Fraxiparine in Latin. Medicinal reference book geotar

Self-medication can be harmful to your health.
You should consult your doctor and read the instructions before use.

Fraxiparine: instructions for use

Compound

1 ml of solution contains fragmented elements of heparin glycosaminoglycan in an amount of 25000 U antiXaIC, which corresponds to 10250 UI antiXa (international units). Solution for subcutaneous administration: in pre-filled syringes with a single dose of 0.2 ml, 10 pieces per package; in pre-filled syringes with a single dose of 0.3 ml, 2 and 10 pieces per package; in pre-filled syringes with a single dose of 0.4 ml, 10 pieces per package: in pre-filled syringes (graduated) with a dose of 0.6 ml or 0.8 ml, 2 and 10 pieces per package; in pre-filled syringes - (graduated) with a dose of 1 ml, 10 pieces per package.

pharmachologic effect

Fraxiparin is a low molecular weight heparin obtained from standard heparin by depolymerization under special conditions. The drug is characterized by pronounced activity against factor Xa and weak activity against factor Na. The anti-Xa activity (i.e., antiplatelet activity) of Fraxiparine is more pronounced than its effect on activated partial thromboplastin time (aPTT), which distinguishes Fraxiparine from unfractionated standard heparin. Thus, Fraxiparine has antithrombotic activity and has a rapid and long-lasting effect.

Pharmacokinetics

The maximum concentration is reached 3 hours after administration of the drug. The half-life is 3.5 hours. Anti-Xa activity appears within 18 hours after administration of the drug. Activity against factor Ha is negligible and reaches its maximum after approximately 3 hours. 98% of the drug is present in the blood biologically active form.

Indications for use

Prevention of thromboembolic disease, primarily in orthopedic and surgical practice, treatment of already formed deep venous thrombosis. Prevention of coagulation in extracorporeal circulation during hemodialysis.

Contraindications

Hypersensitivity, acute bacterial endocarditis, thrombocytopenia (in persons with positive test aggregation in vitro in the presence of the drug), bleeding (except for DIC syndrome), hemorrhagic stroke, pericarditis, vasculitis, arterial hypertension, orthostatic hypotension, fainting states, chorioretinopathy, exacerbation peptic ulcer stomach and duodenum, severe renal/liver failure, severe diabetes, CNS injuries, condition after spinal tap, holding radiation therapy, use of IUD, pregnancy, lactation, postpartum period.

Directions for use and doses

The injection is carried out in subcutaneous tissue belly. The needle is inserted perpendicularly into the thickness of the skin fold formed between the thumb and index finger. The fold should be maintained throughout the entire insertion period. 1 unit (V) of antiXa fraxiparine corresponds to 0.41 international unit (VI) of antiXa;

Preventive treatment of thromboembolic disease. general surgery: prevention is based on a single daily dose of Fraxiparine 0.3 ml. A dose of 0.3 ml is administered 2-4 hours before surgery. The total duration of treatment is at least 7 days. It is recommended to carry out prophylaxis during the entire risk period, until full recovery motor activity patient.
Orthopedic surgery: the dose of the drug is selected depending on the patient’s body weight. The drug is administered once a day daily in the following doses: For patients weighing less than 50 kg: in preoperative period and within 3 days after surgery - 0.2 ml; V postoperative period(starting from the 4th day) - 0.3 ml. For patients weighing from 51 to 70 kg: in the preoperative period and within 3 days after surgery - 0.3 ml; in the postoperative period (starting from the 4th day) - 0.4 ml. For patients weighing from 71 to 95 kg: in the preoperative period and within 3 days after surgery - 0.4 ml; in the postoperative period (starting from the 4th day) - 0.6 ml. The course is at least 10 days.

Therapeutic use: Prevention of coagulation during hemodialysis: in patients without the risk of bleeding and in a session not exceeding 4 hours, at the beginning of the session, inject a single dose into the arterial line: - Patients weighing less than 50 kg: 0.3 ml - Patients weighing more than 51 to 70 kg: 0.4 ml - Patients with body weight above 71 kg: 0.6 ml If necessary, the dose will be more precisely selected depending on each individual case and on technical specifications dialysis. In patients with hemorrhagic risk, it will be possible to conduct a dialysis session using doses reduced by half. Fraxiparine replaces traditional heparin therapy, carried out while awaiting the results of venography. Fraxiparine is administered every 12 hours for 10 days. The dose of the drug depends on the patient’s body weight: with a body weight of 45 kg - 0.4 ml; 55 kg-0.5 ml; 70 kg-0.6 ml; 80 kg-0.7 ml; 90 kg-0.8 ml; 100 kg or more - 0.9 ml.

