{"id":1663,"date":"2023-06-25T17:29:32","date_gmt":"2023-06-25T17:29:32","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/bemiparin-sodium\/"},"modified":"2023-06-25T19:48:31","modified_gmt":"2023-06-25T19:48:31","slug":"bemiparin-sodium","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/bemiparin-sodium\/","title":{"rendered":"Bemiparin sodium"},"content":{"rendered":"

<\/p>\n

Bemiparin sodium<\/h1>\n

CLINICAL USE<\/h3>\n
  • Prophylaxis of thromboembolic disorders of venous origin<\/li>\n
  • Treatment of deep vein thrombosis and pulmonary embolism<\/li>\n
  • Anticoagulation of the extracorporeal circulation during haemodialysis
    \n

    DOSE IN NORMAL RENAL FUNCTION<\/h3>\n<\/li>\n
  • Prophylaxis DVT:<\/li>\n
  • Moderate risk surgery, 2500 units once \u2014daily for 7\u201310 days<\/li>\n
  • High risk surgery, 3500 units once daily \u2014for 7\u201310 days<\/li>\n
  • Treatment DVT and PE: 115 units\/kg every 24 hours for 5\u20139 days<\/li>\n
  • Anticoagulation of extracorporeal circuits \u2013 see \u2018Other Information\u2019
    \n

    PHARMACOKINETICS<\/h3>\n<\/li>\n
  • Molecular weight                           :3600 (3000\u20134200)<\/li>\n
  • %Protein binding                           :\u2013<\/li>\n
  • %Excreted unchanged in urine     : \u2013<\/li>\n
  • Volume of distribution (L\/kg)       :\u2013<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :5\u20136
    \n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Dose as in normal renal function<\/li>\n
  • 10 to 20     : Dose as in normal renal function for prophylaxis only.<\/li>\n
  • <10           : Dose as in normal renal function for prophylaxis only.
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :Not dialysed. Dose as in GFR <10 mL\/min<\/li>\n
  • HD                     :Not dialysed. Dose as in GFR <10 mL\/min<\/li>\n
  • HDF\/high flux   :Dialysed. Dose as in GFR<\/li>\n
  • <10           : mL\/min<\/li>\n
  • CAV\/VVHD      :Not dialysed. Dose as in GFR=10\u201320 mL\/min
    \n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • Analgesics: increased risk of bleeding with NSAIDs \u2013 avoid concomitant use with IV diclofenac; increased risk of haemorrhage with ketorolac \u2013 avoid concomitant usedrotrecogin alfa: manufacturer advises to avoid use of high doses of heparin with drotrecogin alfa<\/li>\n
  • Nitrates: GTN infusions increase the excretion of bemiparin; anticoagulant effect reduced<\/li>\n
  • Use with care in patients receiving oral anticoagulants, platelet aggregation inhibitors, aspirin or dextran
    \n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    \u2013<\/p>\n

    Route<\/h4>\n

    SC<\/p>\n

    Rate of Administration<\/h4>\n

    \u2013<\/p>\n

    Comments<\/h4>\n

    \u2013<\/p>\n

    OTHER INFORMATION<\/h4>\n<\/li>\n
  • In extracorporeal circulation during a 4-hour or less haemodialysis session, for patients <60 kg, 2500 units bemiparin is administered into the arterial line of the circuit at the beginning of the session; for patients >60 kg, 3500 units bemiparin is used<\/li>\n
  • Additional doses may be required if using LMWHs for anticoagulation in HDF<\/li>\n
  • 1.4 mg of protamine should neutralise the effect of 100 units of bemiparin<\/li>\n
  • 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<\/li>\n","protected":false},"excerpt":{"rendered":"

    Bemiparin sodium CLINICAL USE Prophylaxis of thromboembolic disorders of venous<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1663","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1663","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1663"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1663\/revisions"}],"predecessor-version":[{"id":2878,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1663\/revisions\/2878"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1663"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1663"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1663"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}