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Drug Safety
Published in: Drug Safety 4/2005

01-04-2005 | Review Article

Safety Profile of Different Low-Molecular Weight Heparins Used at Therapeutic Dose

Authors: Dr Isabelle Gouin-Thibault, Eric Pautas, Virginie Siguret

Published in: Drug Safety | Issue 4/2005

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Abstract

Low-molecular weight heparins (LMWHs) have been shown to be as safe and effective as unfractionated heparin (UFH) for the treatment of acute venous thrombosis and non-life-threatening pulmonary embolism. Different reports have shown that LMWHs may also be used to treat patients with unstable angina or non-Q-wave infarction. The safety of LMWHs used at therapeutic dose has been widely studied in pivotal clinical trials and analysed in several meta-analyses. However, despite the wide development and use of LMWHs, several issues regarding the safety and optimal use of LMWHs remain unanswered.
The main adverse effect of LMWHs is bleeding and it is uncertain whether a weight-adjusted dosage regimen without laboratory monitoring can be used in patients with a high risk of bleeding, such as patients with renal failure, elderly patients, obese patients or pregnant women. These patients are usually excluded from clinical trials and only a few studies, not sufficiently powered to estimate efficacy and safety, have been carried out in these special populations. Most of the available data comes from pharmacokinetic or population pharmacodynamic studies or clinical reports. Results in patients with renal impairment who are not undergoing haemodialysis suggest that a reduction in calculated creatinine clearance levels is associated with an increased risk of accumulation of anti-Xa activity, the extent of which differs depending on the individual LMWH and the extent to which the compound is cleared by the kidney. The limited data available regarding the use of therapeutic doses of LMWHs in obese patients suggest that there is no need to cap the dose at a maximal allowable dose. Long-term (3-month) treatment with LMWHs appears to be as effective and safe as oral anticoagulant therapy for the treatment of venous thromboembolism. It appears that each LMWH is a distinct compound with unique pharmacokinetic and pharmacodynamic profiles. Until more data are available regarding these special populations, periodic monitoring of anti-Xa activity levels may be recommended to detect accumulation and/or an overdose and minimise the bleeding risk.
The non-haemorrhagic adverse effects of the LMWHs include heparin-induced thrombocytopenia (HIT) and osteoporosis. The incidence of HIT appears to be lower with LMWHs than with UFH; there is currently not enough data to compare the frequency of HIT between the various LMWHs. LMWHs also appear to carry a lower risk of causing osteoporosis than UFH.
In conclusion, studies that include special population patients are required to make conclusive recommendations concerning the safety and monitoring of the different LMWHs.
Literature
1.
Hirsh J, Anand SS, Halperin JL, et al. AHA Scientific statement: guide to anticoagulant therapy. Heparin: a statement for healthcare professionals from the American Heart Association. Circulation 2001; 103: 2994–3018PubMedCrossRef
2.
Eikelboom JW, Anand SS, Malmberg K, et al. Unfractionated heparin and low-molecular-weight heparin in acute coronary syndrome without ST elevation: a meta-analysis. Lancet 2000; 355(9219): 1936–42PubMedCrossRef
3.
Samama MM, Desnoyers P, Gerotziafas GT. Low molecular weight heparins: a comparative review of pharmacodynamic, clinical pharmacology. In: Lugassy G, Brenner B, Schulman S, Samama MM, Cohen M, editors. Thrombosis and antithrombotic therapy. London: Martin Dunitz, 2001: 71–96
4.
The Thrombolysis in Myocardial Infarction (TIMI) 11A Trial Investigator. Dose-ranging trial of enoxaparin for unstable angina: results of TIMI 11A. J Am Coll Cardiol 1997; 29 (7): 1474–82
5.
Bratt G, Tornebohm E, Granqvist S, et al. A comparison between low molecular weight heparin (KABI 2165) and standard heparin in the intravenous treatment of deep venous thrombosis. Thromb Haemost 1985; 54(4): 813–7PubMed
6.
Leizorovicz A, Simonneau G, Decousus H, et al. Comparison of efficacy and safety of low molecular weight heparins and unfractionated heparin in initial treatment of deep venous thrombosis: a meta-analysis. BMJ 1994; 309(6950): 299–304PubMedCrossRef
7.
Lensing AW, Prins MH, Davidson BL, et al. Treatment of deep venous thrombosis with low-molecular-weight heparins: a meta-analysis. Arch Intern Med 1995; 155(6): 601–7PubMedCrossRef
8.
