Anticoagulants Agents
Anticoagulant agent, also known as “Blood thinners”, are those medicines which prevent the formation of clot and improve the circulation of blood in vessels. In the case of DVT, they proved promising action to treat and prevent DVT. Anticoagulants include Apixaban, Dabigatran, Edoxaban, Enoxaparin, Heparin, Rivaroxaban, and Warfarin. The drugs of choice for treating DVT is Heparin, Warfarin, and the directly acting oral anticoagulants such as Apixaban and Rivaroxaban.
In the case of heparin, the injectables are administered 5 to 7 days at the start of therapy. The oral anticoagulants are used for long term therapy and if the condition becomes worst, then warfarin should be administered accordingly within one to two days after heparin administration. Other blood thinners such as oral Edoxaban or Dabigatran etexilate can also be started after 5-7 days of heparin injection, which inhibit clotting factor Xa and prevent clot formation.
The reason for this combined and diverse therapeutic approach is to maintain an optimal therapeutic level of the anticoagulants as certain agents like the Warfarin takes about 5 days to reach effective concentration. So, we utilize the other drugs for 5-7 days to overlap it with rapidly acting heparin.
On the other hand, the Oral Xa Inhibitors and Dabigatran attain a therapeutic effect within 2 to 3 hours of intake and there is no need to back up these drugs with injectable heparin. The selection of anticoagulants and the treatment regime depends on the condition’s severity and comorbidities. So, in that case, other alternative options regarding the treatment regime should be considered to avoid any emergency condition.
It is to be noted that inadequate therapy with Anticoagulation can result in, or increase the risk of recurrence DVT in a short period.