Danaparoid sodium
Danaparoid sodium (Orgaran)
Danaparoid sodium
(dah- NAP-ah-royd)
Pregnancy Category: B Orgaran (Rx)

Classification: Anticoagulant, glycosaminoglycan

Action/Kinetics: A low molecular weight sulfated glycosaminoglycans obtained from porcine mucosa. Prevents fibrin formation in the coagulation pathway via thrombin generation inhibition by anti-Xa and anti-IIa effects. Minimal effect on clotting assays, fibrinolytic activity, or bleeding time. 100% bioavailable with SC use. t 1/2: About 24 hr. Excreted primarily through the kidneys.

Uses: Prophylaxis of postoperative deep vein thrombosis (DVT) in clients undergoing elective hip replacement surgery. Investigational: Thromboembolism, anticoagulation during hemodialysis, hemofiltration during CV operation, and increased risk of thrombosis during pregnancy.

Contraindications: Use in hemophilia, idiopathic thrombocytopenic purpura, active major bleeding state (including hemorrhagic stroke in the acute phase), and type II thrombocytopenia associated with a positive in vitro test for antiplatelet antibody in the presence of danaparoid. Hypersensitivity to pork products. IM use.

Special Concerns: Cannot be dosed interchangeably (unit for unit) with either heparin or low molecular weight heparins. Use with extreme caution in disease states where there is an increased risk of hemorrhage, including severe uncontrolled hypertension, acute bacterial endocarditis, congenital or acquired bleeding disorders, active ulcerative and angiodysplastic GI disease, nonhemorrhagic stroke, postoperative indwelling epidural catheter use, and shortly after brain, spinal, or ophthalmologic surgery. Use with caution during lactation and in those with severely impaired renal function. Use with caution in clients receiving oral anticoagulants or platelet inhibitors. Safety and efficacy have not been determined in children.

Side Effects: CV: Intraoperative blood loss, postoperative blood loss. GI: N&V;, constipation. CNS: Insomnia, headache, dizziness. Dermatologic: Rash, pruritus. GU: UTI, urinary retention. Miscellaneous: Fever, pain at injection site, peripheral edema, joint disorder, edema, asthenia, anemia, pain, infection.

Overdose Management: Symptoms: Bleeding disorders, including hemorrhage. Treatment: Protamine sulfate partially neutralizes the anti-Xa activity of the drug; however, there is no evidence that protamine sulfate will reduce severe non-surgical bleeding. For serious bleeding, discontinue danaparoid and give blood or blood product transfusions as needed.

How Supplied: Injection: 750 anti-Xa units/0.6 mL.

Dosage
?SC only Prophylaxis of DVT in hip replacement surgery.
Adults: 750 anti-Xa units b.i.d. SC, beginning 1 to 4 hr preoperatively and then not sooner than 2 hr postoperatively. Continue treatment throughout the postoperative period until the risk of deep vein thrombosis has decreased. Average duration of treatment is 7 to 10 days, up to 14 days.