Deep vein thrombosis (DVT) is a condition that develops when a blood clot becomes stuck in a “deep vein” in your body — commonly in the pelvis, legs, and thighs. This blocks blood flow to your organs or extremities (arms or legs), leading to pain and swelling.1
DVT treatments focus on preventing blood clots from becoming bigger or breaking off and traveling to the lungs. A clot that dislodges from DVT and travels through your circulatory system is known as an embolus. If the blood clot becomes stuck in the lungs, it’s known as a pulmonary embolism (PE). If left untreated, a PE can cause high blood pressure in the lungs, forcing your heart to work harder to pump blood.2
So, how is deep vein thrombosis treated? There are several medications available to help prevent blood clots from forming or becoming bigger. Surgery is also used to place filters in veins to prevent clots from traveling throughout the body.
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Medications to Treat DVT
Medications used to treat DVT focus on “thinning” your blood to prevent blood clots from forming. Known as blood thinners, these medications can also help prevent blood clots you may have from getting any bigger. It’s important to note that blood thinners can’t break down blood clots that have already formed, but there are other therapies available to do so.3
DVT is mainly treated using a group of blood thinners known as anticoagulants. These medications help slow your body’s blood clotting process by blocking the production or function of clotting factors (specialized proteins that help your blood clot).4 There are a few different types of anticoagulants used to treat DVT. Your doctor will discuss your options with you and determine which medication is best for your specific case.
For many years, warfarin (Coumadin®, Jantoven®) was the mainstay treatment for DVT. While it has proven to be a powerful anticoagulant, it has some drawbacks such as higher risk of accidental bleeding that make the drug difficult for some people to take. In people who are prescribed warfarin, their dose must be closely monitored.
Warfarin works by preventing your body from making clotting factors. These proteins are made by the liver in a process that relies on vitamin K. Warfarin blocks the enzyme that uses vitamin K to make these proteins. As a result, there are less of the clotting factors in your blood, which helps prevent blood clots from forming. Warfarin comes as a pill taken once daily at the same time each day, typically in the evening.5
Side Effects of Warfarin
Taking warfarin to prevent DVT comes with side effects. If you notice any of the following symptoms while taking warfarin, talk to your doctor. They may change your dosage or switch you to another anticoagulation therapy if the symptoms are affecting your daily life:6
- Abdominal pain
- Gas or bloating
- Hair loss
- Changes in taste
- Having chills or feeling cold
Monitoring warfarin therapy involves monthly bloodwork to monitor your clotting factor levels. A test known as a PT/INR measures your prothrombin time (PT) and International Normalized Ratio (INR). It measures how quickly your blood clots — clotting too quickly means you’re at risk of another blood clot, and clotting too slowly means you are at risk of bleeding. Your doctor will work with you to find the correct warfarin dosage to balance your bleeding and clotting risks.7
Since warfarin competes with vitamin K, it’s important to watch your diet and limit or avoid eating foods rich in it. These can make your prescription less effective, increasing your risk of blood clots. Vitamin K is found in dark, leafy green vegetables and some beverages, such as:8
- Turnip greens
- Mustard greens
- Collard greens
- Swiss chard
- Brussels sprouts
- Grapefruit juice
- Cranberry juice
- Green or chamomile teas
Direct Oral Anticoagulants (DOACs)
DOACs are a relatively new class of medication commonly used to treat DVT. They’re also used to prevent blood clots in people with atrial fibrillation (AFib). In studies, DOACs have been found to be as safe and as effective as warfarin while requiring less monitoring. Depending on your DVT case, your doctor may prescribe you a DOAC over warfarin.9
DOACs work by blocking the effects of clotting factors, preventing blood from clotting properly. Currently available DOACs that are approved by the U.S. Food and Drug Administration (FDA) target either clotting factor Xa or thrombin. These include:
- Rivaroxaban (Xarelto®) — factor Xa inhibitor
- Apixaban (Eliquis®) — factor Xa inhibitor
- Edoxaban (Savaysa®) — factor Xa inhibitor
- Betrixaban (Bevyxxa®) — factor Xa inhibitor
- Dabigatran (Pradaxa®) — direct thrombin inhibitor
These medications are taken as pills once or twice daily, at the same time daily. This is important in order for them to stay as effective as possible.
