Study Shows Reduced Dose of Blood Thinners Post-Blood Clot Could Limit Risk of Future Bleeding

A new study led by Michigan Medicine suggests that “for people taking popular blood thinners after having a blood clot, a reduced dose may limit the future risk of bleeding as well as hospital visits.”

The research team specifically focused on the “two most prescribed direct oral anticoagulants, or DOACs” – rivaroxaban and apixaban. They analyzed nearly 1,000 cases of “patients who were treated for a blood clot, also known as venous thromboembolism, and who were taking the medications to prevent one from recurring.” Some patients had their doses reduced after six months, “while others stayed on the full therapeutic dose.”

Both treatments “resulted in a similar rate of recurrent clotting,” but “the therapeutic dosing of either DOAC was associated with an increased risk of bleeding, emergency department visits and hospitalizations compared [to] a reduced dose.” The lead author of the study stresses the importance of careful monitoring when patients are prescribed these popular DOACs.

These findings support guidelines released by the American College of Chest Physicians in 2021 that “suggested reduced dosage of either apixaban or rivaroxaban for extended management of blood clots.” The research team emphasizes, however, that the findings still “need to be confirmed with randomized trials.”