Side effect

Hemorrhages, allergic reactions; rarely - thrombocytopenia, small hematomas and skin necrosis at the injection site.

Overdose

Symptoms: increased bleeding. Treatment: slow intravenous administration protamine sulfate or hydrochloride (0.6 ml of protamine is neutralized by about 0.1 ml of Fraxiparine).

Interaction with other drugs

Fraxiparine may potentiate the effect of the following: medicines non-steroidal anti-inflammatory drugs; acetylsalicylic acid and preparations containing it; platelet antiplatelet agents, dextran, anticoagulants are not direct action.

Features of application

If skin necrosis occurs at the injection site, you should immediately stop using Fraxiparine. Recommended special care in case of renal or liver failure, a history of stomach ulcers or any other organic damage which may bleed, or vascular disease retina and choroid. It is necessary to carry out a quantitative platelet analysis before starting treatment and then 2 times a week.

Fraxiparine is a direct-acting anticoagulant that has an antithrombotic effect. Active ingredient: Nadroparin calcium.

Main active substance represents low molecular weight heparin(NMG). It is obtained by depolymerization from standard heparin and is a glycosaminoglycan with an average molecular weight of 4,300 daltons.

Fraxiparine exhibits a high ability to bind to the blood plasma protein antithrombin III (AT III). This binding leads to accelerated inhibition of factor Xa, which accounts for the high antithrombotic potential of nadroparin.

Nadroparin calcium is characterized by higher anti-Xa factor activity compared to anti-IIa factor or antithrombotic activity and has both immediate and prolonged antithrombotic activity.

In prophylactic doses, nadroparin does not cause a significant decrease in aPTT.

At course treatment during the period of maximum activity, the aPTT may increase to a value 1.4 times higher than the standard. This prolongation reflects a residual antithrombotic effect.

Indications for use

What does Fraxiparine help with? According to the instructions, the drug is prescribed in the following cases:

• prevention of thromboembolic complications during general or orthopedic surgical interventions;
• in patients with high risk thromboembolic complications (respiratory failure and/or infectious diseases respiratory tract, and/or heart failure) hospitalized in the department intensive care; treatment of thromboembolic complications;
• prevention of blood clotting during hemodialysis; treatment unstable angina and myocardial infarction without a pathological Q wave on the ECG.

Instructions for use Fraxiparine, dosage

When administered subcutaneously, the drug is preferably administered with the patient lying down, into the subcutaneous tissue of the anterolateral or posterolateral surface of the abdomen, alternately from the right and left sides. Injection into the thigh is allowed.

To avoid loss of the drug when using syringes, do not remove air bubbles before injection.

The needle should be inserted perpendicularly, and not at an angle, into the pinched fold of skin formed between the large and index fingers. The fold should be maintained throughout the entire period of drug administration. Do not rub the injection site after injection.

• For the prevention of thromboembolism in general surgical practice, the recommended dose of Fraxiparine is 0.3 ml (2850 anti-Xa ME) s.c. The drug is administered 2-4 hours before surgery, then once a day. Treatment is continued for at least 7 days or throughout the entire period increased risk thrombus formation, before transferring the patient to outpatient treatment.
• To prevent thromboembolism during orthopedic operations, Fraxiparine is administered subcutaneously at a dose determined depending on the patient’s body weight at the rate of 38 anti-Xa IU/kg, which can be increased to 50% on the 4th postoperative day. The initial dose is prescribed 12 hours before surgery, the 2nd dose is prescribed 12 hours after the end of the operation. Further, Fraxiparine continues to be used once a day throughout the entire period of increased risk of thrombosis until the patient is transferred to an outpatient regimen. The minimum duration of therapy is 10 days.
• For patients with a high risk of thrombosis (usually those in intensive care units / respiratory failure and / or respiratory tract infection and / or heart failure /), Fraxiparine is prescribed subcutaneously 1 time per day at a dose determined depending on body weight patient. Used throughout the entire period of risk of thrombosis.
• In the treatment of unstable angina and myocardial infarction without a Q wave, subcutaneous injection is prescribed 2 times a day (every 12 hours). The duration of treatment is usually 6 days. IN clinical studies patients with unstable angina/non-Q wave myocardial infarction were prescribed Fraxiparine in combination with acetylsalicylic acid at a dose of 325 mg/day. The instructions for use recommend that the initial dose be administered as a single intravenous bolus injection, subsequent doses should be administered subcutaneously. The dose is set depending on body weight at the rate of 86 anti-Xa IU/kg.
• In the treatment of thromboembolism oral anticoagulants(in the absence of contraindications) should be prescribed as early as possible. Therapy is not stopped until the target values ​​of prothrombin time are achieved. The drug is prescribed subcutaneously 2 times a day (every 12 hours), the usual course duration is 10 days. The dose depends on the patient’s body weight at the rate of 86 anti-Xa IU/kg body weight.

special instructions

Do not administer the drug intramuscularly!

