What anticoagulation options are recommended for the treatment of PE in primary care settings?

In primary care settings, the recommended anticoagulation options for the treatment of pulmonary embolism include apixaban or rivaroxaban for confirmed proximal DVT or PE, as these are preferred options ¹.

If neither apixaban nor rivaroxaban is suitable, consider LMWH for at least 5 days followed by dabigatran or edoxaban, or LMWH concurrently with a vitamin K antagonist (VKA) until the INR reaches at least 2.0 in 2 consecutive readings, then VKA alone ¹.

For patients with active cancer, anticoagulation treatment for 3 to 6 months is recommended, with consideration of a DOAC or LMWH depending on individual factors ¹.

In cases of haemodynamic instability, continuous unfractionated heparin (UFH) infusion is advised, with thrombolytic therapy considered ¹.

In patients with renal impairment or at extremes of body weight, dose adjustments and monitoring are necessary, and options include apixaban, rivaroxaban, or LMWH, with specific recommendations based on renal function ¹.