Monograph: |
Danaparoid Sodium
Danaparoid sodium is a low-molecular-weight heparinoid de-
rived from porcine intestinal mucosa. It contains a mixture of
the sodium salts of heparan sulphate, dennatan sulphate, and
chondroitin sulphate in an approximate ratio of 21:3:1. The
average molecular weight is about 5500 to 6000.
Adverse Effects and Treatment
Haemorrhage may occur after administration of da-
naparoid sodium, although there is a possible de-
creased risk of bleeding complications compared
with heparin. Liver enzymes may be transiently ele-
vated. Other adverse effects include hypersensitivity
reactions, thrombocytopenia and pain at the site of
injection.
Protamine sulphate only partially neutralizes the an-
ticoagulant effect of danaparoid sodium and cannot
be relied on to reverse bleeding associated with
overdosage.
Precautions
As for Heparin.
Danaparoid sodium should not be administered to
patients who have developed thrombocytopenia
with heparin if they demonstrate cross-reactivity in
an in-vitro test.
Pharmacokinetics
Following subcutaneous administration of danapar-
oid sodium, peak anti-factor Xa activity is reached
in approximately 4 to 5 hours. The elimination half-
lives of anti-factor Xa and anti-factor lla (anti-
thrombin) activities are approximately 25 and 7
hours, respectively. Danaparoid sodium is excreted
in the urine.
Uses and Administration
Danaparoid sodium is a low-molecular-weight
heparinoid. It is an anticoagulant and like heparin,
enhances the action of antithrombin III.
Similarly to low-molecular-weight heparins ,
it is characterised by a higher ratio of anti-factor Xa
to anti-factor lla (antithrombin) activity than
heparin. but is reported to be a much more selective
inhibitor of factor Xa than the low-molecular-
weight heparins. It was therefore hoped that dana-
paroid might be associated with a low incidence of
bleeding complications, although this is yet to be es-
tablished.
Danaparoid sodium is used in the prophylaxis of ve-
nous thromboembolism in patients under-
going surgery. It may be used in patients with
heparin associated thrombocytopenia providing
there is no cross-reactivity.
Doses of danaparoid sodium are expressed in terms
of units of anti-factor Xa activity. It is given by sub-
cutaneous injection in a dose of 750 units twice dai-
ly for 7 to 10 days. The first dose should be given I
to 4 hours before surgery.
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