Monograph: |
Bemiparin sodium is prepared by alkaline degradation of heparin obtained from the intestinal mucosa of pigs. The majority of the components have a 2-O-sulfo-4-enepyranosuronic acid structure at the non-reducing end and a 2-N,6-O-disulfo-d-glucosamine structure at the reducing end of their chain. The average relative molecular mass is about 3600 (3000 to 4200). The degree of sulfation is about 2 per disaccharide unit.
Units
As for Low-molecular-weight Heparins.
Adverse Effects, Treatment, and Precautions
As for Low-molecular-weight Heparins.
Severe bleeding with bemiparin sodium may be reduced by the intravenous administration of protamine sulfate; 1.4 mg of protamine sulfate is stated to inhibit the effects of 100 units of bemiparin sodium.
Interactions
As for Low-molecular-weight Heparins.
Pharmacokinetics
Bemiparin sodium is rapidly absorbed after subcutaneous injection with a bioavailability of about 96%. Peak plasma activity is reached in about 2 to 4 hours, depending on the dose. The elimination half-life is about 5 to 6 hours.
Uses and Administration
Bemiparin sodium is a low-molecular-weight heparin with anticoagulant activity. It is used for the prevention and treatment of venous thromboembolism, and to prevent clotting during extracorporeal circulation.
In the prophylaxis of venous thromboembolism during general surgery with moderate risk, bemiparin sodium is given subcutaneously in a dose of 2500 units once daily, with the first dose given 2 hours before or 6 hours after surgery; in patients undergoing orthopaedic surgery with high risk of thromboembolism the dose should be 3500 units initially and then once daily. Treatment should be continued for at least 7 to 10 days and until the patient is fully ambulant. For treatment of thromboembolism, a dose of 115 units/kg is given subcutaneously once daily.
For the prevention of clotting in the extracorporeal circulation during haemodialysis, bemiparin sodium is administered into the arterial side of the dialyser in a single dose of 2500 units for patients weighing less than 60 kg and 3500 units for patients weighing more than 60 kg.
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