Canterbury DHB


Air Travel and Venous Thrombosis

There is reasonable evidence that the risk of venous thromboembolism (VTE) is increased following a flight of over 4 hours. The risk is further increased if the person has thrombophillia or is on the oral contraceptive.

This advice does not relate to those who are already established on therapeutic anticoagulation – their treatment should continue uninterrupted throughout.

The following management is suggested:

  • Is the traveller at increased risk for VTE?
    • previous history of VTE – including travel-related VTE
    • active cancer
    • recent major surgery (< 1 month) or surgery on the lower extremities
    • hereditary thrombophilia
  • If yes to any of the above:
    • Avoid excess alcohol and sedatives when travelling and actively maintain hydration.
    • Class 1 (20 to 30 mmHg) compression stockings (e.g. Venosan® Flight socks) to improve venous return. These should be individually fitted to ensure they are effective. Stockings can be purchased from a number of pharmacies, though several pharmacies also offer a fitting service, including:
      • Papanui Pharmacy, 478 Papanui Road, Christchurch.
      • Staywell Pharmacy, 27 Shands Road, Christchurch
  • Patients considered at higher risk may benefit from pharmacological prophylaxis on top of above measures. Pharmacological options include:
    • Enoxaparin given subcutaneously, one hour before departure and 24 hourly until at destination (if travel > 24 hours):
      • Dose 40 mg for CrCl 30 mL/min or more
      • 20 mg if CrCl less than 30
      • Patients are required to self-fund this treatment
    • Rivaroxaban 10 mg one hour before departure and 24 hourly until at destination (if travel > 24 hours)

    Aspirin has not been shown to be effective in this situation.

These patients are not usually seen in Haematology Outpatients and the above advice should be given to the general practitioner so they can inform the traveller and give any treatment that they and the patient agree upon.

About this Canterbury DHB document (5202):

Document Owner:

Catherine Neal (see Who's Who)

Last Reviewed:

December 2023 (Air Travel and Venous Thrombosis)

Next Review:

December 2025


Clexane, clexane, enox, enoxap,

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Topic Code: 5202