Treatments and drugs

By Mayo Clinic Staff

Doctors generally use medications that reduce your blood's tendency to clot to treat antiphospholipid syndrome. This doesn't cure the disease but does help to prevent its most serious complications.

Standard initial treatment

If you have thrombosis, standard initial treatment involves a combination of anticoagulant (blood-thinning) medications.

  • Heparin. Typically, you'll first be given an injection of the blood thinner heparin, combined with another blood thinner in pill form, likely warfarin (Coumadin).
  • Warfarin. After several days of combined heparin and warfarin, your doctor may discontinue the heparin and continue the warfarin, possibly for the rest of your life.
  • Aspirin. In some cases, your doctor may recommend adding low-dose aspirin to your treatment plan.

When you're taking anticoagulant medication, your doctor will monitor your dosage with blood tests to be sure your blood is capable of clotting enough to stop the bleeding of a cut or the bleeding under the skin from a bruise.

Treatment during pregnancy

Anticoagulation therapy is more complex during pregnancy. The therapy is expensive, requires regular injections and carries some significant risks of side effects.

  • Heparin. Some forms of heparin — enoxaparin (Lovenox) and dalteparin (Fragmin) — are known as low-molecular-weight heparin, which you can inject yourself under your skin (subcutaneously). Heparin is considered safe to take during pregnancy.
  • Aspirin. If you're pregnant, your doctor may recommend taking one tablet of aspirin daily in addition to the heparin, to increase your chances of a successful pregnancy.

Rarely, warfarin can cause birth defects, so it isn't recommended for use during pregnancy. In rare cases, a doctor may prescribe warfarin during pregnancy if the benefits of using it outweigh the risks.

Although anticoagulation therapy during pregnancy may be complicated, the good news is that it usually prevents antiphospholipid syndrome-related miscarriage.

Throughout your pregnancy, your doctor will monitor your dosage of blood-thinning medication with blood tests. These tests ensure that your blood is capable of clotting enough to stop the bleeding of a cut or the bleeding under the skin from a bruise.

Experimental treatments

Several new treatments are being considered for antiphospholipid syndrome, including:

  • Statins. These medications are normally used to lower cholesterol, but they may lessen the risk of blood clots and cardiovascular disease in antiphospholipid syndrome.
  • New blood thinners (anticoagulants). A number of oral blood thinners — dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixaban (Eliquis) — have recently been approved to treat other conditions. It's not clear yet if these drugs are appropriate for treating antiphospholipid syndrome. However, none of these medications is recommended for use during pregnancy or breast-feeding.
  • Rituximab (Rituxan). This drug has been used successfully to treat conditions affecting the function of the immune system. But there isn't enough evidence of benefit to recommend rituximab as a treatment for antiphospholipid syndrome.
April 15, 2014