Enoxaparin | 40 mg subcutaneously | Once daily | Most medical inpatients and critical care patients | — |
| | | Surgical patients (moderate risk for VTE) | |
| | | Abdominal/pelvic cancer surgery | Consider continuing for 4 weeks total duration after abdominopelvic cancer surgery. |
| | Twice daily | Bariatric surgery | Higher doses may be required. |
| 30 mg subcutaneously | Twice daily | Orthopedic surgery2 | Give for at least 10 days. For THR, TKR, or HFS, consider continuing up to 1 month after surgery in high-risk patients. |
| | | Major trauma | Not applicable to patients with isolated lower extremity trauma. |
| | | Acute spinal cord injury | — |
Dalteparin | 2500 units subcutaneously | Once daily | Most medical inpatients | — |
| | | Abdominal surgery (moderate risk for VTE) | Give for 5–10 days. |
| 5000 units subcutaneously | Once daily | Orthopedic surgery2 | First dose = 2500 units. Give for at least 10 days. For THR, TKR, or HFS, consider continuing up to 1 month after surgery in high-risk patients. |
| | | Abdominal surgery (higher risk for VTE) | Give for 5–10 days. Consider continuing for 4 weeks total duration after abdominopelvic cancer surgery. |
| | | Medical inpatients | — |
Fondaparinux | 2.5 mg subcutaneously | Once daily | Orthopedic surgery2 | Give for at least 10 days. For THR, TKR, or HFS, consider continuing up to 1 month after surgery in high-risk patients. |
Rivaroxaban | 10 mg orally | Once daily | Orthopedic surgery: THR, TKR | Give for 12 days following TKR; give for 35 days following THR. |
Apixaban | 2.5 mg orally | Twice daily | Following THR or TKR | Give for 12 days following TKR; give for 35 days following THR. |
Dabigatran | 110 mg orally first day, then 220 mg | Once daily | Following THR | For patients with CrCl > 30 mL/min. Consider continuing up to 1 month after surgery in high-risk patients. |
Betrixaban | Initial single dose of 160 mg, then 80 mg once daily with food Reduce dose for patients with severe renal impairment or taking P-gp inhibitors | Daily | Adult patients hospitalized for an acute medical illness with moderately to severely restricted mobility and other risk factors for VTE | Recommended duration of treatment is 35–42 days. |
Unfractionated heparin | 5000 units subcutaneously | Three times daily | Higher VTE risk with low bleeding risk | Includes gynecologic surgery for malignancy and urologic surgery, medical patients with multiple risk factors for VTE. |
| 5000 units subcutaneously | Twice daily | Hospitalized patients at intermediate risk for VTE | Includes gynecologic surgery (moderate risk). |
| | | Patients with epidural catheters | LMWHs usually avoided due to risk of spinal hematoma. |
| | | Patients with severe kidney disease3 | LMWHs contraindicated. |
Warfarin | (Variable) oral | Once daily | Orthopedic surgery2 | Titrate to goal INR = 2.5. Give for at least 10 days. For high-risk patients undergoing THR, TKR, or HFS, consider continuing up to 1 month after surgery. |
Aspirin | variable | | TKR, THR | For patients at otherwise low VTE risk following major orthopedic surgery. Give for at least 14 days. |