Anticoagulation Meds 💉
Reference guide for anticoagulation medications. Tinzaparin dosing tool (Rotherham chart), drug table, and prescribing for anticoagulation and antiplatelet therapy.
💊 Anticoagulants & Antiplatelets
- Includes common medications used for anticoagulation and antiplatelet therapy in hospital settings.
- Refer to renal and hepatic considerations when prescribing.
- Use the tinzaparin dosing tool below for weight-based VTE prophylaxis and treatment (Rotherham chart).
Tinzaparin dosing
Rotherham tinzaparin dose chartIf <20, prophylaxis uses the renal weight table; treatment adds haematology advice (per chart).
Enter weight to see suggested doses.
Guidance only. Numbers mirror the NHS Rotherham chart; product SPC, local formulary, and specialist advice take precedence (pregnancy, extremes of weight, RRT).
Weight bands (reference)
VTE prophylaxis — standard (eGFR / CrCl ≥20 ml/min/1.73m²)
| Weight | Dose | Frequency |
|---|---|---|
| <50 kg | 3,500 IU | Once daily |
| 50–90 kg | 4,500 IU | Once daily |
| 91–130 kg | 3,500 IU | Twice daily |
| 131–170 kg | 4,500 IU | Twice daily |
| >170 kg | 7,000 IU | Twice daily |
VTE prophylaxis — renal impairment (eGFR / CrCl <20 ml/min/1.73m²)
If weight is below 31 kg, this table does not define a dose — seek advice.
| Weight | Dose | Frequency |
|---|---|---|
| 31–49 kg | 2,500 IU | Once daily |
| 50–99 kg | 4,500 IU | Once daily |
| 100–149 kg | 3,500 IU | Twice daily |
| ≥150 kg | 4,500 IU | Twice daily |
VTE treatment
| Weight | Dose | Frequency |
|---|---|---|
| ≤30 kg | 50 IU/kg (nearest 50 IU) | Once daily — discuss haematology |
| <40 kg or ≥155 kg | 175 × weight (IU, nearest 50 IU) | Once daily |
| 40–49 kg | 8,000 IU | Once daily |
| 50–59 kg | 10,000 IU | Once daily |
| 60–69 kg | 12,000 IU | Once daily |
| 70–84 kg | 14,000 IU | Once daily |
| 85–94 kg | 16,000 IU | Once daily |
| 95–109 kg | 18,000 IU | Once daily |
| 110–119 kg | 20,000 IU | Once daily |
| 120–129 kg | 22,000 IU | Once daily |
| 130–139 kg | 24,000 IU | Once daily |
| 140–154 kg | 26,000 IU | Once daily |
Anticoagulation Medications
Reference table for anticoagulation therapy
| Drug | Dose | Frequency | Route | Notes |
|---|---|---|---|---|
| Enoxaparin | 20-40mg | OD | SC | 40mg OD standard dose. 40mg BD if BMI >40 or >120kg. 20mg for low risk or GFR <30. |
| Tinzaparin | 3500-4500iu | OD | SC | VTE prophylaxis <100kg. More useful for outpatient settings. |
| Aspirin | 75-300mg | OD | PO | 75mg stent protection. 300mg for MI/CVA. |
| Clopidogrel | 75-600mg | OD | PO | |
| Prasugrel | 5-60mg | OD | PO | PCI: 60mg load, 10mg maintenance. 5mg if <60kg. Avoid if prior TIA/stroke. |
| Rivaroxaban | 20mg | OD | PO | GFR 30-49: 15mg. GFR <30: do not use. |
| Edoxaban | 60mg | OD | PO | Cr 15-50 OR <60kg OR inhibitors: 30mg. |
| Apixaban | 2.5-5mg | BD | PO | Use 2.5mg BD if two of: Creat >133, Age >80, Weight <60kg. GFR 15-30: 2.5mg BD. |
Enoxaparin
SCDose:20-40mg
Frequency:OD
Notes: 40mg OD standard dose. 40mg BD if BMI >40 or >120kg. 20mg for low risk or GFR <30.
Tinzaparin
SCDose:3500-4500iu
Frequency:OD
Notes: VTE prophylaxis <100kg. More useful for outpatient settings.
Aspirin
PODose:75-300mg
Frequency:OD
Notes: 75mg stent protection. 300mg for MI/CVA.
Clopidogrel
PODose:75-600mg
Frequency:OD
Prasugrel
PODose:5-60mg
Frequency:OD
Notes: PCI: 60mg load, 10mg maintenance. 5mg if <60kg. Avoid if prior TIA/stroke.
Rivaroxaban
PODose:20mg
Frequency:OD
Notes: GFR 30-49: 15mg. GFR <30: do not use.
Edoxaban
PODose:60mg
Frequency:OD
Notes: Cr 15-50 OR <60kg OR inhibitors: 30mg.
Apixaban
PODose:2.5-5mg
Frequency:BD
Notes: Use 2.5mg BD if two of: Creat >133, Age >80, Weight <60kg. GFR 15-30: 2.5mg BD.