In patients with increased risk bleeding, you can use half the recommended dose of the drug.

If the dialysis session lasts longer than 4 hours, additional small dosages of the drug may be administered.

In elderly patients, no dose adjustment is required (except for patients with impaired renal function). Before starting treatment with Fraxiparine, it is recommended to monitor renal function indicators.

In patients with mild or medium degree severity (creatinine clearance ≥ 30 ml/min and< 60 мл/мин) для профилактики тромбообразования снижения дозы не требуется, у пациентов с почечной недостаточностью тяжелой степени (КК < 30 мл/мин) дозу следует снизить на 25%.

In patients with mild to moderate renal failure, for the treatment of thromboembolism or for the prevention of thromboembolism in patients with a high risk of thrombus formation (with unstable angina and non-Q wave myocardial infarction), the dose should be reduced by 25%; in patients with severe renal failure, the drug is contraindicated.

Signs of the development of necrosis in the area of ​​injection of the solution are usually purpura, a painful erythematous or infiltrated spot (including general symptoms). If they appear, you should stop using Fraxiparine immediately.

Side effects

The instruction warns about the possibility of developing the following side effects when prescribing Fraxiparine:

• Hematopoietic system: thrombocytopenia, eosinophilia, reversible after cessation of therapy.
• Immune system: hypersensitivity reactions ( skin reactions, Quincke's edema).
• Hepatobiliary system: transient increase in the level of activity of liver transaminases.
• Blood coagulation system: bleeding of various locations.
• Local reactions: dense nodules, subcutaneous hematoma or skin necrosis at the injection site. The development of necrosis is usually preceded by purpura or a painful or infiltrated erythematous patch.
• Other: reversible hyperglycemia, priapism.

Contraindications

It is contraindicated to prescribe Fraxiparine in the following cases:

• thrombocytopenia (including in cases where it was observed previously);
• organic lesion internal organs with an increased risk of bleeding (for example, stomach ulcers or ulcerative colitis);
• increased risk of bleeding in various conditions;
• signs of beginning bleeding;
• intracranial hemorrhage;
• head injuries;
• surgery performed on the brain;
• some heavy operations before our eyes;
• endocarditis;
• severe renal and liver failure;
• intolerance to nadroparin calcium.

The drug can be prescribed with caution for the following diseases:

• light and medium shape hepatic and renal failure;
• severe arterial hypertension;
• peptic ulcer;
• risk of bleeding;
• circulatory disorders in choroid eye or retina;
• rehabilitation period after head surgery;
• rehabilitation period after eye surgery;
• lack of weight, dystrophy (less than 40 kg);
• simultaneous use of drugs that increase the risk of bleeding;

special instructions

Due to the existing risk of heparin-induced thrombocytopenia, the platelet count should be monitored during the entire course of treatment with nadroparin.

Reported isolated cases severe thrombocytopenia accompanied by arterial or venous thrombosis. Such a diagnosis can be assumed in the following situations: thrombocytopenia; any significant decrease in platelet count (30 to 50% compared to baseline); negative dynamics of thrombosis for which treatment is prescribed; the appearance of thrombosis during treatment; ICE.

If these conditions occur, treatment with nadroparin should be discontinued.

The above-mentioned effects are of an immunoallergic nature, if treatment is carried out for the first time, and occur between the 5th and 21st day of treatment, but may occur much earlier if the patient has a history of thrombocytopenia associated with heparin treatment.

In patients with a history of thrombocytopenia that occurred during treatment with heparin (both standard and low molecular weight), treatment with nadroparin can be prescribed if necessary. In this case, careful clinical observation and platelet count determination daily. If thrombocytopenia occurs, treatment with nadroparin should be discontinued immediately.

If thrombocytopenia occurs during treatment with heparin (both standard and low molecular weight), it must be discontinued and treatment with another class of antithrombotic agents must be continued. If such a drug is not available, another low molecular weight heparin drug can be used if the use of heparin is necessary.

The platelet count should be monitored at least once a day and treatment should be stopped as soon as possible if the initial thrombocytopenia persists even after changing the drug.

The in vitro platelet aggregation test has limited value to establish the diagnosis of heparin-induced thrombocytopenia.

