Drug reference

parnaparin

Low molecular weight heparin (LMWH) · Anticoagulant

START

Prophylaxis: 3200–4250 IU SC once daily; DVT treatment: 6400 IU SC BID

TYPICAL MAX

~12,800 IU/day (treatment, split)

STOP IF

Major bleeding, HIT (platelets <100), or epidural haematoma

WATCH

Platelets q3 days x 14 (HIT), renal function, bleeding signs; neuraxial timing

CDSCO approvedATC B01AB07

Dose laddermg/d

Renal dose adjustmenteGFR mL/min/1.73m²

KDIGO 2024 + manufacturer label

Pharmacokineticsplasma · t hours

ONSET: 3h · SC absorption
PEAK: 3.5h · anti-Xa Cmax
t½: 6h · t½
DURATION: 1d · once-daily

EXCRETION

Renal — metabolites; some unchanged

route + CYP

INTERACTIONS

2 major

SEVERE in our sources

PREGNANCY

Acceptable when indicated; LMWH preferred over warfarin in pregnancy.

FDA category + note

Top interactionssee all 5 →

Neuraxial AnaesthesiaSevereDatabaseKimi deep-research + Cla
Other AnticoagulantsSevereDatabaseKimi deep-research + Cla

Mechanism

Heparin fragment (average ~5000 Da) that potentiates antithrombin-mediated inhibition primarily of factor Xa (anti-Xa : anti-IIa ratio ~3:1), producing anticoagulation with more predictable PK than unfractionated heparin.

Indications

Prophylaxis of venous thromboembolism (general / orthopaedic surgery)Superficial venous thrombosis / thrombophlebitisTreatment of established DVT (combination with vitamin-K antagonist initiation)

Dosing

Adult: Prophylaxis: 3,200–4,250 IU SC once daily. Treatment of DVT: 6,400 IU SC twice daily (or weight-based per local protocol).
Pediatric: Specialist (paediatric anticoagulation).
Renal adjustment: Caution in severe impairment (CrCl <30); consider unfractionated heparin or anti-Xa monitoring.
Hepatic adjustment: Caution in severe disease (bleeding risk).
Geriatric: Higher bleeding risk; assess renal function.
Max dose: Treatment regimens up to 12,800 IU/day (split BID)

Pharmacokinetics

Onset

Anticoagulation within 2–4 h (SC)

Peak effect

~3 h (anti-Xa Cmax)

Duration

~24 h

Half-life

~6 h

Bioavailability

SC ~90%

Protein binding

Not applicable

Metabolism

Hepatic depolymerisation

Excretion

Renal (metabolites; some unchanged)

Contraindications

Active major bleeding
History of heparin-induced thrombocytopenia (HIT)
Severe uncontrolled hypertension
Hypersensitivity

Side effects

Common

Injection-site haematomaBleedingMild transaminase elevationLocal pain

Serious

Major bleeding (including intracranial)
Heparin-induced thrombocytopenia (HIT, type II)
Spinal/epidural haematoma (with neuraxial procedure)
Severe hypersensitivity

Pregnancy & lactation

Pregnancy

Acceptable when indicated; LMWH preferred over warfarin in pregnancy.

Lactation

Compatible (peptide-class; not orally bioavailable).

Drug interactions

Neuraxial Anaesthesia

Severe

Database

Bleeding into spinal/epidural space

Strict timing rules; weigh risk