Leizorovicz A. Comparison of the efficacy and safety of low molecular weight heparins and unfractionated heparin in the initial treatment of deep venous thrombosis: an updated meta-analysis. Drugs 1996; 52Suppl. 7: 30–7PubMedCrossRef
9.
Siragusa S, Cosmi B, Piovella F, et al. Low-molecular-weight heparins and unfractionated heparin in the treatment of patients with acute venous thromboembolism: results of a meta-analysis. Am J Med 1996; 100(3): 230–769-77CrossRef
10.
Gould MK, Dembitzer AD, Doyle RL, et al. Low-molecular-weight heparins compared with unfractionated heparin for treatment of acute deep venous thrombosis: a meta-analysis of randomized, controlled trials. Ann Intern Med 1999; 130(10): 800–9PubMed
11.
Rocha E, Martinez-Gonzalez MA, Montes R, et al. Do the low molecular weight heparins improve efficacy and safety of the treatment of deep venous thrombosis? A meta-analysis. Haematologica 2000; 85(9): 935–42PubMed
12.
Dolovich LR, Ginsberg JS, Douketis JD, et al. A meta-analysis comparing low-molecular-weight heparins with unfractionated heparin in the treatment of venous thromboembolism: examining some unanswered questions regarding location of treatment, product type, and dosing frequency. Arch Intern Med 2000; 160(2): 181–8PubMedCrossRef
13.
van Den Belt AG, Prins MH, Lensing AW, et al. Fixed dose subcutaneous low molecular weight heparins versus adjusted dose unfractionated heparin for venous thromboembolism. Cochrane Database Syst Rev 2000; (2): CD001100
14.
Quinlan DJ, McQuillan A, Eikelboom JW. Low-molecular-weight heparin compared with intravenous unfractionated heparin for treatment of pulmonary embolism: a meta-analysis of randomized, controlled trials. Ann Intern Med 2004; 140(3): 175–83PubMed
15.
Riess H, Koppenhagen K, Tolle A, et al. Fixed-dose, body weight-independent subcutaneous low molecular weight heparin certoparin compared with adjusted-dose intravenous unfractionated heparin in patients with proximal deep venous thrombosis. Thromb Haemost 2003; 90(2): 252–9PubMed
16.
Planes A. Review of bemiparin sodium: a new second-generation low molecular weight heparin and its applications in venous thromboembolism. Expert Opin Pharmacother 2003; 4(9): 1551–61PubMed
17.
van Dongen CJ, Mac Gillavry MR, Prins MH. Once versus twice daily LMWH for the initial treatment of venous thromboembolism. Cochrane Database Syst Rev 2003; (1): CD003074
18.
Couturaud F, Julian JA, Kearon C. Low molecular weight heparin administered once versus twice daily in patients with venous thromboembolism: a meta-analysis. Thromb Haemost 2001; 86(4): 980–4PubMed
19.
Invasive compared with non-invasive treatment in unstable coronary-artery disease: FRISC II prospective randomised multicentre study. Fragmin and fast revascularisation during instability in coronary artery disease investigators. Lancet 1999; 354 (9180): 708–15
20.
Fragmin during instability in coronary artery disease (FRISC) study group. Low-molecular-weight heparin during instability in coronary artery disease. Lancet 1996; 347 (9001): 561–8
21.
Klein W, Buchwald A, Hillis SE, et al. Comparison of low-molecular-weight heparin with unfractionated heparin acutely and with placebo for 6 weeks in the management of unstable coronary artery disease. Fragmin in unstable coronary artery disease study (FRIC). Circulation 1997; 96(1): 61–8PubMedCrossRef
22.
The FRAXIS study group. Comparison of two treatment durations (6 days and 14 days) of a low molecular weight heparin with a 6-day treatment of unfractionated heparin in the initial management of unstable angina or non-Q wave myocardial infarction: FRAX I.S. (Fraxiparine in ischaemic syndrome). Eur Heart J 1999; 20 (21): 1553–62
23.
Cohen M, Demers C, Gurfinkel EP, et al. A comparison of low-molecular-weight heparin with unfractionated heparin for unstable coronary artery disease: efficacy and safety of subcutaneous enoxaparin in non-Q-wave coronary events study group. N Engl J Med 1997; 337(7): 447–52PubMedCrossRef
24.