Overdose

Symptoms of overdose are bleeding, abnormal platelet counts and other parameters of the blood coagulation system.

In case of minor bleeding, it is sufficient to reduce the next dose of Fraxiparine or delay its administration. Special therapy is required in severe cases.

Protamine sulfate has a pronounced neutralizing effect on the anticoagulant effect of heparin. When calculating the dose of the antidote, it should be taken into account that to neutralize 950 IU of anti-Xa nadroparin, 0.6 ml of protamine sulfate is needed.

It is possible to reduce the dose of the antidote if the a long period after an overdose.

Drug interactions

The drug is not recommended to be prescribed simultaneously with other anticoagulants, as this increases the risk of bleeding. For the same reason, the drug is not prescribed to the patient simultaneously with NSAIDs and acetylsalicylic acid (aspirin).

Particular care should be taken when prescribing Fraxiparine to a patient simultaneously with antiplatelet agents and antipyretics - drug interactions increases the risk of side effects and bleeding.

During treatment with drugs from the group of glucocorticosteroids, care should be taken when prescribing, as there is a high risk of developing severe side effects.

Analogues of Fraxiparine, price in pharmacies

If necessary, you can replace Fraxiparine with an analogue of the active substance - these are the following drugs:

1. Fraxiparine Forte,
2. Athenative,
3. Fragmin,
4. Heparin,
5. Enoxarin,
6. Flenox.

When choosing analogues, it is important to understand that the instructions for use of Fraxiparine, price and reviews of the drugs similar action do not apply. It is important to consult a doctor and not change the drug yourself.

Price in Russian pharmacies: Fraxiparine solution 0.4 ml - from 278 rubles, 9500 ANTI-HA IU/ml 0.3 ml 10 single-dose syringes - from 2437 to 2621 rubles, solution 0.4 ml 10 pcs. – from 2792 to 3127 rubles.

Store at temperatures up to 30 °C, do not allow freezing. Shelf life – 3 years. Dispensing conditions from pharmacies are by prescription.

As a rule, no pregnancy is complete without the use of medications. Expectant mothers often worry about this, especially when the doctor prescribes serious medications, the instructions for which clearly state: “cannot be used during pregnancy.” One of these drugs is Fraxiparine. Currently, scientists do not have detailed information about the influence active substance of this medicine to the fetus, therefore, before prescribing Fraxiparine to the expectant mother, the doctor must make sure that the potential benefit from it will exceed possible danger for a child.

Fraxiparin, which is a low molecular weight heparin, has a direct effect on hemostasis human body– lowers it. Hemostasis is the ability of blood to clot. Nature endowed people with this protective device so that they have a chance to survive in the most dangerous and unforeseen situations. For a pregnant woman, hemostasis indicators have great importance: the slightest excess of the norm poses a serious danger to the intrauterine life of the fetus. That is why doctors, regularly monitoring fluctuations in hemostasis indicators in female body, at the first need, Fraxiparine is prescribed and they are brought back to normal.

What you need to know about Fraxiparine

Medicine in the form of a solution for subcutaneous administration contained in a disposable syringe. There is no other form of the drug, such as tablets. There are several dosages of the drug: Fraxiparine 0.3 ml, 0.4 ml, 0.6 ml, 0.8 ml, 1 ml, as well as Fraxiparine Forte.

The active component of the drug is calcium nadroparin. This substance quickly and effectively binds proteins in the blood plasma, which prevents the unwanted formation of blood clots. Moreover, Fraxiparine thins the blood, suppressing its clotting properties, and prevents blood plasma platelets from sticking together.

The use of Fraxiparine among expectant mothers is practiced in exceptional cases - when the situation becomes critical and threatens the pregnant woman with irreversible complications in the form premature birth, miscarriage or intrauterine death of the baby. Exactly to such dire consequences increased blood coagulation may result if this is not corrected in time pathological condition. Some pregnant women are forced to undergo treatment with Fraxiparine throughout the entire nine months of expecting a child. This is vital if in the past such patients have lost babies due to pathological disorder blood clotting.

You can buy Fraxiparine in a pharmacy only with a prescription. The shelf life of the drug is 3 years. Syringes should be kept where children cannot reach, at a temperature of no more than 30 0 C.

Hemostasiologists are confident that in situations of urgent need long-term use Fraxiparine injections will not harm a pregnant woman, while refusal of the medicine for at least one day can result in the death of the fetus. Then why do the instructions for the drug recommend that pregnant women refrain from using it? The question about the safety of this drug for the expectant mother remains open today.

