Anticoagulants for Pulmonary Embolism
Direct thrombin inhibitors (used in the hospital)
How It Works
Anticoagulants work by increasing the time it takes a blood clot to form. This also prevents a clot from getting bigger.
Why It Is Used
In people who have had pulmonary embolism, anticoagulants are used to prevent more blood clots from forming and causing another episode of pulmonary embolism. They are used in the hospital as first treatment of a pulmonary embolism. And they also may be used at home. Treatment with anticoagulants may continue throughout your life if your risk of having another pulmonary embolism remains high.
Heparin is given as an injection. It immediately affects the clotting system in your body.
Warfarin is taken as a pill. Warfarin is usually started while a person is still being treated with heparin because it takes several days for warfarin to build up to a level that's effective. When warfarin is at the right level in your blood, you stop taking heparin shots and keep taking warfarin pills.
Typically, warfarin is given for at least 3 months after pulmonary embolism to reduce the risk of having another blood clot. If you have a high risk of another pulmonary embolism, you may take warfarin for the rest of your life.
How Well It Works
Anticoagulants are effective in preventing pulmonary embolism and deep vein thrombosis.
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
Call your doctor right away if you have unusual bleeding:
If you are injured, apply pressure to stop the bleeding. Realize that it will take longer than you are used to for the bleeding to stop. If you can't get the bleeding to stop, call your doctor.
Allergic reaction: Call
Heparin: Side effects often happen at injection sites. These side effects include:
Warfarin: Other side effects include:
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
When you take anticoagulants, you need to take extra steps to avoid bleeding problems.
Warfarin. If you take warfarin, you need to:
For more information, see:
Heparin. If you take heparin, you need to:
Long-term use of heparin is not typically recommended. It requires one or two injections each day. And long-term use is linked with osteoporosis.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
If you think you might be pregnant: Call your doctor. If you are pregnant, you will take heparin during your pregnancy.
If you plan on getting pregnant: Talk with your doctor. You and your doctor will decide which medicine you will take—warfarin or heparin—while trying to get pregnant.
If you are pregnant: You will take heparin during your pregnancy. Heparin has not been shown to affect the fetus.
For more information, see Pregnancy and the Increased Risk of Developing Blood Clots.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
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