Antman EM, McCabe CH, Gurfinkel EP, et al. Enoxaparin prevents death and cardiac ischemic events in unstable angina/non-Q-wave myocardial infarction: results of the thrombolysis in myocardial infarction (TIMI) 11B trial. Circulation 1999; 100(15): 1593–601PubMedCrossRef
25.
Husted S, Becker R, Kher A. A critical review of clinical trials for low-molecular-weight heparin therapy in unstable coronary artery disease. Clin Cardiol 2001; 24(7): 492–9PubMedCrossRef
26.
Michalis LK, Katsouras CS, Papamichael N, et al. Enoxaparin versus tinzaparin in non-ST-segment elevation acute coronary syndromes: the EVET trial. Am Heart J 2003; 146(2): 304–10PubMedCrossRef
27.
Cestac P, Bagheri H, Lapeyre-Mestre M, et al. Utilisation and safety of low molecular weight heparins: prospective observational study in medical inpatients. Drug Saf 2003; 26(3): 197–207PubMedCrossRef
28.
Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16(1): 31–41PubMedCrossRef
29.
Nagge J, Crowther M, Hirsh J. Is impaired renal function a contraindication to the use of low-molecular-weight heparin? Arch Intern Med 2002; 162(22): 2605–9PubMedCrossRef
30.
Cadroy Y, Pourrat J, Baladre MF, et al. Delayed elimination of enoxaparin in patients with chronic renal insufficiency. Thromb Res 1991; 63(3): 385–90PubMedCrossRef
31.
Gerlach AT, Pickworth KK, Seth SK, et al. Enoxaparin and bleeding complications: a review in patients with and without renal insufficiency. Pharmacotherapy 2000; 20(7): 771–5PubMedCrossRef
32.
Brophy DF, Wazny LD, Gehr TW, et al. The pharmacokinetics of subcutaneous enoxaparin in end-stage renal disease. Pharmacotherapy 2001; 21(2): 169–74PubMedCrossRef
33.
Collet JP, Montalescot G, Choussat R, et al. Enoxaparin in unstable angina patients with renal failure. Int J Cardiol 2001: 80(1): 81–2PubMedCrossRef
34.
Sanderink GJ, Guimart CG, Ozoux ML, et al. Pharmacokinetics and pharmacodynamics of the prophylactic dose of enoxaparin once daily over 4 days in patients with renal impairment. Thromb Res 2002; 105(3): 225–31PubMedCrossRef
35.
Becker RC, Spencer FA, Gibson M, et al. Influence of patient characteristics and renal function on factor Xa inhibition pharmacokinetics and pharmacodynamics after enoxaparin administration in non-ST-segment elevation acute coronary syndromes. Am Heart J 2002; 143(5): 753–9PubMedCrossRef
36.
Bruno R, Baille P, Retout S, et al. Population pharmacokinetics and pharmacodynamics of enoxaparin in unstable angina and non-ST-segment elevation myocardial infarction. Br J Clin Pharmacol 2003; 56(4): 407–14PubMedCrossRef
37.
Chow SL, Zammit K, West K, et al. Correlation of antifactor Xa concentrations with renal function in patients on enoxaparin. J Clin Pharmacol 2003; 43(6): 586–90PubMed
38.
Spinler SA, Inverso SM, Cohen M, et al. Safety and efficacy of unfractionated heparin versus enoxaparin in patients who are obese and patients with severe renal impairment: analysis from the ESSENCE and TIMI 11B studies. Am Heart J 2003; 146(1): 33–41PubMedCrossRef
39.
Collet JP, Montalescot G, Fine E, et al. Enoxaparin in unstable angina patients who would have been excluded from randomized pivotal trials. J Am Coll Cardiol 2003; 41(1): 8–14PubMedCrossRef
40.
Montalescot G, Collet JP, Tanguy ML, et al. Anti-Xa activity relates to survival and efficacy in unselected acute coronary syndrome patients treated with enoxaparin. Circulation 2004; 110(4): 392–8PubMedCrossRef
41.
Hulot JS, Vantelon C, Urien S, et al. Effect of renal function on the pharmacokinetics of enoxaparin and consequences on dose adjustment. Ther Drug Monit 2004; 26(3): 305–10PubMedCrossRef
42.
Goudable C, Saivin S, Houin G, et al. Pharmacokinetics of a low molecular weight heparin (Fraxiparine) in various stages of chronic renal failure. Nephron 1991; 59(4): 543–5PubMedCrossRef
43.
