There are three general categories of drugs that are commonly used to prevent or treat blood clots (thrombosis): anticoagulants, fibrinolytics, and antiplatelet medications. Some of these (Pradaxa, Angiomax, ReoPro) may be unfamiliar, while others (warfarin, heparin, aspirin) are generally household names.
They have different mechanisms of action, different risks, and are used under different circumstances. One potential side effect common to all of them is excessive bleeding, so all of these drugs must be used with appropriate precautions. Gonadotropic Hormone
While drugs are the mainstay of treatment for blood clots, certain patients may require a surgical procedure to prevent them.
If you have or are suspected to have a blood clot, you'll likely leave your healthcare professional's office with a prescription. What you take will depend on several factors, including your overall health, the probable cause of the clot, its severity, and more.
Anticoagulant drugs inhibit one or more of the clotting factors, a group of blood proteins that are responsible for blood clotting.
Coumadin (warfarin): Until recently, warfarin was the only orally administered anticoagulant drug available.
The biggest problem with warfarin has been getting the dosage just right, which can be difficult for healthcare professionals and inconvenient for patients.
When you start taking it, the dosage must be stabilized over a period of weeks, and frequent blood tests (INR blood tests) are necessary to assure this. Even after stabilization, INR tests need to repeat periodically and one's dosage of warfarin often requires re-adjustment.
Three groups of drugs are used to reduce the "stickiness" of platelets, the tiny blood elements that form the nucleus of a blood clot. By inhibiting the ability of platelets to clump together, anti-platelet drugs inhibit blood clotting. These drugs are most effective in preventing abnormal blood clots from forming in arteries and are much less effective at preventing thrombosis in the veins.
These powerful drugs, also known as fibrinolytic agents or "clot busters," are given intravenously to dissolve blood clots that are in the process of forming. For the most part, their use is limited to patients who are within the first few hours of an acute heart attack or stroke in an attempt to re-open a blocked artery and prevent permanent tissue damage.
These drugs can be tricky to use and they carry a substantial risk of bleeding complications.
However, in the right circumstances, these medications can prevent death or disability from a heart attack or stroke.
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Sometimes a blood clot in the arms or legs (called deep vein thrombosis, or DVT) can travel to the lungs, forming a blood clot called a pulmonary embolism (PE).
For patients who have DVT and for some reason cannot take the available medications, other treatment is available. Surgeons can implant a small metal device called an inferior vena cava filter (IVC) that traps large clot fragments and prevents them from traveling through the vena cava (a large vein in the abdomen that brings blood from the lower body back to the heart).
These filters can remain in place permanently or be removed, depending on the individual patient's situation.
If you have experienced or are at risk of a blood clot in your legs, your healthcare provider may recommend you wear special elastic socks called compression stockings. These can help increase blood flow out of the legs and back to the heart, and reduce pain and swelling in the legs or arms due to damaged blood vessels, a condition known as post-thrombotic syndrome.
Compression stockings are available at drugstores and medical supply stores. Talk with your healthcare provider about which length (knee-high or thigh-high) is best for you.
If you have a blood clot in your leg, known as deep vein thrombosis (DVT), your healthcare professional will likely give you an anticoagulant drug, like warfarin or heparin or one of the new class of blood thinners, which thin your blood and make it harder for clots to form. If your clot is more severe, you may be directed to take thrombolytic drugs, known as clot busters, or surgery may be necessary.
It can take weeks or months for a clot to disappear, depending on the size, location, and severity of the clot. Treatment with anticoagulant drugs is usually recommended for three months, though it may be longer if you're at high risk for developing future clots.
After treatment with anticoagulant medications, which don't break up clots on their own but do prevent them from getting larger, the body will likely start to dissolve the clot itself over a period of weeks and months.
In some cases, yes, blood clots can be managed at home. Your healthcare professional may recommend that you wear compression stockings, which can help increase blood flow to the heart and reduce swelling. But if you have any symptoms of a new blood clot, be sure to seek immediate medical treatment. Don't attempt to treat it yourself at home.
Mekaj YH, Mekaj AY, Duci SB, Miftari EI. New oral anticoagulants: their advantages and disadvantages compared with vitamin K antagonists in the prevention and treatment of patients with thromboembolic events. Ther Clin Risk Manag. 2015;11:967-77. doi:10.2147/TCRM.S84210
Texas Heart Institute. Antiplatelet Therapy.
Johns Hopkins Medicine. Inferior Vena Cava (IVC) Filter Placement.
The North American Thrombosis Forum. Management of DVT by Compression Stockings.
Waldron B, Moll S. A patient’s guide to recovery after deep vein thrombosis or pulmonary embolism. Circulation. 2014 Apr 29;129(17):e477-9. doi:10.1161/CIRCULATIONAHA.113.006285
Harvard University. Harvard Health Blog. Leg clots (aka deep vein thrombosis): an immediate and long-term health hazard.
American College of Radiology and Radiology Society of North America. Inferior Vena Cava Filter Placement and Removal.
Franchini M, Mannucci PM.New Anticoagulants in Internal Medicine.Eur J Intern Med.
Kearon C, Akl E, Omelas J, et al. Antithrombotic Therapy for VTE Disease. CHEST Guideline and Expert Panel Report. Chest.
National Blood Clot Alliance. Blood Clot Treatment.
By Richard N. Fogoros, MD Richard N. Fogoros, MD, is a retired professor of medicine and board-certified in internal medicine, clinical cardiology, and clinical electrophysiology.
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