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Deep vein thrombosis of the lower extremities is a dangerous disease that is accompanied by the formation of blood clots in the veins of the lower leg, thighs and pelvis. Without adequate treatment, this condition leads to severe complications and even death. The task of conservative therapy for thrombosis is to dissolve already appeared blood clots and prevent the formation of new ones.
Together with our experts, we will analyze the principle of action of drugs in deep vein thrombosis of the lower extremities. Let’s talk about the difference between anticoagulants and antiplatelet agents. And we will name the best drugs for deep vein thrombosis of the lower extremities.
Rating of the top 10 drugs for deep vein thrombosis of the lower extremities according to the KP
Our rating combines effective drugs for deep vein thrombosis of the lower extremities. These are anticoagulants of direct and indirect action, antiaggregants and phlebotonics. The list includes injectables and oral medications. Some of these medicines are used only in a hospital under medical supervision, others are suitable for outpatient treatment.
We emphasize that any drugs for deep vein thrombosis of the lower extremities are taken only as directed by a doctor. Self-medication can cause irreparable harm to health.
Direct acting anticoagulants
Drugs from this pharmacological group help neutralize proteins that contribute to the formation of blood clots1. Direct-acting anticoagulants prevent the formation and growth of a blood clot, accelerate the dissolution of a blood clot1,2. The drugs have a quick effect, therefore they are used for emergency care for patients with thrombosis and pulmonary embolism (PE), as well as for the treatment of patients with myocardial infarction and the prevention of thromboembolic complications during hemodialysis, orthopedic and surgical intervention1.
1. Heparin
One of the most popular drugs for deep vein thrombosis of the lower extremities. Available in the form of an injection solution for subcutaneous and intravenous administration. Heparin inhibits the synthesis of coagulation factors – proteins that stimulate the formation of a blood clot. Along with this, it activates the body’s natural anti-coagulant system, strengthens the vascular wall and lowers blood cholesterol levels.
It is indicated for thrombosis and for the prevention of thromboembolism. The drug is dispensed from pharmacies only by prescription.
2. Fraxiparin
Release form – injection solution for subcutaneous administration. Available in a syringe with a small needle. The amount of solution in the syringe is designed for a single use.
After introduction into the body, fraxiparine binds to the blood plasma protein antithrombin III, prevents the appearance of new blood clots and accelerates the dissolution of those that have already formed.3.
It is indicated for the prevention of thromboembolism and the treatment of acute deep vein thrombosis. The tool is a prescription.
3. Clexane
Injection solution for subcutaneous and intravenous administration. Available in glass syringes with and without a needle guard. The active substance enoxaparin sodium reduces blood viscosity and prevents blood clots.
Clexane is prescribed for angina pectoris, coronary circulation disorders, for the prevention of thromboembolism, deep vein thrombosis and pulmonary embolism. You can buy the solution only with a doctor’s prescription.
4. Eliquis
Release form – tablets 2,5 and 5 mg. The active substance apixaban is a selective inhibitor of blood clotting factor Xa.3. Eliquis slows down the synthesis of the thrombin protein and prevents the formation of blood clots.
The drug is prescribed for the treatment and prevention of pulmonary embolism and deep vein thrombosis, the prevention of venous and systemic thromboembolism in patients with atrial fibrillation and after joint replacement. It is released from pharmacies by prescription.
5. Xarelto
The active ingredient rivaroxaban is a direct inhibitor of clotting factor Xa.3. The drug quickly “dilutes” the blood – the maximum activity is observed within 2-4 hours after administration3.
Available in the form of tablets with a dosage of 2,5, 10, 15 and 20 mg. It is used for the treatment of deep vein thrombosis of the lower extremities and PE, the prevention of stroke, heart attack and systemic thromboembolism in patients with cardiovascular diseases. This is a prescription drug.
Indirect anticoagulants
Drugs from this group are called vitamin K antagonists. They disrupt the synthesis of prothrombin and other proteins that are responsible for blood clotting. This process takes place in the liver.
Anticoagulants of indirect action are available in the form of tablets and are intended for long-term use. They are used for the prevention and treatment of thrombosis and thromboembolism of various etiologies.
6. Warfarin
Produced in the form of tablets of 2,5 mg, contains the active substance warfarin sodium – a derivative of coumarin. Suppresses the synthesis of K-dependent proteins and proteins that are formed in the liver and serve as a “building material” for blood clots3.
