Overview
Bemiparin sodium is a low molecular weight heparin (LMWH) anticoagulant used for prevention and treatment of thromboembolic disorders. It exhibits antithrombotic properties by enhancing the inhibition of factor Xa and thrombin through antithrombin III.
Mechanism of Action
Binds to antithrombin III, accelerating its inhibition of activated coagulation factors, particularly factor Xa and thrombin (factor IIa). Has higher anti-Xa to anti-IIa activity ratio (approximately 8:1) than unfractionated heparin.
Indications
- Prophylaxis of venous thromboembolism in surgical patients
- Treatment of deep vein thrombosis
- Prevention of clotting in extracorporeal circulation during hemodialysis
Dosage
Dosage varies by indication: Surgical prophylaxis: 2,500 IU SC once daily starting 2 hours preoperatively; Treatment of DVT: 115 IU/kg SC once daily; Hemodialysis: 2,500-5,000 IU IV bolus. Adjust based on renal function and monitoring.
Contraindications
- Active major bleeding
- Severe thrombocytopenia with positive in vitro tests for antiplatelet antibodies
- Hypersensitivity to bemiparin, heparin, or pork products
- History of heparin-induced thrombocytopenia (HIT)
Side Effects
- Bleeding complications
- Injection site reactions
- Thrombocytopenia
- Elevated liver enzymes
- Allergic reactions
- Osteoporosis with long-term use
Interactions
- Other anticoagulants (increased bleeding risk)
- Antiplatelet agents
- NSAIDs
- Thrombolytics
- Herbal supplements with anticoagulant properties (ginger, ginkgo, garlic)