Doctors who are supporters of Fraxiparine are confident that modern drug completely harmless for mother and her baby. Others doubt this, since studies on the possible teratogenic effect of Fraxiparine on pregnant women have not been conducted. Be that as it may, but early stages This medicine is not prescribed for an “interesting” situation. Treatment and prevention with its help are carried out starting from the second and third trimesters, provided that the expectant mother does not have any contraindications.

If you familiarize yourself in detail with the physiology of pregnancy, then questions about the relevance of Fraxiparine during this period do not arise. During the 9 months of bearing the baby, the placenta is formed and constantly grows, which protects it. Every day more and more blood vessels and capillaries appear in this membrane, feeding the fetus. If for some reason hemostasis increases, blood clots will form in the placenta, which will cause chronic oxygen starvation child.

On later During pregnancy, the uterus descends and puts strong pressure on the pelvis, squeezing the veins in this area. As a result, the outflow of blood from the veins lower limbs significantly worsens, which is a prerequisite for the formation of blood clots. This condition threatens the pregnant woman with a serious complication called thromboembolism. pulmonary artery. Violation can cause the death of a woman and her child.

To summarize, we note that Fraxiparine, with all its nuances, which are mentioned in the instructions for the drug, is still used during pregnancy, but the possibility of its use is carefully analyzed by the doctor in each specific case.

When does a pregnant woman need Fraxiparine?

Fraxiparine is prescribed during pregnancy in several cases:

• to prevent increased blood clotting, which can cause blood clots;
• to prevent the formation of blood clots during surgical intervention;
• during the treatment of myocardial infarction and unstable angina;
• during the treatment of thromboembolism;
• to prevent the development of complications of thromboembolism.

Fraxiparine during pregnancy. Contraindications and side effects

The instructions for Fraxiparine warn that the potent drug has certain contraindications and side effects. The drug is not recommended for use in patients with the following conditions:

• extremely high sensitivity to the active substance Fraxiparine;
• coagulopathy – poor clotting blood in the presence of bleeding;
• absence positive results treatment with antiplatelet drugs: Aspirin Cardio, Cardiomagnyl, Aspecard;
• infection of the heart valve apparatus (endocarditis);
• the appearance of thrombocytopenia after using nadroparin calcium in the past;
• cerebrovascular disease.

Among the possible side effects after using Fraxiparine, we note:

• rash and itching in the injection area;
• hives;
• Quincke's edema;
• anaphylactic shock - in exceptional cases.

And this is a list of factors in the presence of which Fraxiparine is prescribed to pregnant women with great caution:

• liver and kidney dysfunction;
• poor circulation in the area of ​​the eyeballs;
• high blood pressure;
• frequent work disorders gastrointestinal tract before pregnancy.

An overdose of the drug significantly increases the risk of severe bleeding.

Use of Fraxiparine during pregnancy

Treatment of the expectant mother with this drug is possible only after she has passed a blood clotting test. Further use of Fraxiparine is carried out exclusively under the supervision of the attending physician. The dosage and duration of treatment for each pregnant patient is individual.

The drug in the form of a clear, colorless solution is placed in a disposable syringe with a thin needle for hypodermic injection. The instructions for using Fraxiparine say that injections of the drug are given in the stomach, in the area above the navel. Practice shows that injection treatment in most cases it is easily tolerated by pregnant women. Only some people experience nausea and general malaise. If the patient is facing a long course of treatment, she can give herself injections of the drug herself.

How to inject Fraxiparine into the stomach

Of course, at first it is very difficult for a pregnant woman to imagine how she will cope with such a responsible and, to be honest, terrible task - a hypodermic injection. But if there is no one else to do this, and, of course, you cannot refuse treatment, you can master such a skill, especially since there is nothing complicated about subcutaneous injections.

Now we will explain step by step how to inject Fraxiparine:

1. Take the syringe and place it vertically (needle up), and then, gently and slowly pressing on the plunger, squeeze the air out of the syringe. The signal to stop will be the appearance of a small drop of solution at the tip of the needle.
2. Lie on your back on a flat, hard surface. Your “working” area is the area around the navel at a distance of 1–2 cm. Disinfect the site of the future injection with a solution containing alcohol.
3. Grab the fold of skin with two fingers of one hand, and with the other, insert the needle there at a right angle (the needle should be perpendicular to the fold).
4. Gently press the plunger and slowly inject the medicine under the skin, then remove the needle and disinfect the injection site.

A slight swelling may soon form in the injection area - this is normal and should not bother the expectant mother.

