Give 2 options recommended for initial anticoagulation in pulmonary embolism?

Acute Management
Parenteral, weight-adjusted anticoagulation should be used:
  • Low-molecular weight heparin (LMWH) SC 1
  • Fondaparinux SC 1
  • Unfractionated heparin (UFH) IV 1
    • Generally second line due to higher bleeding risk and HIT risk
    • Preferred agent in the setting of:
      • Overt haemodynamic instability or imminent haemodynamic decompensation in whom primary reperfusion treatment will be necessary (short half life and easy reversal)
      • Increased risk of bleeding
      • Serious renal impairment (creatinine clearance <30 mL/min)
Longer-Term Management
Started when the patient's condition is stable and no invasive procedures are planned
  • Non-vitamin K oral anticoagulant (NOAC)
  • Warfarin international normalized ratio (INR) is 2.0 to 3.0:
ESC Guidelines

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