Impact of drugs on venous thromboembolism risk in surgical patients

  • Alenka Premuš Marušič Kovačič
  • Martin Caprnda
  • Aleš Mrhar
  • Peter KubatkaEmail author
  • Igor Locatelli
  • Barbora Zolakova
  • Ludovit GasparEmail author
  • Robert Prosecky
  • Peter KruzliakEmail author
  • Robert Staffa
  • Luis Rodrigo
  • Jozef Radonak
  • Danijel PetrovičEmail author



This review focuses on the most common drugs administered to surgical patients during the perioperative period that affect the risk of venous thromboembolism (VTE).


Among analgesics, the risk of VTE is increased in patients treated with diclofenac, ibuprofen, and rofecoxib, but not naproxen, while metamizole can confer a protective effect. The relationship between sedatives and VTE has not been sufficiently studied. Tricyclic antidepressants, low-potency serotonin reuptake inhibitors, and antipsychotics have been associated with increased risk of VTE. The use of diuretics in the perioperative period is poorly researched; however, hyponatremia is considered a risk factor. Other factors that may influence the risk of VTE include bridging anticoagulation, allogeneic transfusion, and hemostatic management before surgery. Pharmacotherapy for HIV or cancer may also increase VTE risk.


Increased monitoring for VTE is therefore advisable in surgical patients and those receiving antipsychotics, antidepressants, diuretics, or analgesics.


Venous thromboembolism Analgesics Diuretics Antidepressants Antipsychotics Oral contraceptives Surgery Bridging anticoagulation Transfusion Thromboprophylaxis 



This work is supported by the Ministry of Health of the Czech Republic, grant nr. 15-33437A (R. Staffa). This publication is the result of the project implementation: "CENTER OF EXCELLENCE FOR RESEARCH IN PERSONALIZED THERAPY (CEVYPET)", ITMS: 26220120053 supported by the Operational Programme Research and Innovation funded by the ERDF.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Murska Sobota General HospitalMurska SobotaSlovenia
  2. 2.Department of Biopharmaceutics and Pharmacokinetics, Faculty of PharmacyUniversity of LjubljanaLjubljanaSlovenia
  3. 3.1st Department of Internal Medicine, Faculty of MedicineUniversity Hospital and Comenius University in BratislavaBratislavaSlovakia
  4. 4.Department of Medical Biology, Jessenius Faculty of MedicineComenius University in BratislavaMartinSlovakia
  5. 5.Department of Experimental Carcinogenesis, Division of Oncology, Biomedical Center Martin, Jessenius Faculty of MedicineComenius University in Bratislava036 01 MartinSlovakia
  6. 6.Department of Internal MedicineBrothers of Mercy HospitalBrnoCzech Republic
  7. 7.2nd Department of Surgery, Faculty of MedicineMasaryk University and St. Anne’s University HospitalBrnoCzech Republic
  8. 8.Faculty of MedicineUniversity of Oviedo, Central University Hospital of Asturias (HUCA)OviedoSpain
  9. 9.1st Department of Surgery, Faculty of MedicinePavol Jozef Safarik University and University Hospital041 66 KosiceSlovak Republic
  10. 10.Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia

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