Doctors generally use medications that reduce your blood's tendency to clot to help prevent complications of antiphospholipid syndrome.
Standard initial treatment
If you have thrombosis, standard initial treatment involves a combination of blood-thinning (anticoagulant) 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, Jantoven).
- Warfarin. After several days of combined heparin and warfarin, your doctor might discontinue the heparin and continue the warfarin, possibly for the rest of your life.
- Aspirin. In some cases, your doctor might recommend adding low-dose aspirin to your treatment plan.
When you're taking anticoagulant medication, you have an increased risk of bleeding episodes. 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
During pregnancy, treatment to keep your blood from clotting increases your chances of carrying to term. Treatment includes:
- 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 might recommend taking one tablet of aspirin daily in addition to the heparin, to increase your chances of a successful pregnancy.
Possible future treatments
Several new treatments are being considered for antiphospholipid syndrome, including:
- 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. None is recommended for use during pregnancy or breast-feeding.
- Rituximab (Rituxan). This drug has been used successfully to treat conditions affecting the immune system. But there isn't yet enough evidence of benefit to recommend rituximab as a treatment for antiphospholipid syndrome.