Adult <75 yr DVT or pulmonary embolism 1.5 mg/kg (150 U/kg) 24 hrly, usually for at least 5 days, & until adequate oral anticoagulation is established.
Acute ST-segment elevation MI 30 mg (3,000 U) IV 1 mg/kg (100 U/kg), 1 mg/kg SC 12 hrly for up to 8 days. Max: 100 mg (10,000 U) for 1st 2 SC doses only. Patients undergoing percutaneous coronary intervention: Additional dose, 300 mcg/kg (30 U/kg) IV at time of procedure, if last SC dose given >8 hr previously. Note: When administered in conjunction w/ a thrombolytic, give between 15 min before & 30 min after the start of thrombolytic therapy.
Unstable angina & non-ST-segment elevation MI 1 mg/kg (100 U/kg) SC 12 hrly usually for 2-8 days. Min: 2 days.
Venous thromboembolism in pregnancy Early pregnancy <50 kg: 40 mg (4,000 U) SC bd. 50-70 kg: 60 mg (6,000 U) bd. 70-90 kg: 80 mg (8,000 U) SC bd. >90 kg: 100 mg (10,000 U) SC bd.
Prevention of clotting in extracorporeal circuits Recommended dose: 1 mg/kg. Patients w/ high risk of hemorrhage: Reduce to 0.5 mg/kg for double vascular access or 0.75 mg/kg for singular vascular access. May give further dose 0.5-1 mg/kg, if fibrin rings are found eg, after prolonged session.
DVT prophylaxis especially in surgical patients Moderate risk: 20 mg (2,000 U) SC approx 2 hr before surgery, then 20 mg (2,000 U) 24 hrly for 7-10 days. High risk (eg, orthopedic surgery): 40 mg (4,000 U) SC 12 hr before surgery, then 40 mg (4,000 U) 24 hrly for 7-10 days.
DVT prophylaxis in medical patients 40 mg (4,000 U) SC 24 hrly for at least 6 days, continued until patient ambulant. Max: 14 days.
Elderly >75 yr Acute ST-segment elevation MI 750 mcg/kg (75 U/kg) SC only 12 hrly. Max: 75 mg (7,500 U) for 1st 2 doses only.