Xeralto vs Coumadin in DVT, Pulmonary Emboli in Commercial Driver Certification

Last updated Apr 10, 2021 at 5:19PM | Published on Aug 27, 2014 | DOT Exams

If a driver got diagnosed with DVT and PE,  Currently on Xeralto, NOT symptomatic.  I just want to see if I am interpreting this right?  He has to have a CT chest negative.  Then  repeat in 3 months and if negative then certify for a year?   He has been on Xeralto for one month after diagnosis. Guidelines speaks of Coumadin only……
The commercial driver is at an increased risk for developing acute deep vein thrombosis (DVT) due to long hours of sitting as part of the profession. DVT can be the source of pulmonary emboli that can cause gradual or sudden incapacitation or death. Adequate treatment with anticoagulants decreases the risk of recurrent thrombosis by approximately 80%.

The driver should have a minimum waiting period of 3 months post PE and stable on anticoagulants for one month.  If on coumadin, therapeutic INRs should be documented.  There is no guidance on Xarelto or other newly available anticoagulants, so documentation from the treating physician familiar with the job of commercial driving should indicate the driver is stable.

There is no specific guideline or requirement for a CT of the chest, but certainly may be taken into consideration by the medical examiner, along with any other pertinent diagnostic and specialty examinations.

Of course, the driver should be otherwise physically able to perform heavy duties consistent with commercial driving.  The maximum certification period after PE would be one year.

 

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2 Comments

  1. Rhonda Bennett
    Rhonda Bennett on June 2, 2020 at 10:03 am

    I was diagnosed with a DVT on march 12, due to surgery not driving.
    Have been on Xerelto for three months, clot is mostly gone. When can I return to driving? Does it have to be completely gone?

    • lawrence earl
      lawrence earl on June 2, 2020 at 11:07 am

      Only your medical examiner can determine when you can return to work/driving commercially. There is no specific rule for this, if it is resolved, controlled on medication and a driver is otherwise healthy, they may return to driving.