Fraxiparine: drug analogues

Domestic and foreign pharmaceutical industry offers a range of Fraxiparine analogues. They all belong to the same subgroup and also have a similar mechanism of influence on the body. The most well-known are the following drugs:

• Tsibor 2500 and Tsibor 3500 (injections for subcutaneous administration);
• Clexane (injections for subcutaneous administration);
• Heparin and Heparin sodium (injections for subcutaneous and intravenous administration);
• Flagmin (injections for subcutaneous and intravenous administration).

Of course, women, in an effort to get to the bottom of things, ask their doctor a lot of questions. For example, which drug is safer and more effective - Fraxiparine or Clexane? We recommend that you completely rely on the decision of a specialist in such an important matter. The fact is that Fraxiparine and Clexane (like Cibor, Flagmin, etc.), being analogues, have similar indications for use and act on the same principle. And since special research have not been carried out to find out the advantages of one drug over another, the most correct thing that can be done is future mom– is to trust your doctor. A competent specialist, having analyzed clinical picture diseases and general state pregnant woman, will prescribe adequate treatment based on her own experience.

On the virtual network you can find many reviews about Fraxiparine. In truth, some of them are more negative than satisfactory. What dictates such assessments? Some women are concerned about hematomas that appear at the site of drug injections. However, this phenomenon is a consequence of incorrect injection technique, nothing more. In this case, you need to ask the doctor to explain in detail again and show how to handle the medicine in a syringe. Having learned to inject Fraxiparine into the stomach correctly, you will never encounter unpleasant consequences in the form of bruises and hemorrhages.

Other expectant mothers are more concerned about financial issues, because such treatment is not cheap. Thus, the price of Fraxiparine 0.3 ranges from 300 rubles. for 1 syringe up to 2600 - 3000 rubles. for 1 package containing 10 syringes. However, women who have previously experienced repeated miscarriages reasonably note that the joy of motherhood is priceless and they are willing to pay any money for the chance to safely carry a healthy baby. Moreover, in the vast majority of cases, it is possible to get by with only 3 to 5 injections of Fraxiparine. In addition, you can always ask your doctor to select a more affordable analogue of this drug.

Otherwise, the drug, according to pregnant women, is well tolerated. After the injection, many expectant mothers feel a slight burning or itching. However, minor side effects can be easily dealt with if you always think that the life and health of the long-awaited baby is at stake.

How to give a subcutaneous injection correctly. Video

Thromboembolism is one of the severe and dangerous diseases encountered in medical practice.

As a result of blockage of a vessel by a thrombus, the patient may experience ischemia or myocardial infarction, and these conditions often lead to disability or death.

Currently, doctors use many modern drugs to treat this pathology.

One of them is Fraxiparine. You can read reviews about the drug at the bottom of the article, and also add your own impressions to them.

Instructions for use on Fraxiparine

Fraxiparine is a French modern drug that is manufactured at the pharmaceutical enterprise Aspen Pharma Trading Limited.

Compound

Basic active ingredient– nadroparin calcium.

Release form

The medicine is available in the form of a solution for p/v. The solution is collected in disposable syringes and is completely ready for use.

Packages differ in the number of syringes and dosage:

• disposable syringes with a volume of 0.3 ml with a solution of nadroparin calcium with a dosage of 2850 IU;
• disposable syringes with a volume of 0.4 ml with a solution of nadroparin calcium with a dosage of 3800 IU;
• 0.6 ml syringes with a solution dosage of 5700 IU;
• syringes of increased volume 0.8 ml with a dosage of 7600 IU.

pharmachologic effect

Fraxiparine is a direct anticoagulant and is a low molecular weight heparin that is obtained in the laboratory from regular heparin.

The drug has a high antithrombotic effect. It is characterized by low activity against the AP factor and high activity against blood clotting.

Unlike unfractionated heparin, calcium nadroparin has high antiplatelet activity and little effect on thromboplastin time. It has a rapid and prolonged effect and prevents the formation of blood clots. ,

Low doses of nadroparin do not lead to a significant decrease in prothrombin time, so the medicine can be taken not only for treatment, but also for prevention.

Indications for use

Fraxiparine is prescribed in the presence of the following conditions and diseases:

• thromboembolism (acute blockage by a blood clot) blood vessel) any type and severity;
• unstable angina;
• myocardial infarction without scar Q (for the treatment and prevention of subsequent attacks);
• suspicion of blood clotting (for example, during hemodialysis);
• surgical and orthopedic interventions performed on patients with cardiac or respiratory failure(for the prevention of thromboembolic complications).

Mode of application

The duration of therapy and dosage are selected by the doctor based on the characteristics of the disease, its duration and severity.

