Nadroparin calcium: Indication, Dosage, Side Effect, Precaution

Generic Medicine Info Patient Medicine Information

This information is not country-specific. Please refer to the local prescribing information.

Generic Medicine Info

Indications and Dosage

Intra-arterial
Prophylaxis of clotting in the extracorporeal circulation during haemodialysis sessions of less than 4 hours

Adult: <50 kg: 2850 units; 50-69 kg: 3800 units; ≥70 kg: 5700 units. Administer in the arterial line of the circuit at the start of dialysis. Patients at high risk of haemorrhage: Reduce dose.

Parenteral
Unstable angina

Adult: 86 units/kg SC every 12 hr for about 6 days. An initial dose of 86 units/kg may be given IV. Low-dose aspirin should also be given.

Subcutaneous
Thromboembolic disorders

Adult: 85 units/kg every 12 hr for up to 10 days or 171 units/kg/day once daily.

Subcutaneous
Prophylaxis of venous thromboembolism during surgical procedures

Adult: Moderate-risk patients: 2850 units daily for 7 days or until the patient is ambulant; give the 1st dose 2-4 hr before surgery. High-risk patients: 38 units/kg 12 hr before surgery, 12 hr post-operatively and then daily until 3 days after surgery; increase dose by 50% to 57 units/kg daily. Total duration of treatment: At least 10 days.

Renal Impairment

Parenteral:
Dose reduction may be required.
Subcutaneous:
Moderate to severe: Dose reduction may be required.

Contraindications

Acute infective endocarditis; haemorrhage or haemostasis disorder; active peptic ulceration; haemorrhagic cerebrovascular event; severe uncontrolled hypertension; diabetic or haemorrhagic retinopathy; injuries to or operations on the CNS, eyes or ears; history of thrombocytopenia with nadroparin. Lactation. Not for IM admin.

Special Precautions

Patients with recent or anticipated neuraxial anaesthesia; history of heparin-induced thrombocytopenia, congenital or drug-induced thrombocytopenia or platelet defects; patients at increased risk of bleeding; severe hepatic or renal disease. Monitor for signs of bleeding; hyperkalaemia. Pregnancy.

Adverse Reactions

Hypoaldosteronism; bleeding, thrombocytopenia; rash; haematoma and pain at inj site; allergic reactions; osteopaenic effects; increased ALT/AST.

Overdosage

Symptoms: Haemorrhage. Management: Monitor platelet count and other coagulation parameters. Protamine sulfate may be used in severe cases; 6 mg (0.6 ml) neutralises approx 0.1 ml of nadroparin. Do not exceed a rate of 20 mg/min.

Drug Interactions

Increased risk of bleeding with thrombolytic agents, oral anticoagulants and antiplatelet drugs.

Food Interaction

Additive anticoagulant or antiplatelet effects may occur with cat's claw, dong quai, evening primrose, garlic and ginseng.

Action

Description: Nadroparin possesses high anti-factor Xa activity but has low anti-factor IIa (antithrombin) activity, potentially providing equivalent antithrombotic efficacy with less bleeding complications.
Duration: 18 hr.
Pharmacokinetics:
Absorption: ≥89% of dose is absorbed (subcutaneous). Peak plasma concentrations in 3-5 hr.
Excretion: Via urine. Elimination half-life: 3.5 hr; prolonged to 6 hr in renal impairment.

Storage

Store at 15-30°C (59-86°F). Do not freeze or refrigerate.

MIMS Class

Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)

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