Drug Guide
Danaparoid Sodium
Classification
Therapeutic: Anticoagulant
Pharmacological: Heparinoid
FDA Approved Indications
- Prevention of deep vein thrombosis in postoperative patients with limited mobility
- Treatment of deep vein thrombosis and pulmonary embolism in patients with heparin-induced thrombocytopenia (HIT)
Mechanism of Action
Danaparoid inhibits factor Xa and to a lesser extent factor IIa (thrombin), reducing clot formation by enhancing antithrombin III activity.
Dosage and Administration
Adult: Typically 2500-5000 units subcutaneously once daily, adjusted based on patient response and weight.
Pediatric: Limited data; use cautiously and under specialist supervision.
Geriatric: Same as adults; caution due to potential renal impairment.
Renal Impairment: Adjust dose based on renal function; dose reduction may be necessary.
Hepatic Impairment: Use with caution; no specific dosage adjustment established.
Pharmacokinetics
Absorption: Poor oral absorption; administered parenterally.
Distribution: Widely distributed; minimal binding to plasma proteins.
Metabolism: Metabolized enzymatically in tissues; minimal hepatic metabolism.
Excretion: Renally excreted; accumulation can occur in renal impairment.
Half Life: Approximately 24 hours in healthy individuals.
Contraindications
- Active major bleeding
- History of hypersensitivity to danaparoid or other heparinoids
Precautions
- Monitor for bleeding complications, especially in patients with bleeding disorders or on concomitant anticoagulants.
- Use with caution in patients undergoing invasive procedures.
- Increased risk of bleeding in elderly and in patients with renal impairment.
Adverse Reactions - Common
- Bleeding, including minor and major hemorrhage (Common)
- Local injection site reactions (pain, erythema) (Common)
Adverse Reactions - Serious
- Heparin-induced thrombocytopenia (HIT) (Rare)
- Anaphylactic reactions (Rare)
Drug-Drug Interactions
- Other anticoagulants (e.g., heparin, warfarin, direct oral anticoagulants)
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor coagulation parameters (aPTT, anti-Xa activity), platelet counts, and signs of bleeding.
Diagnoses:
- Risk for bleeding
- Impaired tissue perfusion related to bleeding
Implementation: Administer doses as prescribed, monitor for adverse effects, and educate patient on bleeding precautions.
Evaluation: Assess for signs of bleeding, coagulation status, and efficacy of anticoagulation therapy.
Patient/Family Teaching
- Report unusual bleeding or bruising immediately.
- Inform about the importance of regular blood tests.
- Advise to avoid activities that increase bleeding risk.
Special Considerations
Black Box Warnings:
- Potential for bleeding complications.
- Use caution in patients with renal impairment.
Genetic Factors: None specified.
Lab Test Interference: May alter coagulation tests; interpret with caution.
Overdose Management
Signs/Symptoms: Excessive bleeding, hematomas, hypotension, shock.
Treatment: Discontinue drug immediately, apply pressure to bleeding sites, and provide supportive care. In severe cases, administer protamine sulfate if appropriate and available.
Storage and Handling
Storage: Store at room temperature, away from direct light.
Stability: Stable for the duration specified by the manufacturer; check the packaging for expiry date.