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.