Extended full-dose therapeutic anticoagulation for VTE

Some patients require extended full-dose therapeutic anticoagulation for VTE (eg patients who have had 2 or more unprovoked VTEs, those with antiphospholipid syndromeTran, 2019); referral for specialist management is often required. Generally, a specialist would continue the full therapeutic dose of the anticoagulant used initially.

Periodically reassess the patient’s risk of a thromboembolic event versus risk of bleeding (eg annually or when their clinical condition changes), to ensure that the drug and dose are still appropriate.