Nadroparin calcium


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : SC Prophylaxis of venous thromboembolism during surgical procedures Moderate-risk patients: 2,850 u/day for 7 days or until the patient is ambulant; give 1st dose 2-4 hr pre-op. High-risk: 38 u/kg 12 hr pre-op, 12 hr post-op and then daily until 3 days post-op; increase dose by 50% to 57 u/kg/day. Total duration: ≥10 days. Thromboembolic disorders 85 u/kg 12 hrly for up to 10 days or 171 u/kg/day once daily. Unstable angina 86 u/kg 12 hrly for about 6 days. An initial dose of 86 u/kg may be given IV. Low-dose aspirin should also be given. Intra-arterial Prevention of clotting in the extracorporeal circulation during haemodialysis sessions <4 hr <50 kg: 2,850 u; 50-69 kg: 3,800 u; ≥70 kg: 5,700 u. Administer at the start of dialysis. Patients at high risk of haemorrhage: Reduce dose.
Dosage Details
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.
Disclaimer: This information is independently developed by MIMS based on Nadroparin calcium from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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