ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Length Of Time On Warfarin, Coumadin, Or Other Anticoagulant After Pulmonary Embolism or Deep Vein Thrombosis (DVT)

Updated on September 27, 2012
Blood Cells From A Scanning Electron Microscope photo
Blood Cells From A Scanning Electron Microscope photo

Treatment After A Pulmonary Embolism Or Deep Vein Thrombosis

After a person experiences a pulmonary embolism, deep vein thrombosis, or other venous clot he or she will be placed on anticoagulation therapy. This therapy may include warfarin, Coumadin, Lovenox or other "blood thinners". The treating doctor has an important decision to make at this time. After a clot, one has to decide how long to continue blood thinners. This decision is very important. One must balance the risk of a subsequent clot with the risks of being on anticoagulants. Here are some of the factors considered by doctors after a clot.

Treatment After The First Blood Clot

After the first blood clot, a number of factors need to be considered. The first question will be what type of clot did the patient have and how significant was the clotting. Anticoagulation treatment will typically last 3 months - 1 year with some patients remaining on anticoagulation for life. If the patient had a DVT, doctors may recommend a shorter treatment time of 3-6 months. Due to the life threatening nature of having clots in the lungs, pulmonary embolism often requires treatment times of 6 months - 1 year. Typically, the more severe the clot, the longer the patient will be on warfarin, Coumadin, Lovenox, or another anticoagulant.

Lifelong Warfarin, Coumadin "lifers"

Some people will need to remain on warfarin, Coumadin, or other anticoagulation for life. Doctors will evaluate a number of factors before making this decision. Anticoagulation has risks. For this reason, doctors must weight the risk of side effects with the risk of death from a blood clot. Here are some things that will be considered:

  • Location of the clot
  • Number of clots that are found
  • DId the clot have a specific, one time cause such as surgery, hormone medication, major injury, long haul flight, or other factor?
  • Does the patient have any clotting conditions? If so, what are they and how significant are the clotting risks?
  • Has the patient had clots before? If so, how many times and for what reasons?

If the clot was caused by a preventable event such as surgery and if the patient has had no other risk factors, it is likely that the doctor will opt for a short treatment. In this case, the patient will avoid the event that caused the clot. For instance, if she was on hormonal contraception, she will stop that form of birth control, do a short term period of anticoagulation, and then continue on without warfarin or another anticoagulant.

If a patient has had previous clots, the doctor will need to assess why he or she has had the clots. Typically, if the patient has had two or more unprovoked clots, the doctor will opt to place the patient on some form of lifelong anticoagulation. Often, these patients refer to themselves as warfarin lifers.

Many doctors will recommend that the patient be tested for clotting conditions if no cause for a clot is determined. Some patients will find it a good idea to request these tests even if there is a cause for the clot. Blood clotting conditions can significantly increase the risk of a clot and therefore death. If a patient knows that she or he has a clotting condition, the doctor and patient can make a joint, informed decision about remaining on warfarin for life. If a clotting condition is found, it is important that the patient understand how serious the condition is. This will help him or her consider lifelong warfarin therapy.

Repeating Anticoagulation When Risks Are High

Another option is for patients to do repeated rounds of anticoagulation as needed. These patients are more likely to use Lovenox than warfarin. Warfarin takes a build up time of about a week whereas Lovenox can be started instantly. These patients are at a higher risk than most people for clots, but, have what may be considered to be an "acceptable risk" that can be addressed at times when the risk is the highest. Times when Lovenox may be considered are:

  • When traveling by car, plane, or train when one has had a clot and has other risk factors
  • Any long haul flight after a previous clot
  • During pregnancy
  • After pregnancy
  • During periods of bed rest
  • During surgery is recommended in a few circumstances
  • During illness when the patient is confined to the bed
  • When there is to be major surgery
  • During recovery from some surgeries such as a hip replacement or hysterectomy

More Information About Lifelong Warfarin Or Anticoagulation Therapy

Talk to your doctor about your risk factors and about the risks of lifelong Coumadin or anticoagulation therapy. Also, if you have a period of increased risk such as travel, surgery, or pregnancy and have a history of pulmonary embolism or deep vein thrombosis, discuss the benefits of short term Lovenox use.

Comments

    0 of 8192 characters used
    Post Comment

    • Ed Halifax profile image

      Tobe Advized 

      2 years ago from United Kingdom

      New to Hubpages, I never expected such a wealth of DVT coverage. As a warfarin lifer, your article attracted my attention. I'm just not quite sure from your article if warfarin has any long-term, adverse effects. However, the content is useful. Thank you.

    working

    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, hubpages.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://hubpages.com/privacy-policy#gdpr

    Show Details
    Necessary
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
    Features
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Marketing
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Statistics
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)