Treatment - Antiphospholipid syndrome (APS)

Treatment for antiphospholipid syndrome (APS) aims to reduce your risk of developing more blood clots.

Medication

As part of your treatment you'll be prescribed anticoagulant medicine such as warfarin, or an antiplatelet medication such as low-dose aspirin.

These work by interrupting the process of blood clot formation. This means blood clots are less likely to form when they're not needed.

Your treatment plan

Most people with APS need to take anticoagulant or antiplatelet medication daily for the rest of their life.

If blood tests show you have abnormal antiphospholipid antibodies, but you don't have a history of blood clots, low-dose aspirin tablets are usually recommended.

If you can't take aspirin, you may be prescribed an alternative antiplatelet tablet called clopidogrel.

Warfarin tablets are usually recommended if you have APS and a history of blood clots, such as previously having DVT (deep vein thrombosis) or a stroke.

But this needs to be changed if you become pregnant or are planning a pregnancy. Tell your doctor if this is the case.

If you develop a blood clot or your symptoms suddenly become severe, injections of an anticoagulant called heparin may be needed.

These injections may be given in hospital, or you may be trained to give them yourself.

Side effects

Side effects of these medications are uncommon and generally mild, such as indigestion or feeling sick (nausea).

But there's a risk that the disruption to the blood's ability to clot can cause excessive bleeding (a haemorrhage).

Symptoms of excessive bleeding can include:

• blood in your pee or poo
• black poo
• severe bruising
• prolonged nosebleeds (lasting longer than 10 minutes)
• blood in your vomit
• coughing up blood

Contact your GP immediately if you have any of these symptoms while taking an anticoagulant.

If this isn't possible, call your local out-of-hours service or NHS 111.

Treatment during pregnancy

Women diagnosed with APS are strongly advised to plan for any future pregnancy.

This is because treatment to improve the outcome of a pregnancy is most effective when it begins as soon as possible after an attempt to conceive.

Some medications used to treat APS can also harm an unborn baby.

If you don't plan your pregnancy, it may be several weeks before you realise you're pregnant.

This may increase the risk of treatment to safeguard the pregnancy being unsuccessful.

If you are sexually active you should use a reliable method of contraception.

If you do want to have a baby, you should talk to the doctor in charge of your treatment for APS.

Treatment during pregnancy involves taking daily doses of aspirin or heparin, or a combination of both.

This depends on whether you have a history of blood clots and previous complications during pregnancy.

Warfarin isn't recommended during pregnancy because it carries a small risk of causing birth defects.

Treatment with aspirin or heparin, or both, is usually started at the beginning of the pregnancy and may continue for 1 to 6 weeks after you have given birth.

Lifestyle changes

If you're diagnosed with APS, it's important to take all possible steps to reduce your risk of developing blood clots.

Effective ways of achieving this include:

• quit smoking
• eating a healthy, balanced diet – low in fat and sugar and containing plenty of fruit and vegetables
• taking regular exercise
• maintaining a healthy weight and losing weight if you're obese (have a body mass index of 30 or more)

It is recommended that you wear a medical alert bracelet or similar. This is because it is important for medical staff to know you have a blood clotting disorder in case of an accident.

The MedicalAlerty charity has more information on its website about types of medical alert identification you can wear.