Approximate treatment regimens

1. To prevent thromboembolic complications during surgery, the patient is administered 0.3 ml of Fraxiparine solution 2-3 hours before surgery. Treatment is continued for another 7 days under the supervision of a doctor, administering the solution once a day.
2. After orthopedic surgery, it is possible to increase the dosage on day 4 to 5700 IU. The initial dose can also be changed according to medical indications and selected at the rate of 38 IU per kilogram of patient weight. In this case, the first injection is carried out twelve hours before surgery, and the second twelve hours after surgery. Course duration postoperative treatment- one week.
3. For the treatment of unstable angina, Fraxiparine is prescribed to be administered 2 times a day every twelve hours. The same regimen is prescribed for patients with myocardial infarction. The course of treatment is six days. The solution is administered at 325 mg. Patients are simultaneously prescribed a course of acetylsalicylic acid.
4. For the treatment of thromboembolism, the drug is prescribed to be administered 2 times a day every twelve hours. The dosage is selected at the rate of 86 IU per kilogram. The course of treatment is 6-7 days.

Technique of drug administration

When administering the solution, care should be taken:

• it is recommended to administer the solution in a lying position;
• the needle is inserted into the posterolateral or anterolateral region of the abdomen alternately on each side (the first injection in one part, the second in the other, etc.);
• By special instructions vision of the medicine into the thigh is allowed;
• the needle is inserted perpendicularly, the site after the injection is not rubbed.

special instructions

1. Old age is not an indication for changing the initial and subsequent dosage;
2. Patients with renal failure are advised to consult a urologist, have their kidney function checked and urinary tract before the start of therapy and after its completion. At mild form renal failure, no dosage change is required. For patients with a moderate form of the disease, it is advisable to reduce it by 25%.

Treatment with medication is carried out strictly under the supervision of the attending physician! The solution must be administered in a medical facility.

Interaction with other drugs

1. Potassium salts, NSAIDs, cyclosporine, trimethoprim and potassium-sparing diuretics increase the risk of hyperkalemia.
2. Fraxiparine may reduce the effect of NSAIDs and vitamin K antagonists.
3. Clopidogrel, Tirofiban, Ticlopidine, Beraprost, Iloprost increase the risk of bleeding.

Precautionary measures

Be sure to pay attention to contraindications and possible side effects.

Side effects

As a rule, Fraxiparine injections are well tolerated by patients, but in some cases the following adverse reactions may occur:

Contraindications

A drug forbidden use if available the following diseases or states:

• thrombocytopenia (including in cases where it was observed previously);
• organic damage to internal organs with an increased risk of bleeding (for example, stomach ulcers or ulcerative colitis);
• increased risk of bleeding in various conditions;
• signs of beginning bleeding;
• intracranial hemorrhage;
• head injuries;
• surgery performed on the brain;
• some major eye surgeries;
• severe renal and liver failure;
• intolerance to nadroparin calcium.

Carefully the drug can be prescribed for the following diseases:

• mild and moderate forms of liver and kidney failure;
• severe arterial hypertension;
• peptic ulcer;
• risk of bleeding;
• circulatory disorders in the choroid of the eyes or retina;
• rehabilitation period after head surgery;
• rehabilitation period after eye surgery;
• lack of weight, dystrophy (less than 40 kg);
• simultaneous use of drugs that increase the risk of bleeding;

Don't forget to tell your doctor about any concomitant chronic pathologies before starting Fraxiparine therapy. This will help avoid unpleasant consequences and side effects.

Why is a drug such as Fraxiparin prescribed? Instructions for use of the mentioned medicine, its release form and composition will be presented below. Also from the materials in this article you will learn whether this drug has side effects and contraindications.

Form, packaging, composition

In what packaging is the drug “Fraxiparin” sold? Instructions for use indicate that this remedy is available in a syringe, which, in turn, is placed in a blister and a cardboard box.

A slightly opalescent preparation intended for is colorless and clear liquid. It may contain 9500, 5700, 2850, 3800 or 7600 IU of anti-Xa nadroparin calcium. In addition, the medication also contains additional substances such as purified water, calcium hydroxide solution,

Pharmacological and pharmacokinetic features

What is the drug "Fraxiparin"? The instructions for use included with the medicine indicate that this is a very effective antithrombotic and anticoagulant agent.

The active substance of the drug is low molecular weight heparin. It is obtained by depolymerization and exhibits a fairly high ability to bind to plasma proteins. This effect leads to increased inhibition of factor Xa.

After the procedure, maximum anti-Xa activity is observed after approximately five hours. The drug is absorbed by 88%.

