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Treatments and drugs
By Mayo Clinic staffDoctors generally use blood-thinning (anticoagulant) medications, such as warfarin (Coumadin), heparin or low molecular weight heparin to treat people who develop blood clots.
If genetic tests have confirmed that you have a factor V mutation, but you haven't had any blood clots, then your doctor probably won't prescribe blood thinners unless you're in a high-risk situation, such as being hospitalized for surgery or other medical reasons. In that case, you may receive preventive doses of blood thinners during your hospital stay.
If you have a blood clot, standard initial treatment involves a combination of heparin and warfarin. Your doctor will discontinue the heparin after the initial treatment and continue the warfarin. How long you need to take medication will depend on the circumstances of your thrombosis.
- Heparin. This anticoagulant medication works more quickly than warfarin does, but when administered directly through a vein (intravenously) must be monitored closely due to the risk of excess bleeding. Other forms of heparin — enoxaparin (Lovenox) and dalteparin (Fragmin) — are known as low molecular weight heparin, which you can inject yourself. Heparin is considered safe to take during pregnancy. Possible risks of heparin include excess bleeding and allergic reaction.
- Warfarin (Coumadin). This anticoagulant comes in pill form, so it's easier to take than heparin is. Warfarin may cause birth defects, so it isn't usually recommended during pregnancy, especially not during the first trimester. A doctor may prescribe warfarin after the first trimester of pregnancy, but only if the benefits outweigh the risks. Bleeding is the most common side effect of warfarin. This drug interacts with numerous other medications and herbs, so be sure to check with your doctor or pharmacist before taking anything else.
Pregnancy considerations
Most women with factor V Leiden have normal pregnancies. However, the risk of blood clots during pregnancy is higher. Pregnant women with factor V Leiden need close medical supervision throughout their pregnancies.
Ongoing monitoring
If you're taking anticoagulant medication, your doctor will monitor your dose with blood tests to be sure your blood is capable of clotting enough to stop bleeding if you bruise or cut yourself.
- Learning about factor v Leiden thrombophilia. National Human Genome Research Institute. http://www.genome.gov/pfv.cfm?pageID=15015167. Accessed May 21, 2010.
- Ornstein DL, et al. Factor V Leiden. Circulation. 2003;107:e94.
- Deep vein thrombosis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec07/ch081/ch081b.html. Accessed May 21, 2010.
- Pulmonary embolism. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec05/ch050/ch050a.html. Accessed May 21, 2010.
- Laubach J, et al. Hematological changes of pregnancy. In: Hoffman R, et al. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008. http://www.mdconsult.com/book/player/book.do?method=display&type=aboutPage&decorator=header&eid=4-u1.0-B978-0-443-06715-0..X5001-8--TOP&isbn=978-0-443-06715-0&uniq=203749156. Accessed May 21, 2010.
- Konkle BA, et al. Hemostasis, thrombosis, fibrinolysis, and cardiovascular disease. In: Libby P, et al. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/book/player/book.do?method=display&type=aboutPage&decorator=header&eid=4-u1.0-B978-1-4160-4106-1..X5001-8--TOP&isbn=978-1-4160-4106-1&uniq=203749156. Accessed May 21, 2010.
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