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Treatments and drugs
By Mayo Clinic staffDoctors generally use medications that reduce your blood's tendency to clot to treat antiphospholipid syndrome.
Standard initial treatment
If you have thrombosis, standard initial treatment initially involves a combination of anticoagulant (blood-thinning) medications.
- Heparin. Typically, you'll first be given a shot or infusion of the blood thinner heparin, combined with another blood thinner in pill form, likely warfarin (Coumadin).
- Warfarin. After several days of combined heparin and warfarin, your doctor will discontinue the heparin and continue the warfarin, possibly for the rest of your life.
- Aspirin. In some cases, your doctor may recommend adding low-dose aspirin to your treatment plan.
Treatment during pregnancy
Anticoagulation therapy is particularly complex during pregnancy. The therapy is expensive, requires regular injections and carries some significant risks of side effects.
- Heparin. Some forms of heparin — enoxaparin (Lovenox) and dalteparin (Fragmin) — are known as low molecular weight heparin, which you can inject yourself under your skin (subcutaneously). Heparin is considered safe to take during pregnancy.
- Aspirin. Along with heparin, your doctor may recommend taking one tablet of aspirin daily throughout your pregnancy to increase your chances of a successful pregnancy.
Rarely, warfarin can cause birth defects, so it isn't usually recommended during pregnancy. Rarely, a doctor may prescribe warfarin during pregnancy, but only if the benefits of using it outweigh the risks.
Though anticoagulation therapy during pregnancy may be complicated, the good news is that it usually prevents antiphospholipid syndrome-related miscarriages.
If you're taking anticoagulant medication, your doctor will monitor your dosage with blood tests to be sure your blood is capable of clotting enough to stop your bleeding if you bruise or cut yourself.
- Donadini MP, et al. Antiphospholipid syndrome: A challenging hypercoagulable state with systemic manifestations. Hematology/Oncology Clinics of North America. 2010;24:669.
- Erkan D, et al. Antiphospholipid syndrome. In: Firestein GS, et al. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-6/0/1807/0.html. Accessed Feb. 22, 2011.
- Bermas BL, et al. Pathogenesis of the antiphospholipid syndrome. http://www.uptodate.com/home/index.html. Accessed Feb. 22, 2011.
- Bermas BL, et al. Treatment of the antiphospholipid syndrome. http://www.uptodate.com/home/index.html. Accessed Feb. 22, 2011.
- Blood thinner pills: Your guide to using them safely. U.S. Department of Health and Human Services: Agency for Healthcare Research and Quality. http://www.ahrq.gov/consumer/btpills.htm. Accessed Feb. 22, 2011.
- Long BR, et al. The role of antiphospholipid syndrome in cardiovascular disease. Hematology/Oncology Clinics of North America. 2008;22:79.
- Bermas BL, et al. Clinical manifestations of the antiphospholipid syndrome. http://www.uptodate.com/home/index.html. Accessed Feb. 22, 2011.
- Antiphospholipid syndrome information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/antiphosphlipid/antiphospholipid.htm. Accessed Feb. 22, 2011.
- Vitamin K. The National Academies Press. http://books.nap.edu/openbook.php?record_id=10026&page=162. Accessed Feb. 28, 2011.
- Pruthi RK (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 27, 2011.
- Giannakopoulos B, et al. How we diagnose the antiphospholipid syndrome. Blood. 2009;113:985.
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