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: Therapy

  • Xarelto® – Good News

    Summary Good news. A major study published in December 2010 in the prestigious New England Journal of Medicine (NEJM) shows that the new oral “blood thinner” Xarelto® (=Rivaroxaban) is (a) as safe and effective as warfarin in patients with acute deep vein thrombosis (DVT), and (b) is quite effective in preventing recurrent blood clots (DVT…

  • Pradaxa – Management of Major Bleeding

    Major and life-threatening bleeding is expected to occur in some patients treated with Pradaxa® (=Dabigatran). The question will then urgently arise how to best treat such catastrophic bleeding.

  • Pradaxa – Management of Major Bleeding

    Major and life-threatening bleeding is expected to occur in some patients treated with Pradaxa® (=Dabigatran). The question will then urgently arise how to best treat such catastrophic bleeding.  As there have been no data published on this topic in the peer-reviewed medical literature, we don’t know how to best manage a patient with major and…

  • Safe Pain Medications on Warfarin

    Certain pain medications increase the risk of bleeding in patients on warfarin (coumadin®, Jantoven).  Two mechanism can be at play: (1) non-steroidal pain medications (NSAIDs = non-steroidal anti-inflammatory drugs) may lead to gastritis which can lead to bleeding into the stomach, made worse by being on “blood thinners”, and (2) pain medications taken on a…

  • Heavy Menstrual Bleeds on Anticoagulants – Treatment Options

    Evaluation Anticoagulants often increase the amount of bleeding during menses and sometimes the number of days that a woman bleeds. However, this does not happen in every woman.  In general, the more vaginal bleeding a woman has, the more cramping she experiences. Since warfarin may increase the vaginal bleeding

  • Heavy Menstrual Bleeds on Blood Thinners – What to Do?

    Evaluation Warfarin (coumadin®, Janotven®) and other blood thinners often increase the amount of bleeding during menses and sometimes the number of days that a woman bleeds.  However, this does not happen in everyone – in some women there is no change in the bleeding pattern.  In general, the more vaginal bleeding a woman has, the…

  • Pradaxa Approval – Great News!

    The new oral anticoagulant Pradaxa® (Dabigatran) was approved by the FDA on October 20th, 2010 [ref 1,2]. As of Feb 3rd, 2012, Pradaxa® is only FDA approved for use in patients with atrial fibrillation. It is not approved yet for patients with DVT and PE.

  • INRs that Fluctuate

    Background and summary Quite a few patients on warfarin have unstable, i.e. significantly fluctuating INRs, making warfarin therapy quite cumbersome.  The cause of such fluctuations is often not clear.  However, the following causes should be considered. Solutions how to deal with fluctuating INRs are also listed below.