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Table of Contents
COMPARISON OF FORMULARY LOW MOLECULAR WEIGHT HEPARINS
and FONDAPARINUX
| Drug |
Dalteparin
(
Fragmin®) |
Enoxaparin
(Lovenox®) |
Fondaparinux (Arixtra®) |
|
Indications & Dose
Prophylaxis of DVT/PE |
≤ 40 kg:
2500 units SC daily
> 40 kg:
5000 units SC daily
|
30mg SC Q12H (major
ortho trauma or spinal cord injury |
2.5 mg SC daily3 |
Treatment of DVT/PE
|
200 units/kg SC daily2
|
1mg/kg SC Q12H1,2
OR
1.5mg/kg SC daily1,2
|
5-10 mg SC daily3
(dependent on weight)
|
Acute Coronary
Syndrome
(ACS)
|
- |
1mg/kg SC Q12H2
|
2.5 mg SC daily3
|
|
Peak Onset (SC)
|
4 hours |
3 hours |
2 hours |
|
Anti Xa:lla Ratio
|
2-2.7:1 |
2.7-4.1:1 |
Pure Anti-Xa |
|
Plasma Half-Life
(anti-Xa activity)
|
2-2.3 hours |
3.5-4.2 hours |
17-21 hours
|
|
Elimination
|
renal |
renal |
renal |
|
When to Hold SC Dose Prior to Surgery |
Q24H Treatment dose:
at least 24 hrs4,5
Prophylaxis: at least 12 hrs |
Q12H Treatment dose:
at least 12 hrs4,5
Prophylaxis: at least 12 hrs |
Treatment dose:
at least 48 hrs
Prophylaxis: at least 24 hrs |
1
non-formulary indication at
Vancouver Acute
2
the manufacturer recommends a
maximum dose of dalteparin 18,000 units/day and enoxaparin 1
80 mg/day or 100 mg Q12H; however, dosage should be individualized and
higher dosages may
be administered for obese patients
3
formulary for unstable angina/non-ST elevation myocardial infarction, and
patients with HIT
4
for Q24H treatment dose, Chest
2008 recommends give only 50% of daily dose 24hr preop
5
for Q12H treatment dose, Chest
2008 recommends omit last dose 12 hours preop
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