A Clearinghouse for Information about Blood Clots (DVT/)PE) and Clotting Disorders (thrombophilia) provided as a public service by the University of North Carolina Blood Research Center

Category: Anticoagulants

  • Pradaxa: Interruption for Colonoscopies, Dental Procedures, Surgery, etc.

    When to stop the drug – General comments The patient on Pradaxa® (Dabigatran) may need interruption of therapy for dental work, a medical procedure such as colonoscopy, or minor or major surgical procedure. As to when exactly to take the last dose of Pradaxa® before the procedure depends on (a) what type of procedure is…

  • DVT and PE: How Long to Treat With Anticoagulants?

    Explanation for Patients The complex topic of “Length of Anticoagulant Treatment” for patients with VTE  is being addressed in a blog entry written for patients, found on the Clot Connect patient education blog (here). For the Health Care Professional Well respected treatment guidelines exist [ref 1,2].

  • Warfarin-Induced Skin Necrosis

    How common is it? Warfarin-induced skin necrosis is a rare complication of warfarin (coumadin®, Jantoven®) therapy. It occurs in approximately 1 of 10,000 patients treated with warfarin. What is it? Patients with warfarin-induced skin necrosis develop very painful skin areas, most commonly in the breasts,

  • Purple Toe Syndrome

    Warfarin can, in rare instances, cause violaceous painful discoloration of the toes and the sides of the feet, referred to as the “purple toe syndrome” 1 – see photograph below. Occasionally, the hands can also be involved and a net-like skin rash on abdomen and legs (= livedo reticularis) can occur. This typically happens within the…

  • Low Molecular Weight Heparins – Osteoporosis?

    Occasionally, a patient is treated with long-term low molecular weight heparin (LMWH) (enoxaparin = Lovenox®; Dalteparin = Fragmin®; Tinzaparin = Innohep®) . LMWH may be given because the patient (a) tolerated warfarin poorly (widely fluctuating INRs; significant side-effects, such as marked hair loss or fatigue), (b) had a recurrent thrombotic event which occured with a therapeutic INR, or…

  • Apixaban (Eliquis®) – Another New Oral Anticoagulant

    Good news.  Another one of the new oral anticoagulants in development,  Apixaban (Eliquis®), has moved forward.  On May 20th, 2011, the European Medicines Agency (EMA) approved Eliquis® for DVT prevention after orthopedic surgery (hip and knee replacement) in the 27 countries of the European Community. In the U.S., however, Eliquis® is still some way away from getting FDA approval

  • HIT (Heparin-Induced Thrombocytopenia)

    A detailed discussion of Heparin-Induced Thrombocytopenia (HIT) written for patients is available on the Clot Connect Patient blog- connect here. We hope that the health care professional will consider this document to be suitable as an information handout to his/her patients with HIT. The discussion also contains 2 resources for use by the health care provider:

  • Dental Work on Warfarin

    A number of dental procedures can be done safely withouthaving to discontinue warfarin. A clinically helpful table is can be found here: Dental procedures and Warfarin (from ref 1).