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Dosing and Monitoring of Low‐Molecular‐Weight Heparins in Special Populations
Author(s) -
Duplaga Beth A.,
Rivers Christina W.,
Nutescu Edith
Publication year - 2001
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.21.2.218.34112
Subject(s) - medicine , dosing , deep vein , antithrombotic , low molecular weight heparin , heparin , thrombosis , pulmonary embolism , anticoagulant , aspirin , clinical trial , intensive care medicine , pharmacology
As a result of numerous clinical trials and meta‐analyses supporting the superior efficacy and relative safety of low‐molecular‐weight heparins (LMWHs) compared with unfractionated heparin (UFH), LMWHs are emerging as the antithrombotic agents of choice for the prevention and treatment of deep vein thrombosis and pulmonary embolism. In addition, data indicate that enoxaparin given with low‐dosage aspirin is more effective than UFH in treating acute coronary syndromes. Anti‐Xa activity can be used as a biologic marker of LMWH activity. Because of the more predictable anticoagulant response to subcutaneous administration of LMWHs compared with UFH, routine monitoring of anti‐Xa activity in clinically stable adults with uncomplicated disease is not recommended. Because the optimal dosage of LMWHs has not been established for patients with renal insufficiency or extremes of body weight, during pregnancy, or for children, anti‐Xa activity monitoring may be warranted in these subsets.