Xaparin
Generic Name
Nadroparin Calcium
Manufacturer
Aspen Pharma
Country
Various (e.g., France, UK, South Africa)
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| xaparin 6000 anti xa injection | ৳ 590.00 | N/A |
Description
Overview of the medicine
Xaparin (Nadroparin) is a low molecular weight heparin (LMWH) used to prevent and treat blood clots. It is administered as an injection.
Uses & Indications
Dosage
Adults
Dosage varies greatly depending on the indication (prophylaxis vs. treatment, weight-based or fixed). E.g., for DVT prophylaxis, typical doses range from 2850 to 5700 anti-Xa IU SC once daily. For DVT treatment, 85 anti-Xa IU/kg SC twice daily.
Elderly
No specific dose adjustment for elderly patients with normal renal function. Renal function should be monitored. For patients over 75 years, dose may be reduced.
Renal_impairment
Dose reduction recommended in patients with moderate renal impairment (creatinine clearance 30-50 mL/min). Contraindicated in severe renal impairment (CrCl < 30 mL/min) for therapeutic indications.
How to Take
Administer by subcutaneous injection (SC) into the abdominal wall or thigh. Alternate injection sites. Do not inject intramuscularly. For hemodialysis, administer into the arterial line at the start of the session.
Mechanism of Action
Nadroparin acts as an anticoagulant by selectively binding to antithrombin III, which potentiates the inactivation of Factor Xa. This prevents the formation and growth of blood clots.
Pharmacokinetics
Onset
Within 1-2 hours of subcutaneous injection.
Excretion
Mainly via the kidneys, with unchanged or depolymerized fragments.
Half life
Approximately 3-4 hours for anti-Xa activity. Elimination half-life can be prolonged in renal impairment.
Absorption
Rapid and almost complete absorption after subcutaneous administration. Peak anti-Xa activity is reached within 3-5 hours.
Metabolism
Primarily depolymerization and desulfation in the liver.
Side Effects
Contraindications
- Hypersensitivity to nadroparin or other LMWHs/heparins.
- Active bleeding or increased risk of hemorrhage (e.g., active gastric ulcer, hemorrhagic stroke).
- Severe renal impairment (CrCl < 30 mL/min) for therapeutic indications.
- History of heparin-induced thrombocytopenia (HIT).
- Spinal or epidural anesthesia (risk of spinal hematoma) when therapeutic doses are used.
Drug Interactions
Dextran
Increased risk of bleeding.
NSAIDs (e.g., Aspirin, Ibuprofen)
Increased risk of bleeding. Concurrent use should be avoided or closely monitored.
Oral anticoagulants (e.g., Warfarin)
Increased risk of bleeding. Requires careful monitoring and bridging therapy.
Platelet aggregation inhibitors (e.g., Clopidogrel)
Increased risk of bleeding. Concurrent use should be avoided or closely monitored.
Storage
Store below 25°C. Do not freeze. Protect from light. Keep out of reach of children.
Overdose
Overdose can lead to hemorrhagic complications. Management involves careful monitoring and discontinuation of the drug. Protamine sulfate can partially neutralize the anti-Xa effect of nadroparin, but it does not fully reverse it.
Pregnancy & Lactation
Use in pregnancy should only be considered if clearly necessary, after a careful risk-benefit assessment. Nadroparin does not cross the placental barrier. Excretion into breast milk is minimal, but caution is advised during lactation.
Side Effects
Contraindications
- Hypersensitivity to nadroparin or other LMWHs/heparins.
- Active bleeding or increased risk of hemorrhage (e.g., active gastric ulcer, hemorrhagic stroke).
- Severe renal impairment (CrCl < 30 mL/min) for therapeutic indications.
- History of heparin-induced thrombocytopenia (HIT).
- Spinal or epidural anesthesia (risk of spinal hematoma) when therapeutic doses are used.
Drug Interactions
Dextran
Increased risk of bleeding.
NSAIDs (e.g., Aspirin, Ibuprofen)
Increased risk of bleeding. Concurrent use should be avoided or closely monitored.
Oral anticoagulants (e.g., Warfarin)
Increased risk of bleeding. Requires careful monitoring and bridging therapy.
Platelet aggregation inhibitors (e.g., Clopidogrel)
Increased risk of bleeding. Concurrent use should be avoided or closely monitored.
Storage
Store below 25°C. Do not freeze. Protect from light. Keep out of reach of children.
Overdose
Overdose can lead to hemorrhagic complications. Management involves careful monitoring and discontinuation of the drug. Protamine sulfate can partially neutralize the anti-Xa effect of nadroparin, but it does not fully reverse it.
Pregnancy & Lactation
Use in pregnancy should only be considered if clearly necessary, after a careful risk-benefit assessment. Nadroparin does not cross the placental barrier. Excretion into breast milk is minimal, but caution is advised during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date, refer to packaging for exact expiry.
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory authorities worldwide (e.g., MHRA, EMA)
Patent Status
Generics available
WHO Essential Medicine
YesClinical Trials
Nadroparin has undergone extensive clinical trials demonstrating its efficacy and safety in the prophylaxis and treatment of various thromboembolic conditions, including DVT, PE, and in acute coronary syndromes.
Lab Monitoring
- Complete Blood Count (CBC) with platelet count (before treatment and regularly thereafter)
- Renal function (creatinine clearance) before initiation and periodically during treatment.
- Liver enzymes (periodically)
- Anti-Xa levels (for specific populations like renal impairment, obesity, or prolonged treatment, not routinely required).
Doctor Notes
- Always assess patient's bleeding risk and renal function (CrCl) before initiating and during treatment with nadroparin.
- Educate patients on proper subcutaneous injection technique and advise them to report any signs of bleeding or adverse reactions promptly.
- Avoid intramuscular injection due to risk of hematoma.
Patient Guidelines
- Administer the injection exactly as instructed by your healthcare provider; do not try to self-inject without proper training.
- Do not rub the injection site after administration to minimize bruising.
- Report any unusual bleeding, bruising, or adverse reactions immediately to your doctor or nurse.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a missed one. Consult your doctor or pharmacist.
Driving Precautions
Nadroparin is not expected to affect the ability to drive or operate machinery.
Lifestyle Advice
- Avoid activities that may increase the risk of bleeding or injury, such as contact sports.
- Inform all healthcare providers, including dentists and other specialists, that you are on this medication.
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