Adult:
As sodium: Inj of 3200 units 2 hr before the procedure, followed by 3200 units once daily for 7 days or until the patient is fully ambulant.
Subcutaneous
FOR SURGICAL PROCEDURES IN HIGHER RISK OR ORTHOPAEDIC PATIENTS
Adult:
As sodium: Inj of 4250 units 12 hr before the procedure, followed by 4250 units 12 hr post-op and then once daily for 10 days.
Subcutaneous
TREATMENT OF THROMBOEMBOLISM
Adult:
As sodium: Inj of 6400 units for 7-10 days.
Precautions
Elderly, renal or hepatic impairment, extremes of body weight, hypertension, or other patients with increased risk of bleeding; post-operative period following brain or spinal cord surgery; spinal anaesthesia or analgesia. Pregnancy and lactation. Not generally recommended for use in patients with prosthetic heart valves as they may not provide adequate prophylaxis against thromboembolism even at high doses. Monitor platelet counts in long-term treatments. Do not switch from one brand of LMWH to another during treatment.
Adverse Drug Reactions
Hyperkalaemia related to hypoaldosteronism; bleeding; thrombocytopenia; urticarial rash or hypersensitivity skin reactions; skin necrosis reactions (localised to or distant from the inj site); increase in transaminases.
Interactions
Increased risk of haemorrhage with oral anticoagulants or drugs (e.g. aspirin and dipyridamole) that affect platelet function; NSAIDs; dextrans, thrombolytic enzymes such as streptokinase, high doses of penicillins and some cephalosporins, some contrast media, asparaginase, and epoprostenol; alcohol. Hyperkalaemia in patients on ACE inhibitors. Reduced activity if given by IV with IV glyceryl trinitrate. Reduced half-life woth tobacco.
