Adults

Dosage varies by indication. For DVT prophylaxis, typically 40 mg SC once daily. For DVT/PE treatment, 1 mg/kg SC every 12 hours or 1.5 mg/kg SC once daily. For 6000 anti-Xa (60 mg), it may be used for DVT/PE treatment or specific prophylaxis regimens. Always follow physician's instructions.

Elderly

No dosage adjustment is generally required for elderly patients, unless renal function is impaired. Close monitoring is advised.

Renal_impairment

Severe renal impairment (CrCl < 30 mL/min) requires significant dose reduction; e.g., for DVT/PE treatment, 1 mg/kg SC once daily. Moderate renal impairment (CrCl 30-50 mL/min) may require careful monitoring.

Onset

Rapid, with peak anti-Xa activity occurring 3-5 hours post-subcutaneous injection.

Excretion

Mainly renal, with unchanged drug and metabolites excreted via urine.

Half life

Approximately 4.5 to 7 hours based on anti-Xa activity after a single subcutaneous dose, extending with repeated dosing.

Absorption

High (approximately 100%) bioavailability after subcutaneous injection, with peak anti-Xa activity observed within 3 to 5 hours.

Metabolism

Primarily hepatic, through desulfation and depolymerization to less active or inactive metabolites.

Thrombolytic agents

Significantly increased risk of bleeding.

NSAIDs (Nonsteroidal Anti-inflammatory Drugs)

Increased risk of bleeding. Use with caution.

Antiplatelet agents (e.g., Aspirin, Clopidogrel)

Increased risk of bleeding. Close monitoring is required.

Oral Anticoagulants (e.g., Warfarin, Rivaroxaban)

Concurrent use increases bleeding risk. Bridging therapy involves overlap.