Baumelou A, Singlas E, Petitclerc T, et al. Pharmacokinetics of a low molecular weight heparin (reviparine) in hemodialyzed patients. Nephron 1994; 68(2): 202–6PubMedCrossRef
44.
Hainer JW, Sherrard DJ, Swan SK, et al. Intravenous and subcutaneous weight-based dosing of the low molecular weight heparin tinzaparin (Innohep) in end-stage renal disease patients undergoing chronic hemodialysis. Am J Kidney Dis 2002; 40(3): 531–8PubMedCrossRef
45.
Polkinghorne KR, McMahon LP, Becker GJ. Pharmacokinetic studies of dalteparin (Fragmin), enoxaparin (Clexane), and danaparoid sodium (Orgaran) in stable chronic hemodialysis patients. Am J Kidney Dis 2002; 40(5): 990–5PubMedCrossRef
46.
Swedko PJ, Clark HD, Paramsothy K, et al. Serum creatinine is an inadequate screening test for renal failure in elderly patients. Arch Intern Med 2003; 163(3): 356–60PubMedCrossRef
47.
Goldberg TH, Finkelstein MS. Difficulties in estimating glomerular filtration rate in the elderly. Arch Intern Med 1987; 147(8): 1430–3PubMedCrossRef
48.
Bliss MR, Vellupillai S, Julian PA, et al. Measured and predicted creatinine clearance [letter]. Lancet 1987; I(8536): 815CrossRef
49.
Siguret V, Pautas E, Gouin I. Low molecular weight heparin treatment in elderly subjects with or without renal insufficiency: new insights between June 2002 and March 2004. Curr Opin Pulm Med 2004; 10(5): 366–70PubMedCrossRef
50.
Merli GJ. Treatment of deep venous thrombosis and pulmonary embolism with low molecular weight heparin in the geriatric patient population. Clin Geriatr Med 2001; 17(1): 93–106PubMedCrossRef
51.
Mismetti P, Laporte-Simitsidis S, Navarro C, et al. Aging and venous thromboembolism influence the pharmacodynamics of the anti-factor Xa and anti-thrombin activities of a low molecular weight heparin (nadroparin). Thromb Haemost 1998; 79(6): 1162–5PubMed
52.
Siguret V, Pautas E, Fevrier M, et al. Elderly patients treated with tinzaparin (Innohep) administered once daily (175 anti-Xa IU/kg): anti-Xa and anti-IIa activities over 10 days. Thromb Haemost 2000; 84(5): 800–4PubMed
53.
Pautas E, Gouin I, Bellot O, et al. Safety profile of tinzaparin administered once daily at a standard curative dose in two hundred very elderly patients. Drug Saf 2002; 25(10): 725–33PubMedCrossRef
54.
Sanderink GJ, Le Liboux A, Jariwala N, et al. The pharmacokinetics and pharmacodynamics of enoxaparin in obese volunteers. Clin Pharmacol Ther 2002; 72(3): 308–18PubMedCrossRef
55.
Hainer JW, Barrett JS, Assaid CA, et al. Dosing in heavyweight/obese patients with the LMWH, tinzaparin: a pharmacodynamic study. Thromb Haemost 2002; 87(5): 817–23PubMed
56.
Wilson SJ, Wilbur K, Burton E, et al. Effect of patient weight on the anticoagulant response to adjusted therapeutic dosage of low-molecular-weight heparin for the treatment of venous thromboembolism. Haemostasis 2001; 31(1): 42–8PubMed
57.
Smith J, Canton EM. Weight-based administration of dalteparin in obese patients. Am J Health Syst Pharm 2003; 60(7): 683–7PubMed
58.
Ginsberg JS, Bates SM. Management of venous thromboembolism during pregnancy. J Thromb Haemost 2003; 1(7): 1435–42PubMedCrossRef
59.
Bates SM, Greer IA, Hirsh J, et al. Use of antithrombotic agents during pregnancy: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126Suppl. (3 Suppl.): 627S–44SPubMedCrossRef
60.
Lopaciuk S, Bielska-Falda H, Noszczyk W, et al. Low molecular weight heparin versus acenocoumarol in the secondary prophylaxis of deep vein thrombosis. Thromb Haemost 1999; 81(1): 26–31PubMed
61.
