low molecular weight (LMW) heparin

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Introduction

Made from unfractionated heparin using a variety of methods.* MW: 5 kD (vs heparin 15 kD)

Indications

* patients who did not receive spinal anesthesia

Contraindications

pregnancy-category B

safety in lactation ?

Advantages

* over heparin

Disadvantages

  • expensive

Dosage

Pharmacokinetics

Monitor

Adverse effects

Overdose

Drug interactions

Mechanism of action

* see dalteparin for comparison of different LMW heparins.

More general terms

More specific terms

Additional terms

References

  1. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998 - not on National VA formulary
  2. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  3. 3.0 3.1 3.2 3.3 3.4 Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 17, 18, 19. American College of Physicians, Philadelphia 1998, 2012, 2015, 2018, 2022.
  4. 4.0 4.1 4.2 Journal Watch 25(10):84, 2005 Klerk CP, Smorenburg SM, Otten HM, Lensing AW, Prins MH, Piovella F, Prandoni P, Bos MM, Richel DJ, van Tienhoven G, Buller HR. The effect of low molecular weight heparin on survival in patients with advanced malignancy. J Clin Oncol. 2005 Apr 1;23(10):2130-5. Epub 2005 Feb 7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15699479
    Lee AY, Rickles FR, Julian JA, Gent M, Baker RI, Bowden C, Kakkar AK, Prins M, Levine MN. Randomized comparison of low molecular weight heparin and coumarin derivatives on the survival of patients with cancer and venous thromboembolism. J Clin Oncol. 2005 Apr 1;23(10):2123-9. Epub 2005 Feb 7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15699480
  5. UpToDate 14.1 http://www.utdol.com
  6. 6.0 6.1 O'Donnell MJ, Kearon C, Johnson J, Robinson M, Zondag M, Turpie I, Turpie AG. Brief communication: Preoperative anticoagulant activity after bridging low-molecular-weight heparin for temporary interruption of warfarin. Ann Intern Med. 2007 Feb 6;146(3):184-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17283349
  7. 7.0 7.1 7.2 7.3 FDA MedWatch Low Molecular Weight Heparins: Drug Safety Communication - Recommendations to Decrease Risk of Spinal Column Bleeding and Paralysis. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm373918.htm
  8. 8.0 8.1 8.2 8.3 Deprecated Reference
  9. Kalyani BS, Roberts CS. Low molecular weight heparin: current evidence for its application in orthopaedic surgery. Curr Vasc Pharmacol. 2011 Jan;9(1):19-23. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21044028
  10. 10.0 10.1 Saltiel M. Dosing low molecular weight heparins in kidney disease. J Pharm Pract. 2010 Jun;23(3):205-9. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21507815
  11. 11.0 11.1 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013

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