Bemiparin sodium

CLINICAL USE

  • Prophylaxis of thromboembolic disorders of venous origin
  • Treatment of deep vein thrombosis and pulmonary embolism
  • Anticoagulation of the extracorporeal circulation during haemodialysis

    DOSE IN NORMAL RENAL FUNCTION

  • Prophylaxis DVT:
  • Moderate risk surgery, 2500 units once —daily for 7–10 days
  • High risk surgery, 3500 units once daily —for 7–10 days
  • Treatment DVT and PE: 115 units/kg every 24 hours for 5–9 days
  • Anticoagulation of extracorporeal circuits – see ‘Other Information’

    PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :3600 (3000–4200)
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :–
  • %Excreted unchanged in urine &nbsp &nbsp : –

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :–

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :5–6

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function for prophylaxis only.
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function for prophylaxis only.

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR <10 mL/min

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR=10–20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Analgesics: increased risk of bleeding with NSAIDs – avoid concomitant use with IV diclofenac; increased risk of haemorrhage with ketorolac – avoid concomitant usedrotrecogin alfa: manufacturer advises to avoid use of high doses of heparin with drotrecogin alfa
  • Nitrates: GTN infusions increase the excretion of bemiparin; anticoagulant effect reduced
  • Use with care in patients receiving oral anticoagulants, platelet aggregation inhibitors, aspirin or dextran

    ADMINISTRATION

    Reconstition

    –

    Route

    SC

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

  • In extracorporeal circulation during a 4-hour or less haemodialysis session, for patients 60 kg, 3500 units bemiparin is used
  • Additional doses may be required if using LMWHs for anticoagulation in HDF
  • 1.4 mg of protamine should neutralise the effect of 100 units of bemiparin
  • Low molecular weight heparins are renally excreted and hence accumulate in severe renal impairment. While the doses recommended for prophylaxis against DVT and prevention of thrombus formation in extracorporeal circuits are well tolerated in patients with ESRF, the doses recommended for treatment of DVT and PE have been associated with severe, sometimes fatal, bleeding episodes in such patients. Hence the use of unfractionated heparin would be preferable in these instances
    Tags:

    • Related News

    sotalol hydrochloride.txt

    tazocin.txt