What factors should be considered when using LMWH to treat venous thromboembolism in patients with high body weight?

· Medicines Information, NHS Greater Glasgow and Clyde

Treatment of venous thromboembolism (VTE) in patients with high body weight constitutes a challenge in clinical practice. Adjustments in the dose calculation may be necessary in certain circumstances and may justify the off-label use of low molecular weight heparins (LMWHs). This decision should however be made following careful consideration of both the clinical and practical risks introduced by changing standard practice in the prescribing of LMWHs. Monitoring anti-factor Xa levels is key to the safe use of these medicines in patients who receive an altered dosage regimen.

This Q&A offers guidance on what factors should be considered when calculating a LMWH treatment dose following a VTE in non-pregnant adult patients with a high body weight, defined as more than 120 kg.

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