Drug reference

low-molecular-weight heparin

Anticoagulant

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

1 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 2 →

Heparin AntibodiesSevereTextbookG&G 14e · p715

Mechanism

Like unfractionated heparin, LMWH exerts its anticoagulant activity by activating antithrombin. With a mean molecular weight of about 5000, at least half of the pentasaccharide-containing chains of LMWH are too short to bridge thrombin to antithrombin, but they retain the capacity to accelerate factor Xa inhibition by antithrombin. Thus, LMWH catalyzes factor Xa inhibition by antithrombin more than thrombin inhibition (anti–factor Xa to anti–factor IIa ratios ranging from 2:1 to 4:1).

Side effects

Common

Bleeding

Serious

Heparin-induced thrombocytopenia (lower risk than unfractionated heparin)
Osteoporosis (lower risk than unfractionated heparin)

Drug interactions

Heparin Antibodies

Severe

Textbook

Development of heparin-induced thrombocytopenia.

LMWH should be avoided in patients with heparin-induced thrombocytopenia.

Source: G&G 14e · p715

Antiplatelet Drugs

Moderate

Textbook

Increased risk of bleeding.

Underlying causes for bleeding should be considered, such as concomitant administration of antiplatelet drugs. The text does not provide specific management guidance beyond identification of the interaction.

Source: G&G 14e · p715