• Thaksin Jansing Faculty of Pharmacy, Siam University, Bangkok
Keywords: thromboprophylaxis, venous thromboembolism, multiple myeloma, immunomodulatory drugs


Multiple myeloma (MM) has been associated with an increase in the risk of venous thromboembolism (VTE) and death. Several risk factors of VTE include patients, diseases, and treatments such as patients receiving immunomodulatory drugs (IMiDs) in combination with high doses of dexamethasone or chemotherapy. The thromboprophylaxis protocols depend on risk stratifications. Patients with a standard risk of VTE are given 81-325 mg of aspirin daily. However, patients who are at higher risk are given a daily dose of low-molecular-weight heparins/LMWH (enoxaparin 40 mg), subcutaneously or dose-adjusted warfarin that has a target INR of 2.0-3.0. Medication is given for a minimum of 4-6 months or it can be given in combination with IMiDs during treatment for MM. Importantly, risk assessment for VTE and bleeding should be regularly monitored.


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