Pulmonary Embolism medications & treatments

Medically reviewed by  Jamie Winn, PharmD

Complete a free online enrollment application to find out if you’re eligible to pay only $49 per month for your Pulmonary Embolism medication with our help.

Get started today

A pulmonary embolism (PE) is a blood clot that travels from another part of the body and blocks blood flow to the lungs. This condition affects around 1 in 1,000 American every year. PE is the third most common type of cardiovascular disease behind coronary artery disease and stroke. It is a life-threatening condition that is responsible for 100,000 deaths per year in the U.S. PE can be treated successfully, especially if it is diagnosed early on. It can be a chronic condition with about 33% of those with PE or a related deep vein thrombosis (DVT) will have a recurrence within 10 years.

What is pulmonary embolism?

A pulmonary embolism (PE) is a blood clot (embolus) that develops in a blood vessel in your body, often in the leg. It then travels to the lungs, causing a blockage in one of the pulmonary arteries in your lungs. This can block the blood flow to the lungs and can be fatal if not treated immediately.

 Pulmonary embolism causes

Most pulmonary embolisms start as a deep vein thrombosis (DVT) so the risk factors for a PE are the same as for a DVT, including:

• Inactivity. Being inactive or immobile for long periods due to bed rest or while traveling can increase your risk.
• Family history. Genetics can play a role in the development of PE.
• Heart disease. Having a history of stroke, high blood pressure, heart failure, or heart attacks increases your risk of PE.
• Obesity. Being overweight or obese increases your risk of blood clots, especially if you smoke or have other risk factors.
• Estrogen therapy. If you are taking birth control pills or hormone replacement therapy, it can increase your blood clotting risk.
• Smoking. Smoking can damage your blood vessels and make it more likely for you to form blood clots.
• Pregnancy. If you are pregnant or have given birth in the past 6 weeks, your risk of blood clots is increased.
• Central venous catheters. The placement of a catheter in your arm or leg can increase your risk of blood clots.
• Cancer. Having a history of cancer or receiving chemotherapy increases your risk.

How is pulmonary embolism diagnosed?

To properly diagnose pulmonary embolism, your doctor or healthcare professional will look at your symptoms, review your medical history, perform a physical exam, and run some blood and imaging tests.

Pulmonary embolism symptoms

Symptoms of pulmonary embolism will vary depending on the size of the clot and any other medical conditions you have. Some common symptoms of PE include:

• Shortness of breath
• Chest pain
• Cough
• Irregular or rapid heartbeat
• Dizziness or lightheadedness
• Sweating
• Pale or blue-colored skin
• Low blood pressure
• Pain, swelling, or tenderness in your leg

If your doctor suspects a DVT or PE, they may perform the following tests to help confirm your diagnosis:

• Blood tests. These are used to check the blood’s clotting status. This may include a D-dimer test. D-dimer is a protein that is present in your blood after a clot is broken down. High levels of D-dimer suggest an increased possibility of blood clots, although it can be high for other reasons. Blood tests can also be used to measure the oxygen levels in your blood or to check for genetic clotting disorders.
• Computed tomographic pulmonary angiography (CTPA). This CT scan uses special x-rays and contrast dye injected into your veins to create 3D images that can show pulmonary embolism within the arteries in your lungs. This is the most common test used to diagnose PE.
• Ventilation-perfusion scan (V/Q scan). If you cannot undergo a CTPA, your doctor may perform a V/Q scan. It uses a small amount of radioactive material to show which parts of your lungs are getting airflow (ventilation) and the blood flow within the lungs (perfusion).
• Chest X-ray. This imaging test cannot diagnose PE but can be used to rule out other conditions.
• Pulmonary angiogram. This test is the most accurate way to diagnose PE. It involves inserting a catheter into a large vein (usually in the groin) and then threading it into the arteries in your lungs. A dye is injected through the catheter and x-rays of your blood vessels are taken as the dye passes through them.
• Magnetic resonance imaging (MRI). This imaging test makes detailed images of organs and structures within your body. It is typically used in pregnant women or in patients who cannot tolerate the dye used in other tests.
• Duplex venous ultrasound. This imaging test uses high-frequency sound waves to create images of blood vessels and organs to check for blood clots.