Das SK, Cohen AT, Edmondson RA, et al. Low-molecular-weight heparin versus warfarin for prevention of recurrent venous thromboembolism: a randomized trial. World J Surg 1996; 20(5): 521–6PubMedCrossRef
62.
Veiga F, Escriba A, Maluenda MP, et al. Low molecular weight heparin (enoxaparin) versus oral anticoagulant therapy (acenocoumarol) in the long-term treatment of deep venous thrombosis in the elderly: a randomized trial. Thromb Haemost 2000; 84(4): 559–64PubMed
63.
Pini M, Aiello S, Manotti C, et al. Low molecular weight heparin versus warfarin in the prevention of recurrences after deep vein thrombosis. Thromb Haemost 1994; 72(2): 191–7PubMed
64.
Monreal M, Lafoz E, Olive A, et al. Comparison of subcutaneous unfractionated heparin with a low molecular weight heparin (Fragmin) in patients with venous thromboembolism and contraindications to coumarin. Thromb Haemost 1994; 71(1): 7–11PubMed
65.
Monreal M, Roncales FJ, Ruiz J. Secondary prevention of venous thromboembolism: a role for low-molecular-weight heparin. Haemostasis 1998; 28: 236–43PubMed
66.
Hull RD, Pineo GF, Mah AF. Home-Lite: safety and efficacy results for a study investigating the long-term out-of-hospital treatment of patients with proximal venous thrombosis using subcutaneous low-molecular-weight heparin versus warfarin [abstract OC1647]. Thromb Haemost 2001 Jul
67.
Hull RD, Pineo GF, Mah AF. A randomized trial evaluating long-term low-molecular-weight heparin therapy for three months versus intravenous heparin followed by warfarin sodium [abstract OC395]. J Thromb Haemost 2003 Jul
68.
Iorio A, Guercini F, Pini M. Low-molecular-weight heparin for the long-term treatment of symptomatic venous thromboembolism: meta-analysis of the randomized comparisons with oral anticoagulants. J Thromb Haemost 2003; 1(9): 1906–13PubMedCrossRef
69.
Hirsh J, Warkentin TE, Shaughnessy SG, et al. Heparin and low-molecular-weight heparin: mechanisms of action, pharmacokinetics, dosing, monitoring, efficacy, and safety. Chest 2001; 119(1 Suppl.): 64S–94SPubMedCrossRef
70.
Hirsh J, Raschke R. Heparin and low-molecular-weight heparin: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126(3 Suppl.): 188S–203SPubMedCrossRef
71.
Bounameaux H, de Moerloose P. Is laboratory monitoring of low-molecular-weight heparin therapy necessary? No. J Thromb Haemost 2004; 2(4): 551–4PubMedCrossRef
72.
Alhenc-Gelas M, Jestin-Le Guernic C, Vitoux JF, et al. Adjusted versus fixed doses of the low-molecular-weight heparin fragmin in the treatment of deep vein thrombosis. Fragmin-Study Group. Thromb Haemost 1994; 71(6): 698–702PubMed
73.
Boneu B, de Moerloose P. How and when to monitor a patient treated with low molecular weight heparin. Semin Thromb Hemost 2001; 27(5): 519–22PubMedCrossRef
74.
Hirsh J. Laboratory monitoring of low-molecular-weight heparin therapy. J Thromb Haemost 2004; 2(6): 1003PubMedCrossRef
75.
Duplaga BA, Rivers CW, Nutescu E. Dosing and monitoring of low-molecular-weight heparins in special populations. Pharmacotherapy 2001; 21(2): 218–34PubMedCrossRef
76.
Boneu B, Nguyen F, Cambus J. Difficulties and pitfalls in the monitoring of heparin therapy. Sang Thrombose Vaisseaux 2003; 15(3): 131–4
77.
Harenberg J. Fixed-dose versus adjusted-dose low molecular weight heparin for the initial treatment of patients with deep venous thrombosis. Curr Opin Pulm Med 2002; 8(5): 383–8PubMedCrossRef
78.
Messmore H, Jeske W, Wehrmacher W, et al. Benefit-risk assessment of treatments for heparin-induced thrombocytopenia. Drug Saf 2003; 26(9): 625–41PubMedCrossRef
79.
Lee D, Warkentin T. Frequency of heparin-induced thrombocytopenia. In: Warkentin T, Greinacher A, editors. Heparininduced thrombocytopenia. New York: Marcel Dekker, 2001: 87–122
80.