The action begins 36-72 hours after the start of administration with a maximum effect after 5-7 days. Warfarin is prescribed for the prevention and treatment of acute thrombosis, PE, postoperative thrombosis and recurrent myocardial infarction. Released by prescription.
7. Phenylin
The active substance phenindione is a vitamin K antagonist. It slows down the synthesis of K-dependent blood coagulation factors and prothrombin, proteins that are involved in the formation of blood clots. Begins to act 36-72 hours after the start of administration.
Available in tablets with a dosage of 30 mg, it is used to prevent thromboembolism and deep vein thrombosis. It is released from pharmacies only by prescription.
Antiplatelet agents
Drugs from this group slow down the production of thromboxane, an lipid that enhances the “gluing” of platelets and causes the formation of blood clots. Antiplatelet agents are prescribed prophylactically to prevent recurrence of thrombosis.
8. Aspirin Cardio
The active substance acetylsalicylic acid blocks the cyclooxygenase enzyme, thereby inhibiting the synthesis of thromboxane A2 and slowing down platelet aggregation. In addition, Aspirin Cardio has an analgesic and anti-inflammatory effect.
Available in tablets with a dosage of 100 and 300 mg, it is used to prevent thrombosis and pulmonary embolism, including when immobilizing a patient after surgery.
Phlebotonics
Phlebotonics improve venous and lymphatic outflow, reduce capillary permeability, strengthen the vascular wall and prevent the formation of edema.2. For the prevention of thrombosis, drugs are taken in a course of at least 4 weeks.2.
9. Detralex
Contains a complex of flavonoids, has anti-protective and venotonic properties. Reduces the extensibility of veins and prevents venous stasis in patients with chronic diseases of the veins of the lower extremities. Available in the form of a suspension and tablets with a dosage of 500 and 1000 mg.
Detralex is prescribed for the prevention of thrombosis and the treatment of chronic venous diseases. The drug effectively eliminates the symptoms of venous-lymphatic insufficiency: pain, cramps and heaviness in the legs.
10. Phlebodia-600
The active substance diosmin has venotonic and anti-protective properties.3. The drug improves microcirculation and reduces capillary permeability, reduces venous pressure and has a decongestant effect. Release form – tablets 600 mg.
Phlebodia-600 is used to prevent the development of thrombosis and reduce the risk of relapse. The drug is taken in a course of at least 2 months.
How to choose drugs for deep vein thrombosis of the lower extremities
The tactics of treatment and effective drugs for deep vein thrombosis of the lower extremities are selected by a general practitioner, vascular surgeon or phlebologist.
- In acute thrombosis, direct-acting anticoagulants are indicated, which are administered intravenously or subcutaneously.
- Then the patient is prescribed vitamin K antagonists, which have a prolonged action.
- Antiplatelet agents and phlebotonics are usually used for prophylactic purposes.
Popular questions and answers
Our experts answer popular questions from readers: phlebologist surgeon Ivan Pakhomov and phlebologist surgeon, ultrasound doctor Alexei Agaltsov. The opinion of experts will be useful to anyone who wants to learn about topical methods of treatment and prevention of deep vein thrombosis of the lower extremities.
Another common complication of thrombosis is post-thrombophlebitic disease, in which venous outflow from the lower extremities is disturbed. As a result, persistent edema appears on the legs, skin pigmentation is disturbed and trophic ulcers form.
Sources:
- Deep vein thrombosis. Thrombophlebitis of superficial veins. FGBOU V RyazGMU. Department of Cardiovascular, Operative Surgery and Topographic Anatomy. https://www.rzgmu.ru/images/upload/lect/angio/%D0%A2%D1%80%D0%BE%D0%
BC%D0%B1%D0%BE%D0%B7%D1%8B%20%D0%B3%D0%BB%D1%83%D0%B1
%D0%BE%D0%BA%D0%B8%D1%85%20%D0%B2%D0%B5%D0%BD.pdf
- venous thrombosis. Federal State Budgetary Educational Institution of Higher Education Ural State Medical University of the Ministry of Health of the Russian Federation Department of Surgical Diseases and Cardiovascular Surgery. http://elib.usma.ru/bitstream/usma/1558/1/UMK_2019_020.pdf
- Vidal. Directory of medicines in the edition of 2021.