"Is there an oral blood thinner I can use instead of shots during pregnancy?"
"I went to the hospital for pain in my leg last week and they found a a blood
clot in my leg. They sent me home on lovenox injections. I have a big fear of
needles, and was wondering if there is an oral blood thinner I can use? "
Low molecular weight heparins , Lovenox (enoxaparin)
, Fragmin (dalteparin) , and Innohep (tinzaparin) are the treatment of choice
for blood clots during pregnancy. Low molecular weight heparins are effective
and safe for treatment or prophylaxis of venous thromboembolism during
pregnancy, because they do not cross the placenta. Unfortunately these drugs
come only in the injectable form .
Warfarin (Coumadin®) is the most common oral anticoagulant
used to prevent blood clots. Warfarin use during pregnancy causes defects in the
offspring of exposed mothers including include nasal hypoplasia, stippled
epiphyses, limb deformities, mental retardation, and seizures . It is used
rarely during pregnancy such as in the treatment of women with artificial
heart valves where there may be no safer effective medicine available .
There is no significant data supporting the safety of newer
oral anticoagulants ( eg, rivaroxaban , apixaban, and dabigatran) during human
pregnancy [5-7]. Because most of these drugs are small molecules
they would be expected to cross the placenta and might have harmful effects on the
Authorities have recommended these drugs should be avoided in pregnancy at