If the medication was administered intravenously, its highest concentration in the blood is observed after about 10 minutes. The half-life is 2 hours.

The drug is metabolized in the liver by depolymerization and desulfation.

Indications for use

What is Fraxiparin used for? Instructions for use (you can find a photo of the medicine in this article) states that this medication is very often prescribed to prevent thromboembolic complications, including after surgical and orthopedic surgeries.

Contraindications for use

It should also be said that Fraxiparin, reviews of which are ambiguous, should be taken with extreme caution in case of renal or liver failure, changes in blood circulation in the retina or choroid, arterial hypertension severe, diseases with an increased risk of bleeding, peptic ulcers in the past, as well as when combined with other anticoagulants, after surgery and in patients weighing up to 40 kg.

The drug "Fraxiparin": instructions for use

During IVF, the drug Fraxiparin is prescribed to improve rheological blood parameters and facilitate implantation.

This drug should be used only as prescribed by a doctor. It must be injected subcutaneously into the abdominal area, alternating left and right side. In this case, the patient should be in a lying position. In some cases, the medication is injected into the thigh.

How to inject Fraxiparin? The needle must be inserted perpendicular to the fold of skin that is formed by the fingers of the free hand. In this case, the pinch should be held during the entire injection. After the injection, rubbing the injection site is prohibited.

What should be the dosage of Fraxiparin? 0.3 ml is prescribed to prevent thromboembolism during surgery (2850 anti-Xa ME). The medication is administered four hours before surgery, and subsequently once a day. Treatment can be continued for at least one week or the entire period of risk of increased thrombosis (for example, until transition to outpatient observation).

Now you know for what purposes the drug Fraxiparin (0.3 ml) can be prescribed.

In addition to surgery, this drug is actively used to prevent thromboembolism in orthopedics. It is administered subcutaneously at 38 anti-Xa IU per kg of body weight. The indicated dose can be increased by 1.5 times, but only on the fourth day after orthopedic intervention.

For people with a strong risk of thrombosis, the drug "Fraxiparin" is administered subcutaneously 1 time per day in an amount calculated depending on the patient's weight (for less than 70 kg - 3800 anti-Xa IU per day, and more - 5700 anti-Xa IU).

When treating thromboembolism, anticoagulants in tablet form should be prescribed as quickly as possible. Fraxiparin therapy is not stopped until the goal is achieved.

Overdose symptoms

Now you know how to inject Fraxiparin. It should be noted that when using increased dosages of this drug, the patient may experience bleeding of various locations. Wherein light bleeding do not require urgent therapy (you just need to lower the dose or postpone the next injection).

As for severe overdoses, it helps to neutralize the anticoagulant effect of heparin. Its use is required only in severe cases.

Side effects

Which side effects can Fraxiparin cause it? Reviews from patients say that this drug promotes the development of bleeding in various locations, thrombocytopenia, eosinophilia, increased levels of liver enzymes and hypersensitivity. Patients may also develop small subcutaneous hematomas at the injection site. In these cases, treatment with Fraxiparin should be discontinued.

Drug interactions

The risk of developing hyperkalemia increases significantly when the drug in question is combined with ACE inhibitors, potassium salts, angiotensin receptor blockers, potassium-sparing diuretics, Tacrolimus, heparins, Cyclosporin, NSAIDs and Trimethoprim.

It should also be said that the combination with acetylsalicylic acid, NSAIDs, indirect anticoagulants, “Dextran” or fibrinolytics mutually enhances the effects of the drugs.

Pregnancy and lactation period

Is it possible to take Fraxiparin while pregnant? Instructions for use during pregnancy (reviews of the drug will be presented below) state that nadroparin calcium (the active ingredient of the drug) penetrates the placenta quite easily. Also this medicinal component excreted in breast milk.

In connection with all of the above, it should be noted that Fraxiparin injections when carrying a child and during breastfeeding It is highly not recommended to prescribe. However, in some cases, such a drug is still prescribed to patients.

So how to use the drug "Fraxiparin"? Instructions for use during pregnancy should only be developed by an experienced specialist. In this case, the woman should be constantly monitored by her doctor.

Analogs, price

Analogs this drug are the following medications: “Heparin-Pharmex”, “Atenativ”, “Enoxarin”, “Wessel Due F”, “Cibor”, “Heparin”, “Fragmin”, “Heparin-Biolek”, “Flenox”, “Heparin-Darnitsa” ", "Novoparin", "Heparin-Indar", "Clexan", "Heparin-Novopharm".

The price of the drug "Fraxiparin" is very high. For 10 syringes (0.3 ml) you will have to pay about 2,500 rubles.