Table II.

Anticoagulation strategies

Thromboprophylaxis

Low-molecular-weight heparin, 40 mg daily (or 30 mg twice daily)

Subcutaneous heparin, 5000 units 3 times daily

Full-dose anticoagulation

Heparin nomogram for DVT/PE

Low-molecular-weight heparin, 1.5 mg/kg daily (or 1 mg/kg twice daily)

Direct oral anticoagulant (standard dosing)

Low-dose anticoagulation protocol

Many patients can receive heparin nomogram for DVT/PE without bolus

Heparin nomogram for ACS/AF (Xa target, 0.2-0.5)

Non-nomogram heparin at discretion of attending (Xa target 0.2-0.3)

ACS, acute coronary syndrome; AF, atrial fibrillation; DVT, deep venous thrombosis; PE, pulmonary embolism.