Advances in the application of anticoagulants in obese patients
- VernacularTitle:抗凝药物在肥胖患者中的应用进展
- Author:
Guohui SHOU
1
;
Shengye LIU
2
;
Guohua CHEN
2
;
Boxia LI
3
Author Information
1. Dept. of Pharmacy，Tianshui Second People’s Hospital，Gansu Tianshui 741020，China
2. Dept. of Interventional Medicine，the First Hospital of Lanzhou University，Lanzhou 730030，China
3. Dept. of Pharmacy，the First Hospital of Lanzhou University，Lanzhou 730030，China
- Publication Type:Journal Article
- Keywords:
obesity;
anticoagulants;
venous thromboembolism;
atrial fibrillation;
special populations;
dose optimization
- From:
China Pharmacy
2025;36(24):3137-3142
- CountryChina
- Language:Chinese
-
Abstract:
Obesity is a well-established risk factor for thrombotic events such as venous thromboembolism， and the alterations in pharmacokinetics induced by obesity pose challenges for anticoagulation management. This article systematically reviews the advances of the use of various anticoagulants in obese patients， and finds that the dosage of low-molecular-weight heparin needs to be adjusted according to preventive or therapeutic goals in severely obese patients， the preventive dose may be increased to 40 mg， q12 h or 0.5 mg/（kg·d）， while the therapeutic dose is recommended to be reduced to 0.8 mg/（kg·d）， q12 h. Direct oral anticoagulant drugs are safe and effective for general obese patients； in severely obese patients， standard doses of rivaroxaban or apixaban may be used， warranting cautious application and consideration for therapeutic drug monitoring. In special clinical scenarios such as obesity combined with trauma， pregnancy， advanced age， or bariatric surgery， anticoagulation strategies should be individualized， with close attention to monitoring. Future research should focus on optimizing anticoagulant regimens for special populations and addressing anticoagulation management in obese patients with other embolic diseases.
