Usage
Ardeparin is prescribed for the prevention of deep vein thrombosis (DVT), a condition in which harmful blood clots form in the deep veins of the legs. These clots can travel to the lungs and cause pulmonary embolism (PE), a potentially life-threatening condition. Ardeparin is commonly used after major surgeries such as hip or knee replacement, and in some cases, other orthopedic and abdominal procedures. It is also used to prevent the recurrence of DVT or PE in patients with cancer undergoing chemotherapy.
Ardeparin is classified as a low molecular weight heparin (LMWH), an anticoagulant.
Ardeparin’s mechanism of action involves potentiating the activity of antithrombin III, a natural anticoagulant protein. This leads to the inactivation of clotting factors Xa and IIa (thrombin), thereby inhibiting the formation of fibrin clots.
Alternate Names
Generic Name: Ardeparin sodium
Brand Name: Normiflo (Discontinued in the US)
How It Works
Pharmacodynamics: Ardeparin primarily inhibits factor Xa, with less effect on factor IIa (thrombin). This preferential inhibition of factor Xa is responsible for its antithrombotic effect.
Pharmacokinetics: Ardeparin is administered subcutaneously and has good bioavailability. It is metabolized in the liver and the reticuloendothelial system and predominantly excreted by the kidneys. The elimination half-life for anti-factor Xa activity averages 3.3 hours following a single intravenous dose, while the elimination half-life for anti-factor IIa activity averages 1.2 hours.
Mode of Action: Ardeparin binds to antithrombin III, enhancing its ability to neutralize clotting factors, primarily factor Xa and to a lesser extent factor IIa. This prevents the conversion of prothrombin to thrombin and fibrinogen to fibrin, ultimately preventing the formation of a blood clot.
Elimination Pathways: Ardeparin is primarily eliminated through renal excretion. Hepatic metabolism plays a minor role.
Dosage
As of today’s date (February 16, 2025), Ardeparin (Normiflo) is discontinued in the US. Therefore, providing dosage information is not applicable. If the drug becomes available again, the dosage should be determined and prescribed by a doctor based on individual patient needs.
Standard Dosage
Children: Ardeparin use in children has not been well-established and should be determined by a doctor based on individual patient needs and careful monitoring only if necessary.
Special Cases: Dosing adjustments for elderly, renally impaired, or hepatically impaired patients should be carefully determined by a doctor only if necessary due to the drug being discontinued.
Clinical Use Cases
As Ardeparin is discontinued, providing dosage recommendations for specific clinical use cases is not applicable.
Dosage Adjustments
Not applicable.
Side Effects
Common Side Effects
Bleeding or bruising (including bleeding gums, nosebleeds, increased menstrual flow), pain, redness, or swelling at the injection site
Rare but Serious Side Effects
Severe bleeding (internal bleeding, coughing up blood, blood in urine or stool), allergic reactions (difficulty breathing, swelling of the face or throat), spinal or epidural hematoma (numbness, tingling, weakness in the legs or feet), heparin-induced thrombocytopenia (HIT).
Long-Term Effects
Osteoporosis with prolonged use (rare).
Adverse Drug Reactions (ADR)
Heparin-induced thrombocytopenia (HIT), severe bleeding, allergic reactions.
Contraindications
Active major bleeding, severe thrombocytopenia, hypersensitivity to ardeparin or pork products, history of heparin-induced thrombocytopenia (HIT).
Drug Interactions
Anticoagulants (warfarin, other heparins), antiplatelet agents (aspirin, clopidogrel), NSAIDs (ibuprofen, naproxen). These medications can increase the risk of bleeding.
Pregnancy and Breastfeeding
Ardeparin is pregnancy category C. Animal studies showed adverse effects at high doses, but there are no adequate and well-controlled studies in humans. It is not known if ardeparin is excreted in human milk. Caution is advised when administering ardeparin to pregnant or breastfeeding women.
Drug Profile Summary
Since Ardeparin is discontinued, a drug profile summary would not be current. Consult updated resources if and when the drug becomes available again.
Popular Combinations
Not Applicable.
Precautions
Assess for bleeding risk factors, monitor for signs of bleeding and thrombocytopenia, avoid intramuscular injections. Caution in patients with renal impairment, hepatic disease, or history of bleeding disorders.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Ardeparin?
A: Ardeparin is discontinued in the U.S. Therefore, no current dosage recommendations are available. Consult updated resources if and when it becomes available again.
Q2: How is Ardeparin administered?
A: Ardeparin is administered subcutaneously.
Q3: What are the common side effects of Ardeparin?
A: Common side effects include bleeding or bruising, pain, redness, or swelling at the injection site.
Q4: What are the serious side effects of Ardeparin?
A: Serious side effects can include severe bleeding, allergic reactions, and heparin-induced thrombocytopenia (HIT).
Q5: What are the contraindications for using Ardeparin?
A: Contraindications include active major bleeding, severe thrombocytopenia, and hypersensitivity to ardeparin or pork products.
Q6: What should be done if a dose of Ardeparin is missed?
A: Since the drug is discontinued, recommendations about a missed dose are not applicable. However, generally for anticoagulants, if a dose is missed, it is usually recommended to take it as soon as remembered unless it’s close to the time for the next dose. Never double the dose.
Q7: Can Ardeparin be used during pregnancy or breastfeeding?
A: Ardeparin is a pregnancy category C drug. Caution should be used during pregnancy and breastfeeding, and its use should be carefully evaluated by a doctor.
A: Ardeparin is metabolized in the liver and reticuloendothelial system and primarily excreted by the kidneys.
Q9: What is the mechanism of action of Ardeparin?
A: Ardeparin works by potentiating the activity of antithrombin III, which inactivates clotting factors Xa and IIa, preventing clot formation.
Q10: What other medications can interact with Ardeparin?
A: Medications that can interact with Ardeparin include other anticoagulants, antiplatelet agents, and NSAIDs, potentially increasing the risk of bleeding.
