What Are the Best Medication and Treatment Options for Deep Vein Thrombosis?

Deep vein thrombosis (DVT) is a blood clot that forms in a vein. Every year, up to about 900,000 Americans have a DVT. This usually happens in the thigh or lower leg. But it can happen in other deep veins in the body — like the arm, chest, abdomen, or pelvis. A deep vein is simply a vein that is deeper inside the body rather than near the skin surface. 

DVTs are treatable, no matter where they are in the body. But treatment isn’t the same for all clots. And you may have some options for your treatment. We’ll explain the different treatments so you can understand the best treatment for you. 

DVT treatment options

If you have a DVT, the treatment that is best for you depends on the location of the DVT, your medical history, and your personal preferences.

We’ll explain treatment for DVT in the legs specifically, since this is most common. If you have a DVT in the arm or in another part of the body, your treatment may be slightly different. But a lot of these treatments are still used.

Medications

Prescription anticoagulant medications — often called “blood thinners” — are the main treatment for a DVT. 

There are several different types of blood thinners, and they work in slightly different ways. But they all prevent the DVT from getting bigger and prevent new clots from forming. This gives the body time to dissolve the DVT over time. Treatment usually lasts at least 3 months, but it may be longer for some people. 

Examples of blood thinners include:

• Warfarin (Coumadin): Warfarin is an older but inexpensive and effective blood thinner. It’s still commonly used. People who take warfarin need regular blood tests to make sure they’re taking the right dose. Certain foods and other medications interact with warfarin, which can also affect the dose.

• Direct oral anticoagulants (DOACs): DOACs are a group of newer blood thinners. They include medications like rivaroxaban (Xarelto) and apixaban (Eliquis). Sometimes they can be more expensive, depending on the insurance plan. One advantage is they don’t require blood testing to monitor the dose. This also means they don’t need frequent dose changes during treatment. 

• Low molecular weight heparin (LMWH): This includes enoxaparin (Lovenox), which is given as an injection under the skin. Enoxaparin is safe for people who are pregnant. You can also give yourself injections at home, so you don’t need to go to the clinic or hospital.

You and your provider will consider many factors when deciding the best blood thinner for you — like cost, your other medical conditions, and your personal preference. 

For example, some of the options are better for people who have kidney disease. Treatment also depends on your risk for bleeding, which is a serious side effect of all anticoagulants. Some of the options are safer for people who have a higher risk for bleeding than others. And some people may not be able to take a blood thinner at all if their risk is particularly high.

Procedures

Blood thinners are often the preferred treatment for DVTs, but there are also other treatments.

Thrombolytic therapy

This type of treatment uses a medication called “tissue plasminogen activator” (tPA) to break down the blood clot. This is different from a blood thinner because it can actually break down the clot. People can get tPA through an IV or a catheter a provider places inside the vein at the location of the DVT.

Thrombolytic therapy isn’t a routine treatment for a DVT because it doesn’t decrease the risk of death from a DVT or of another DVT. And it has a higher risk of bleeding. The treatment also requires you to be in a hospital, and it’s more expensive. So, for most people, there’s likely to be more risk than benefit. 

Healthcare providers may use thrombolytic therapy for people with complicated or severe DVTs. This includes clots that are blocking blood flow to the leg or those that cause severe symptoms despite treatment with blood thinners.

Thrombectomy

Thrombectomy is a procedure that physically removes the blood clot from the vein. This is done with surgery or by inserting a catheter into the vein at the location of the blood clot. 

Like thrombolytic therapy, thrombectomy gets rid of the clot right away. And providers may use these treatments together. But, like thrombolytic therapy, thrombectomy is only for severe DVTs.

IVC filter

An IVC filter is a small medical device that a provider inserts into one of the body’s larger veins near the heart — the inferior vena cava (IVC). This is done to trap any blood clots traveling toward the heart and lungs, where clots can be more dangerous.

IVC filters come with risks, and most people do not need one. Providers usually recommend them for people who can’t take a blood thinner. 

Do all DVTs need treatment?

No. In some cases, people and their providers will decide not to treat a DVT with medication or a procedure. For example, this may be a better option for someone who has a small blood clot and a very high risk of bleeding.

If the DVT is in the lower part of the leg (below the knee), you may be able to monitor it without treatment. This is because DVTs in this location can sometimes resolve on their own. And compared to a DVT above the knee, there’s a lower risk that a piece of the clot will break off and travel to the lungs.

Can you cure deep vein thrombosis?

Yes, a DVT can be cured. Most DVTs will resolve without any long-term problems. But some people may have ongoing symptoms like leg pain. And about 15% of people will develop post-thrombotic syndrome with chronic pain and swelling.

It’s important to know that even after they’re cured, DVTs can happen again. This means that after you’ve had one DVT, you’re at risk for developing another blood clot in the future. 

The risk isn’t the same for everyone. It depends on what caused your DVT in the first place. For example, if you developed a blood clot after surgery or during pregnancy, your risk for another clot might be lower once you recover. But if you have a long-term medical condition that increases your risk — like heart disease or a blood-clotting disorder — your ongoing risk may be higher. 

Your healthcare provider can help you understand your risk. Some people at higher risk may need to take blood thinners longer to prevent another blood clot.

How long does it take for a DVT to go away

After you’re diagnosed with a DVT, your body will start to heal by gradually absorbing the blood clot over weeks to months. Blood thinners don’t dissolve the DVT, but they prevent the DVT from getting bigger as the body absorbs it. Any symptoms you have from the DVT will slowly go away as the clot resolves.

How serious are DVTs?

DVT is a serious condition. The biggest concern with a DVT is that a piece of the blood clot will break off and travel to the lungs. This is a pulmonary embolism (PE), which can be life-threatening. DVT and PE cause up to about 100,000 deaths every year in the U.S. 

Another possible complication of DVT is post-thrombotic syndrome (PTS). PTS happens when the blood clot damages the vein and affects blood flow through the vein. For a DVT in the leg, this can lead to chronic leg pain, swelling, skin color changes, and ulcers.

The good news is that treatment helps to prevent these serious complications. So don’t hesitate to see a healthcare provider.

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Written by:

Sarah Pozniak, MD

Sarah Pozniak, MD, has 9 years of experience since graduating medical school (6 since completing residency). She is a board-certified general internal medicine physician and has practiced as a primary care physician in both Utah and Washington, D.C. Currently, she cares for patients with chronic illnesses such as diabetes and high blood pressure using telemedicine as part of a virtual care program.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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