How can DVT and PE be treated?

DVT and PE treatments

If you – or someone you know – has a deep vein thrombosis (DVT) or pulmonary embolism (PE), you will probably have been prescribed treatment by your doctor. If you have any questions about your treatment you should ask your doctor for more information.

These conditions are potentially serious, but there are several different treatments available. Your doctor will generally discuss these with you and will try to find the one that is most suitable for you. DVT and PE medications can have unwanted effects. If this happens, you should speak to your doctor or healthcare team straightaway, as they can give you the right advice about what to do.

Watch a short animation about the medications that you might be given for DVT or PE

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How do DVT / PE medications work

Medications for DVT aim to do two things:1–3

1.Help to stop the blood clot from growing
2.Help to prevent it from breaking away and developing into a PE.

Both of these also help to prevent further clots from developing. 1–3

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Types of medication

There are two main types of medication for these conditions:

1Anticoagulants (or blood thinners)

Anticoagulants don’t actually thin the blood, as the expression ‘blood thinner’ may indicate. However, they do make it harder for blood clots to form.1-3

There are several different types of anticoagulants: some are taken as tablets (oral), others as injections. They all help to stop a blood clot from getting bigger and help to prevent new clots from developing by interrupting the body’s natural mechanism for clotting blood.1,2

Oral anticoagulants

For some of the tablet anticoagulants, you may need to have regular blood tests and check-ups to see if you have the right level of anticoagulant in your blood.1

Some people, particularly those with a PE, may need to take more than one kind of medication at first.2 Your doctor or healthcare team will tell you if you need this and explain why.

Injected anticoagulants

If an anticoagulant is injected, this may be either as an injection under the skin (also known as subcutaneous injection) or into a vein, usually in your arm (also known as an intravenous or IV injection).1

You should bear in mind that all anticoagulants can cause you to bruise or bleed more easily than usual. Some bleeds can be very serious, so you should consult a doctor without delay if you notice any bleeding that does not stop.2

If you have a more serious type of DVT or PE, or if anticoagulants don’t work or are not suitable for you, you may be given a clot buster to try and break up the blood clot.

These medications (also known as thrombolytics) are given intravenously, usually directly into the clot. They are generally given in hospital or under medical supervision in emergency situations when the patient is not stable.1,2

In some cases – usually when someone has a large PE – you may need an operation to remove the clot.2

During treatment

Medications for DVT and PE can have unwanted effects – also known as side effects. For example, the most likely effect from taking an anticoagulant is that you may bleed more easily, especially if you hurt yourself or fall.4

Bleeding can occur in different parts of your body. You may notice more bleeding than usual in your:4

  • Nose
  • Gums
  • Urine - as bright pink, red or dark brown blood
  • Stools - as bright red, dark brown, or tarry black stools
  • Vomit - as bright red or dark brown vomit, looking like coffee grounds
  • Cough
  • Heavier menstrual periods, if you are a woman

You should tell your doctor about any bleeding that you may have. Seek immediate medical help if you suffer major trauma or a blow to the head, or if you are unable to stop bleeding.5
If you, or those around you, notice any dark brown blood in your urine or vomit, or a black, tarry stool – you should seek medical help immediately. Your healthcare team will know what to do.
Some patients experience nausea, diarrhoea and / or heartburn. If these symptoms persist, contact your doctor.5

Watch a short animation on what to consider if you have anticoagulant-related bleeding

Following your doctor’s advice is important

For all the oral medications, you should be sure to follow your doctor’s advice and take the medication as and when you have been directed. If you are unsure, you should ask your doctor or healthcare team to explain.1 This is because these medications can have serious effects if you take too much or too little.1

Some people may also be advised to make changes to their diet. This will depend on the type of medication you are taking.3

How long you will need to take an oral anticoagulant for depends on various factors, but it is likely that you will need to be on them for three months at first.1 Your doctor will discuss this with you and arrange to see you again to decide if you need to take them for longer.

What to do if you are worried

If you are concerned about taking medication for DVT or PE, or if you are worried about possible bleeding, you might find it helpful to talk to your doctor or healthcare team. They will be able to discuss your concerns and offer reassurance and support as well as practical help and advice.

If in doubt, ask your doctor

If you have any questions about your treatment or experience any side effects while you are taking medication for DVT or PE, you should discuss this with your doctor or healthcare team.

If you would like more information, your healthcare team will be able to provide this.

Questions you might want to ask your healthcare team

  1. How long will I need to take my treatment for?
  2. What should I do if I cut myself?
  3. I am worried because I have had two nosebleeds in the last few days. What should I do?
  4. I am frightened of having a bleed that will not stop – should I stop taking my DVT / PE treatment?
  5. What other treatments are available for DVT / PE?
References

1. Mayo Clinic. Deep vein thrombosis (DVT). Diagnosis and treatment. 2020. Available at
https://www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/diagnosis-treatment/drc-20352563?p=1. Last accessed September 2021.
2. Mayo Clinic. Pulmonary embolism. Diagnosis and treatment. 2020. Available at
https://www.mayoclinic.org/diseases-conditions/pulmonary-embolism/diagnosis-treatment/drc-20354653?p=1. Last accessed September 2021.
3. Cleveland Clinic. Deep vein thrombosis (DVT): Management and Treatment. July 2019. Available at
https://my.clevelandclinic.org/health/diseases/16911-deep-vein-thrombosis-dvt#management-and-treatment. Last accessed September 2021.
4. NHS. Anticoagulant medications. July 2021. Available at
https://www.nhs.uk/conditions/anticoagulants/. Last accessed September 2021.
5. Thrombosis UK. Patient Information and Support. Direct Oral Anticoagulant Therapy. Available at
https://thrombosisuk.org/admin/resources/downloads/thrombosis-uk-patient-information-sheet-direct-oral-anticoagulation-therapy-download.pdf Last accessed September 2021.

PP-ELI-HKG-0861 MAY 2022