Superficial vein thrombosis, where the thrombosis is >5cm in length and >3cm of a junction with a deep vein (for clots closer to a deep vein, full VTE treatment should be given)
Dose = 10 mg daily for 6 weeks
See APC recommendation for further information (link below)
As an option for Heparin Induced Thrombocytopenia (HIT) in stable patients at low risk of bleeding. Usually started after initial management with parenteral therapy, e.g. argatroban.
Thrombosis team approval only
Usual dose for HIT without thrombosis = 15 mg twice daily until platelets >150x109/L and the patient is stable, followed by 20 mg daily (adjusted according to renal function).
Usual dose for HIT complicated by thrombosis = 15 mg twice daily for 3 weeks followed by 20 mg daily (adjusted according to renal function). Usual total course of 3 months.
See APC recommendation (link below) for further information
Specialist or hospital prescribing only.
The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist or hospital.
In very exceptional circumstances a specialist may discuss individual patient need for a RED drug to be prescribed by a GP and the GP should consider informing the Medicines Management team before a decision is made to prescribe for individual patients.
Treatment can be initiated in primary care after a recommendation from an appropriate specialist
Specialist initiation followed by maintenance prescribing in primary care
Specialist initiation with ongoing monitoring required. After dose stabilisation GPs can be requested to take over prescribing responsibilities using the approved APC shared care documentation