Danaparoid (Orgaran) (Last Updated - 3/10/2005)
-non-heparin glycosaminoglycan anti-coagulant
-composed of:
A) 84% heparan sulfate
B) 12% dermatan sulfate
C) 4% chondroitin sulfate
-Mechanism:
-promotes inhibition of Factor Xa by anti-thrombin (but to lesser extent than does Heparin)
-has less sulfate groups than Heparin to bind anti-thrombin
-Uses (Approved For):
1) DVT Prophylaxis
2) Anti-coagulation in pts. w/ Heparin-Induced Thrombocytopenia (HIT) --> low cross-reactivity w/ Heparin
-Advantages:
A) NO need for routine lab monitoring --> does not prolong aPTT or PT at recommended doses
 -same mechanism as Heparin but works to a lesser degree
B) weight-adjusted dosing available
-Admin:
-given sub-Q either:
A) 750 units BID --> Prophylaxis
or
B) Weight-adjusted --> higher doses for full anti-coagulation
-1/2-Life:
~24 hrs.
-Cautions:
-ESRD --> prolongs 1/2-life --> monitor anti-factor Xa assay in these pts.
-NO antidote
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References:
Goodman & Gilman's: The Pharmacologic Basis Of Therapeutics - 10th Edition - 2001. Chapter 55.