What are some pulmonary embolism treatment options?

The treatment goals for this condition are to keep the blood clot from getting bigger and prevent new clots from forming. It will vary depending on the size and location of the blood clot. Immediate treatment is important to prevent serious complications or death. Treatment for pulmonary embolism (PE) may include:

Medications

• Blood thinners. These anticoagulant medications reduce the ability of your blood to clot. This helps stop a clot from growing and helps decrease the risk of further clotting. Examples include Coumadin (warfarin), Heparin, and low molecular-weight heparins such as Lovenox (enoxaparin).
• Thrombolytic therapy. These “clot busters” such as tissue plasminogen activator (TPA), are used to dissolve the clot. Since they can cause an increased risk of severe bleeding, clot busters are usually given in the hospital for life-threatening situations.

Compression stockings

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.

Embolectomy

This rarely used procedure involves inserting a thin, flexible tube (catheter) into a vein in your thigh or arm and onto your lung. The doctor will then remove the clot or use medicine to dissolve it.

What is the best medication for pulmonary embolism?

The best medication for the treatment of pulmonary embolism will depend on the individual’s specific medical pulmonary embolism, medical history, medications that the individual is already taking that may potentially interact with pulmonary embolism 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 pulmonary embolism medications approved by the Food and Drug Administration (FDA).

Best medications for pulmonary embolism

Your healthcare provider will determine the right dosage based on your response to the treatment, medical condition, weight, and age. Other possible side effects may exist; this is not a complete list.

What are the most common side effects of pulmonary embolism medications?

As with all medications, those used for PE will have side effects, depending on the class of medication you are taking. Since the medications used to treat PE 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:

• Fever
• Nausea
• Rash
• Stomach pain
• Anemia
• Dizziness
• Injection site reactions

What are some home remedies for pulmonary embolism?

While medications are essential to help resolve and prevent PEs, there are some lifestyle changes and self-care measures you can do to reduce your risk of blood clots.

Pulmonary embolism prevention

Try these tips to help prevent PE, including: 

• Try short walks daily and during long trips in the car or on a plane.
• Exercise regularly as tolerated.
• Maintain a healthy weight.
• 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 but avoid excess caffeine and alcohol.
• Stop smoking.
• Do not wear tight-fitting clothing.

Frequently asked questions about pulmonary embolism

What are some complications of pulmonary embolism?

Pulmonary embolisms can be a fatal condition. About 33% of people with undiagnosed and untreated pulmonary embolism don’t survive. It can also cause pulmonary hypertension. This is a condition

Is venous thromboembolism (VTE) the same as a pulmonary embolism (PE)?

Venous thromboembolism (VTE) refers to a blood clot that starts in a vein. If the clot develops in a vein and stays there, it is called a thrombus (DVT). If the clot travels to another part of your body, it’s called an embolus (PE).

What medications increase your risk of pulmonary embolism?

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.

What are the chances of getting another pulmonary embolism?

If you have had a DVT or PE, you are at a higher risk to develop another one. Approximately 33% of people with DVT will have another one within 10 years.

Can I exercise after a pulmonary embolism?

Once you have been cleared by your doctor, it is beneficial to resume or start exercising as tolerated. Exercise can strengthen your heart and improve circulation, which both help prevent any further pulmonary embolisms.

Related resources for pulmonary embolism

• Acute pulmonary embolism. National Library of Medicine
• Pulmonary embolism overview. MayoClinic
• What is pulmonary embolism? John Hopkins Medicine
• Pulmonary embolism symptoms and causes. Cleveland Clinic
• Data and statistics on blood clots. Centers for Disease Control and Prevention
• Pulmonary embolism practice essentials. Medscape