Included in the formulation
Pharmacodynamics:Anticoagulant and antithrombotic effects are due to binding to antithrombin III, an increase in its blocking effect on the coagulation factor Xa, which activates the prothrombin transition in thrombin. Inhibition of coagulation factor Xa is manifested with a content of 200 U / mg, thrombin - 50 U / mg.
Pharmacokinetics:Bioavailability with subcutaneous injection is - 89%. The connection with plasma proteins is low. The half-life of 3.5 hours, with impaired renal function - 6 hours. Anti-Xa activity persists for 18 hours. Activity against factor IIa is negligible and reaches a maximum after 3 hours. Elimination of renal.
Indications:Prevention of deep vein thrombosis in surgical practice; treatment of deep vein thrombosis, thromboembolism; acute myocardial infarction, acute violations of the coronary circulation; preventive maintenance of coagulation of a blood at a hemodialysis.
XIV.N25-N29.N28.0 Ischemia and myocardial infarction
IX.I60-I69.I63.1 Cerebral infarction caused by embolism of precerebral arteries
IX.I60-I69.I63 Cerebral infarction
IX.I20-I25.I21.9 Acute myocardial infarction, unspecified
IX.I20-I25.I21 Acute myocardial infarction
IX.I80-I89.I82.9 Embolism and thrombosis of unspecified vein
IX.I80-I89.I82 Embolism and thrombosis of other veins
IX.I70-I79.I74.9 Embolism and thrombosis of unspecified arteries
IX.I70-I79.I74 Embolism and thrombosis of the arteries
Contraindications:Hypersensitivity, acute bacterial endocarditis, thrombocytopenia (in individuals with a positive aggregation test in vitro in the presence of the drug), bleeding (except for the syndrome of disseminated intravascular coagulation), hemorrhagic stroke, pericarditis, vasculitis, arterial hypertension, orthostatic hypotension, syncope, chorioretinopathy, exacerbation of gastric ulcer
and duodenal ulcers, severe renal / hepatic insufficiency, severe diabetes mellitus, CNS trauma, condition after spinal puncture, radiotherapy, use of intrauterine contraception, pregnancy, breast-feeding, postpartum period.
Carefully: Arterial hypertension, postural hypotension, syncope, chorioretinopathy, vasculitis, severe renal and hepatic impairment, severe diabetes mellitus
Pregnancy and lactation:Category FDA not determined.
Qualitative and well-controlled clinical trials were not conducted.Studies in animals and humans have not shown the presence of teratogenic or fetotoxic effects. However, one must take into account the potential risk when deciding to use nadroparin during pregnancy. There is no information on the penetration of breast milk, but breastfeeding with adiparapine is not recommended.
Dosing and Administration:Enter into the subcutaneous tissue of the stomach (the needle is located perpendicular to the skin fold).
With a therapeutic purpose: 2 times a day for 10 days, at a dose of 225 U / kg (100 IU / kg), which corresponds to: 45-55 kg - 0.4-0.5 ml; 55-70 kg - 0.5-0.6 ml; 70-80 kg - 0,6-0,7 ml; 80-100 kg - 0.8 ml; more than 100 kg - 0.9 ml.
For prophylaxis of thromboembolic complications in surgical practice: subcutaneously 0.3 ml for 2-4 hours before the operation and 0.3 ml once a day for the next 7 days; in orthopedic surgery: 100 units / kg (41 IU / kg) 12 hours before and 12 hours after surgery, then daily for 3 days, then 150 U / kg (61 IU / kg) for 10 days. If necessary, the injection is continued until the patient's recovery is completely restored.
Side effects:From the coagulation system of the blood: hemorrhages, thrombocytopenia are possible.
Local reactions: possible hyperemia, infiltration, soreness, hematomas at the injection site; rarely - skin necrosis.
Overdose:Symptoms: bleeding.
Treatment: intravenous antagonist - protamine sulfate (0.6 ml per 0.1 ml of calcium supraparin), symptomatic therapy.
Interaction:With simultaneous use of antiaggregants, anticoagulants of indirect action, NSAIDs (including acetylsalicylic acid), dextran potentiate antiaggregant effect, increase the risk of bleeding.
Special instructions:It is necessary before the beginning of treatment, and then (with prolonged therapy) twice a week to count the number of blood platelets. It is necessary to cancel the drug when skin necrosis occurs at the injection site. The risk of bleeding is higher for kidney failure and for women over the age of 60 years.