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Duration Of Therapy

  • Duration of LMW heparin therapy is dependent upon the primary problem.

  • General recommendations include:

Table 4 - Duration of LMW heparin: 

Problem

LMW heparin duration

Provoked thrombus

DVT

3 months of anticoagulation therapy suggested; consider conversion from LMW heparin to warfarin based on clinical situation.

Extensive DVT or large PE

Administer LMW heparin for 7-14 days prior to consideration for conversion to warfarin*. Minimum of 6 months of anticoagulation therapy with prolongation based on clinical situation. Convert to warfarin based on clinical situation.

Unprovoked thrombus

Administer LMW heparin for 7-14 days prior to consideration for conversion to warfarin*. Minimum of 6 months of anticoagulation therapy with prolongation based on clinical situation. Convert to warfarin based on clinical situation.

*Warfarin:
-Is not typically used in infants.
-Is generally added on day 1 for a DVT and day 5 for an extensive DVT or
large PE.

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.