Treatment of DVT and PE: The recommended dose is 175 IU anti-Xa/kg body-weight s.c. once daily.
Thromboprophylaxis in patients with moderate risk of thrombosis (general surgery): On the day of operation 3,500 IU anti-Xa s.c. 2 hours before surgery and postoperatively once daily 3,500 IU anti-Xa for 7-10 days.
Thromboprophylaxis in patients with high risk of thrombosis (e.g. total hip replacement): On the day of operation 4,500 IU anti-Xa s.c. 12 hours before surgery or 50 IU anti-Xa/kg body-weight s.c. 2 hours before surgery and then once daily until the patient has been mobilized.
For short-term haemodialysis (less than 4 hours): A bolus dose of 2,000-2,500 IU anti-Xa into the arterial side of the dialyser (or intravenously) at the beginning of dialysis.
Long-term haemodialysis (more than 4 hours): A bolus dose of 2,500 IU anti-Xa into the arterial side of the dialyser (or intravenously) at the beginning of dialysis, followed by an infusion of 750 IU anti-Xa/hour.
Dose adjustment: Increase or decrease of the bolus dose, if required, can be made in steps of 250-500 IU anti-Xa until a satisfactory response is obtained.
Elderly: Renal function should be assessed with e.g. the Cockcroft-Gault formula to estimate creatinine clearance levels.
No dose reduction is needed in elderly patients with normal renal function. (See Precautions.)
Renal impairment: No dose reduction is needed in patients having creatinine clearance levels down to 20 ml/min. However, precaution is recommended when treating patients with severe renal impairment (creatinine clearance <30 ml/min). (See Precautions.)