration of the skin on the affected area
- Cramping in the affected area (usually begins in the calf)
Along with a medical history, symptoms, and physical exam, your healthcare provider may do imaging tests such as:
- Duplex venous ultrasound. This test is non-invasive and is commonly used to diagnose DVT. It uses sound waves to create a picture of the blood vessels and look at your blood flow and check for clots.
- Magnetic resonance imaging (MRI) scan. This non-invasive test is used to find blood clots in specific areas of your body such as your pelvis or thigh.
- Venography. This test uses a catheter to inject a special dye into your veins to check for blood clots and see if they are blocking blood flow. This test is rarely performed.
- Computed tomography (CT) scan. This scan uses X-ray technology to take three-dimensional pictures of your veins. You may be given an injection of contrast material or dye. It will travel through the veins as they scan it which makes blood clots more visible. This test is typically used to check for clots in your lungs, legs, pelvis, and stomach.
If your healthcare provider thinks you may have a clotting disorder, they may run some blood tests, including:
- D-dimer test. This test measures a substance (D-dimer) that is released when the proteins that help hold the clot together (fibrin) dissolve. A high level of D-dimer can indicate you are likely to have a DVT. It can also be elevated due to other clotting disorders such as pulmonary embolism, stroke, or disseminated intravascular coagulation (DIC). Your D-dimer level is also typically elevated if you are pregnant.
What are some deep vein thrombosis treatment options?
Treatment of DVT will focus on preventing the blood clot from getting bigger, preventing it from breaking loose and causing a pulmonary embolism, preventing other complications as well as decreasing the chance of having another DVT. Your treatment will likely include medications, compression stockings, and surgery.
Medications for DVT include:
- Anticoagulants (blood thinners). These blood-thinning medications are the first-line therapy for DVTs. They help stop blood clots from getting bigger as well as help decrease the risk of further clotting. Anticoagulant therapy will typically last at least 3 to 6 months. The most common injectable anticoagulants are heparin, Lovenox (enoxaparin), and Arixtra (fondaparinux). Common oral blood thinners include Coumadin (warfarin), Xarelto (rivaroxaban), Eliquis (apixaban), and Pradaxa (dabigatran).
- Thrombolytics. Also called clot busters, these medications help dissolve clots in severe cases.
These socks are tight at the ankle and get looser as they go up to the knee or right above it. They can help prevent blood pooling in your legs, which can lower your chance of developing DVTs. If you are at high risk of DVT, your doctor may recommend you wear these every day.
Inferior vena cava filter
If you cannot take anticoagulants or didn’t respond to therapy, your doctor may place a filter inside a large vein (vena cava) in your abdomen that brings back blood to the heart. An IVC filter will help stop traveling clots from reaching your lungs.
What is the best medication for deep vein thrombosis?
The best medication for the treatment of deep vein thrombosis will depend on the individual’s specific medical deep vein thrombosis, medical history, medications that the individual is already taking that may potentially interact with deep vein thrombosis medications, and the individual’s potential response to the treatment. It is advisable to always speak with your healthcare provider about the best medication for you. The table below includes a list of the most prescribed or over-the-counter deep vein thrombosis medications approved by the Food and Drug Administration (FDA).
Best medications for deep vein thrombosis
|Drug name||Drug class||Administration route||Standard dosage||Common side effects
|Coumadin (warfarin)||Vitamin K antagonist||Oral||2mg to 5mg once daily for 2 days then adjust based on the patient’s INR.||Bleeding, bruising, stomach pain, rash
|Lovenox (enoxaparin)||Low molecular weight heparin||Injection||1mg per kg of body weight injected under the skin every 12 hours or 1.5mg/kg once daily.||Bleeding, fever, injection site reactions, low platelet levels, nausea, anemia
|Arixtra (fondaparinux)||Factor Xa inhibitor||Injection||Dose is weight-based and then injected under the skin once daily.||Anemia, fever, nausea, rash, dizziness, swelling, constipation
|Bevyxxa (betrixaban)||Factor Xa inhibitor||Oral||80mg once daily.||Nosebleed, stomach bleed, brain bleed, blood in the urine
|Eliquis (apixaban)||Factor Xa inhibitor||Oral||10mg twice daily for 7 days, then 5mg twice daily thereafter.||Stomach bleed, brain bleed, nonmajor bleed, allergic reaction, rash
|Savaysa (edoxaban)||Factor Xa inhibitor||Oral||Less than 60kg – 30mg once daily.|
More than 60kg – 60mg once daily.
|Abnormal liver function tests, rash, anemia, nonmajor bleed
|Xarelto (rivaroxaban)||Factor Xa inhibitor||Oral||15mg every 12 hours for 21 days, then 20mg once daily thereafter.||Bruising, back pain, stomach pain, dizziness, itching
|Pradaxa (dabigatran)||Thrombin inhibitor||Oral||150mg twice daily.||Bleeding, indigestion, upset stomach, rash
|Fragmin (dalteparin)||Anticoagulant||Injection||Dose is based on what type of surgery is being performed as well as your risk of a DVT.||Injection site reactions, low platelet levels, bleeding
Your healthcare provider will determine the right dosage based on your response to the treatment, medical deep vein thrombosis, weight, and age. Other possible side effects may exist; this is not a complete list.
What are the most common side effects of deep vein thrombosis medications?
As with all medicines, those used for deep vein thrombosis will have some side effects, depending on the class of medication you are taking. Since the medications used to treat and prevent DVTs all inhibit your body’s ability to make clots, bleeding is the major side effect. This can range from bruising and nosebleeds to major bleeding in your stomach and brain. Some other common side effects include:
- Stomach pain
- Injection site reactions
What are some home remedies for deep vein thrombosis?
While medications are necessary to help resolve and prevent DVTs, there are some self-care measures you can do to help improve blood flow.
Deep vein thrombosis prevention
Some tips to try to prevent blood clots include:
- Try short walks daily and during long trips in the car or on a plane.
- Try compression stockings after surgery or if you are at a higher risk of developing DVTs.
- Elevate your feet to at least hip level to help reduce blood pooling.
- Drink plenty of fluids.
- Stop smoking.
Frequently asked questions about deep vein thrombosis
What are some complications of DVT?
Some complications of DVT include:
- Pulmonary embolism. When a clot breaks loose and travels to your lungs, it can cause symptoms such as chest pain, shortness of breath, cough, increased heart rate, and fainting.
- Post-thrombotic syndrome (PTS). When the clot doesn’t break free, it can still cause damage to your veins and you may see symptoms such as swelling, pain, redness, and ulcers in severe cases.
What medications increase your risk of DVT?
Certain medications such as birth control pills, hormone replacement therapy, tamoxifen, erythropoietin, and some cancer chemotherapy medications, especially if you have other risk factors for DVTs.
Can DVTs be cured?
Yes, with proper treatment with medications for 3 to 6 months, DVTs can be resolved. You can prevent them from coming back with a combination of lifestyle changes, compression stockings, and medications.
What are the chances of getting another DVT?
If you have had a DVT you are at a higher risk to develop another one than someone who has never had one. Approximately 33% of people with DVT will have another one within 10 years.
Can I exercise if I have a DVT?
Exercise increases circulation reduces swelling, and is a big part of DVT therapy. It can help prevent blood clots from getting bigger as well as prevent new blood clots from forming. Always consult your healthcare provider to determine the amount and type of exercise that is safe for you.
Related resources for deep vein thrombosis
The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.