Warkentin T. Clinical picture of heparin-induced thrombocytopenia. In: Warkentin T, Greinacher A, editors. Heparininduced thrombocytopenia. New York: Marcel Dekker, 2001: 43–86
81.
Gruel Y, Pouplard C, Nguyen P, et al. Biological and clinical features of low-molecular-weight heparin-induced thrombocytopenia. Br J Haematol 2003; 121(5): 786–92PubMedCrossRef
82.
Breddin HK, Hach-Wunderle V, Nakov R, et al. Effects of a low-molecular-weight heparin on thrombus regression and recurrent thromboembolism in patients with deep-vein thrombosis. N Engl J Med 2001; 344(9): 626–31PubMedCrossRef
83.
Simonneau G, Sors H, Charbonnier B, et al. A comparison of low-molecular-weight heparin with unfractionated heparin for acute pulmonary embolism. The THESEE Study Group. N Engl J Med 1997; 337(10): 663–9PubMedCrossRef
84.
Koopman MM, Prandoni P, Piovella F, et al. Treatment of venous thrombosis with intravenous unfractionated heparin administered in the hospital as compared with subcutaneous low-molecular-weight heparin administered at home. The Tasman Study Group. N Engl J Med 1996; 334(11): 682–7PubMedCrossRef
85.
Levine M, Gent M, Hirsh J, et al. A comparison of low-molecular-weight heparin administered primarily at home with unfractionated heparin administered in the hospital for proximal deep-vein thrombosis. N Engl J Med 1996; 334(11): 677–81PubMedCrossRef
86.
Simonneau G, Charbonnier B, Decousus H, et al. Subcutaneous low-molecular-weight heparin compared with continuous intravenous unfractionated heparin in the treatment of proximal deep vein thrombosis. Arch Intern Med 1993; 153(13): 1541–6PubMedCrossRef
87.
Hull RD, Raskob GE, Pineo GF, et al. Subcutaneous low-molecular-weight heparin compared with continuous intravenous heparin in the treatment of proximal-vein thrombosis. N Engl J Med 1992; 326(15): 975–82PubMedCrossRef
88.
Fiessinger JN, Lopez-Fernandez M, Gatterer E, et al. Once-daily subcutaneous dalteparin, a low molecular weight heparin, for the initial treatment of acute deep vein thrombosis. Thromb Haemost 1996; 76(2): 195–9PubMed
89.
Lindmarker P, Holmstrom M, Granqvist S, et al. Comparison of once-daily subcutaneous Fragmin with continuous intravenous unfractionated heparin in the treatment of deep vein thrombosis. Thromb Haemost 1994; 72(2): 186–90PubMed
90.
Prandoni P, Vigo M, Cattelan AM, et al. Treatment of deep venous thrombosis by fixed doses of a low-molecular-weight heparin (CY216). Haemostasis 1990; 20Suppl. 1: 220–3PubMed
91.
Pettila V, Leinonen P, Markkola A, et al. Postpartum bone marrow mineral density in women treated for thromboprophylaxis with unfractionated heparin or LMWHeparin. Thromb Haemost 2002; 87: 182–6PubMed
92.
Hui CK, Yuen MF, OI-Lin Ng I, et al. Low molecular weight heparin-induced liver toxicity. J Clin Pharmacol 2001; 41(6): 691–4PubMedCrossRef
93.
Liautard C, Nunes AM, Vial T, et al. Low-molecular-weight heparins and thrombocytosis. Ann Pharmacother 2002; 36(9): 1351–4PubMedCrossRef
94.
Abdel-Raheem MM, Potti A, Tadros S, et al. Effect of low-molecular-weight heparin on potassium homeostasis. Pathophysiol Haemost Thromb 2002; 32(3): 107–10PubMedCrossRef
95.
Gheno G, Cinetto L, Savarino C, et al. Variations of serum potassium level and risk of hyperkalemia in inpatients receiving low-molecular-weight heparin. Eur J Clin Pharmacol 2003: 59: 373–7PubMedCrossRef
Metadata
Title
Safety Profile of Different Low-Molecular Weight Heparins Used at Therapeutic Dose
Authors
Dr Isabelle Gouin-Thibault
Eric Pautas
Virginie Siguret
Publication date
01-04-2005
Publisher
Springer International Publishing
Published in
Drug Safety / Issue 4/2005
Print ISSN: 0114-5916
Electronic ISSN: 1179-1942
DOI
https://doi.org/10.2165/00002018-200528040-00005

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