Side Effects of DOACs
DOACs are associated with side effects such as:10-13
- Abdominal pain
- Muscle spasms
- Pale skin
- Feeling unusually weak or tired
If you notice any of these symptoms, call your doctor immediately, as they may be signs that your blood is “too thin:”
- Unusual bruising or bleeding
- Coughing up blood
- Frequent nosebleeds
- Bleeding from your gums
- Heavy menstrual bleeding
- Excessive bleeding from a cut or injury that doesn’t seem to stop
- Vomit that looks like coffee grounds or that has blood in it
- Blood in your urine
- Bloody stools
Low-Molecular-Weight (LMW) Heparin
Heparin is a compound made by your liver that has anticoagulation effects. LMW heparin is manufactured and given as an injection under the skin to help treat DVT. You may receive heparin treatments in the hospital, or you may perform self-injections at home. Your doctor will show you how to perform the injections as needed.
Examples of LMW heparin include:1
- Enoxaparin (Lovenox®)
- Dalteparin (Fragmin®)
- Tinzaparin (Innohep®)
Side Effects of LMW Heparin
Common side effects of LMW heparin include hair loss and bruising, redness, pain, or soreness at the injection site. If you begin to experience any of the following symptoms while taking LMW heparin, call your doctor immediately:14
- Signs of excessive bleeding, similar to the symptoms listed as potential side effects of DOACs
- Sudden trouble walking or balancing
- Vision problems
- Dizziness or fainting
- Black or purple skin
- Sudden trouble speaking or understanding speech
- Chest pain or pressure
- Discomfort in your jaw, neck, shoulders, arms, or back
Anticoagulant Treatment Plan for DVT
After a DVT diagnosis, your doctor will start anticoagulation therapy right away. You may be prescribed LMW heparin for 5 to 10 days, then move on to taking an anticoagulant for another three to 12 months. Your doctor may prescribe you a DOAC or warfarin for long-term management. These medications help prevent another blood clot from developing, leading to another DVT.1
After you start anticoagulation therapy, it’s important to get active during your treatment. Once your pain and swelling have gone down, you’ll be encouraged to get up and walk several times a day. This helps keep blood moving throughout your body, helping to prevent another blood clot.
IVC Filters to Treat DVT
If you can’t take blood thinners or they don’t work well at preventing blood clots, your doctor may recommend a minimally invasive procedure to place an inferior vena cava (IVC) filter. This filter is placed in the vena cava, which is the largest vein in your body that carries blood from the lower part of your body back up to your heart. An IVC filter helps stop DVT blood clots from traveling from your body to your lungs, preventing PE. However, it doesn’t prevent new blood clots from forming elsewhere in your body.3,15
During the procedure, which may take only 15 to 20 minutes, your surgeon will numb a site in your neck or groin and make a small incision. They’ll insert a long, thin, flexible tube known as a catheter that’s carrying the collapsed IVC filter. The catheter is gently moved into your IVC, and the filter is pushed out so it expands inside the vein. The catheter is then removed, and the filter stays in place.
Risks that come with an IVC filter placement include:
- Infection at the incision site
- Blood vessel damage
- Excess bleeding
- Movement of the filter into the lungs or heart
- Blood flow blockage through the vena cava, leading to leg swelling
When there is no longer risk of DVT or PE developing, the IVC filter can be removed. This is important because IVC filters left in place can actually cause DVT.
Along with medications or surgery, DVT symptoms can also be managed through lifestyle changes. These can include diet changes, adding more exercise to your daily routine, and wearing compression socks.
The Mayo Clinic recommends a heart-healthy diet that includes plenty of fruits and vegetables, whole grains, and lean proteins. Limiting unhealthy fats and salt can also help you control your cholesterol and blood pressure levels.16
After you’ve recovered from DVT, it’s important to stay active and continue walking throughout the day. Try to avoid sitting for long periods of time, as this can increase your risk of blood clots. Your doctor may send you home with a list of exercises you can try — they’ll advise you on which activities are safe for your condition and which ones to avoid.
You can also wear compression stockings to help reduce swelling in your legs. These socks are designed with tight compression at your ankles to help circulate blood from your feet and legs back toward your heart. Studies show that wearing compression stockings throughout the day can improve pain and swelling by at least 50 percent.3
The Future of DVT Treatments
Every year, doctors and researchers start clinical trials to find new ways of diagnosing and treating DVT. These include new medications and medical devices that help change how doctors treat blood clots. Learn more about DVT clinical trials.