Low molecular weight heparin
In hematology, low molecular weight heparin (LMWH) is an anticoagulant that consists of "heparin fractions with a molecular weight usually between 4000 and 6000 kD. These low-molecular-weight fractions are effective antithrombotic agents. Their administration reduces the risk of hemorrhage, they have a longer half-life, and their platelet interactions are reduced in comparison to unfractionated heparin. They also provide an effective prophylaxis against postoperative major pulmonary embolism."[1]
| Prophylaxis dose | Full dose | Comments | |
|---|---|---|---|
| Enoxiparin (Lovenox) |
Either: 30 mg twice daily 40 mg once daily |
Either: 1 mg/kg/dose every 12 hours 1.5 mg/kg once daily more information is at Enoxaparin |
|
| Dalteparin (Framin) |
After loading, 2500 to 5000 int. units daily | 150 int. units/kg up to 18,000 int. units) once daily dosing is complicated and more information is at DailyMed |
If creatinine clearance is less then 30 mL/minute, monitor anti-Xa levels |
Oncology
Venous thromboembolism (VTE), usually as pulmonary embolism (PE) or deep vein thrombosis, is the second leading cause of death in patients with cancer. While less than 5% of cancer patients routinely receive VTE prophylaxis, for which LMWH is preferred,[2] the American Society of Clinical Oncology (ASCO),[3] the American College of Chest Physicians (ACCP),[4] and the National Comprehensive Cancer Network (NCCN)[5] have all recently issued clinical practice guidelines for the prevention and treatment of cancer-associated thrombosis. ,
References
- ↑ Anonymous (2024), Low molecular weight heparin (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Khorana AA (2009), "Cancer and Thrombosis: Implications of Published Guidelines for Clinical Practice", Annals of Oncology 20 (10): 1619-1630
- ↑ Lyman GH, Khorana AA, Falanga A, et al. American Society of Clinical Oncology guideline: recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer. J Clin Oncol 2007; 25: 5490-5505.
- ↑ Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. (8th edition). Chest 2008; 133: (6 Suppl): 381S-453S.
- ↑ NCCN Clinical Practice Guidelines in Oncology. Venous Thromboembolic Disease. http://www.nccn.org/professionals/physician_gls/PDF/vte.pdf. (1 November 2008, date last accessed)