Bemiparin
Therapeutic Indications
Bemiparin is indicated for:
Prevention of clotting in the extracorporeal circuit during haemodialysis
Irrespective of gender only Adults (18 years old or older)
For this indication, the medical literature mentions below treatments (click for details):
Treatment 1: Intra-arterial - 2500-3500 IU
Prevention of thromboembolic disease in orthopaedic surgery
Irrespective of gender only Adults (18 years old or older)
Prevention of thromboembolic disease in patients undergoing orthopaedic surgery.
For this indication, the medical literature mentions below treatments (click for details):
Treatment 1: Subcutaneous - 3500 IU
Deep vein thrombosis
Irrespective of gender only Adults (18 years old or older)
The treatment of established deep vein thrombosis, with or without pulmonary embolism, during the acute phase.
For this indication, the medical literature mentions below treatments (click for details):
Treatment 1: Subcutaneous - 5000-25000 IU
Contraindications
Active ingredient Bemiparin is contraindicated in the following cases:
Severe impairment of liver or pancreatic function
No gender/age discrimination
Acute bacterial endocarditis, slow endocarditis
No gender/age discrimination
Haemorrhage
No gender/age discrimination
Active haemorrhage or increased risk of bleeding due to impairment of haemostasis.
Locoregional anaesthesia
No gender/age discrimination
In patients receiving heparin for treatment rather than for prophylaxis, locoregional anaesthesia in elective surgical procedures is contra-indicated.
Disseminated intravascular coagulation (DIC)
No gender/age discrimination
Disseminated Intravascular Coagulation (DIC) attributable to heparin-induced thrombocytopenia.
Operations on the central nervous system, eyes and ears
No gender/age discrimination
Injuries to or operations on the central nervous system, eyes and ears within the last 2 months.
High risk of bleeding, peptic ulcer, haemorrhagic stroke, cerebral aneurysm or cerebral neoplasms
No gender/age discrimination
Any organic lesion with high risk of bleeding (e.g.: active peptic ulcer, haemorrhagic stroke, cerebral aneurysm or cerebral neoplasms).
Heparin induced thrombocytopenia
No gender/age discrimination
History of confirmed or suspected immunologically mediated heparin induced thrombocytopenia (HIT).
Occasionally a mild transient thrombocytopenia (HIT type I) at the beginning of therapy with heparin with platelet counts between 100,000/mm³ and 150,000/mm³ due to temporary platelet activation has been observed. As a general rule, no complications occur, therefore treatment can be continued.
In rare cases antibody-mediated severe thrombocytopenia (HIT type II) with platelet counts clearly below 100,000/mm³ has been observed. This effect usually occurs within 5 to 21 days after the beginning of treatment, although in patients with a history of heparin-induced thrombocytopenia this may occur sooner.
Platelet counts are recommended before administration of bemiparin, on the first day of therapy and then regularly 3 to 4 days and at the end of therapy with bemiparin. In practice, treatment must be discontinued immediately and an alternative therapy initiated if a significantly reduced platelet count is observed (30 to 50 %), associated with positive or unknown results of in-vitro tests for anti-platelet antibody in the presence of bemiparin, other LMWHs and /or heparins.