Heparin (Dalteparin, Enoxaparin)

Heparin (low molecular weight)
(Dalteparin, Enoxaparin): Uses, Dosage and Side Effects

Overview

• Anticoagulant low molecular weight heparin (LMWH) suppresses Factor Xa and thrombin.
• When compared to unfractionated heparin (UFH), LMWH has lower anti-IIa activity relative to anti-Xa activity (anti-Xa to anti-IIa ratio is 2-4:1 vs. UFH 1:1).
• At therapeutic levels, LMWH has little influence on aPTT.
• Anti-Xa activity is used to monitor LMWH therapeutically.

Uses of Heparin (low molecular weight)
(Dalteparin, Enoxaparin)

• Treatment of thromboembolic complications and hypercoagulable syndromes, such as pulmonary thromboembolism and immune-mediated hemolytic anaemia (IMHA).
• Humans are also treated with LMWH for myocardial infarction, atrial fibrillation, deep vein thrombosis, and pulmonary thromboembolism.
• Its use in DIC is controversial because controlled clinical trials on humans have failed to demonstrate any beneficial effects.
• No longer is LMWH utilised to prevent DIC.

Dose of Heparin (low molecular weight)
(Dalteparin, Enoxaparin) in Dogs and Cats

Dogs:
• 100–175 IU/kg s.c. q8h (Dalteparin).
• 0.08 mg/kg s.c. q6h (Enoxaparin).

Cats:
• 75 IU/kg s.c. q6h (Dalteparin).
• 0.75–1 mg mg/kg s.c. q6–12h (Enoxaparin).

Dogs, Cats:

• Anticoagulation: 80–150 IU/kg s.c. q4–8h.

Side Effects of Heparin (low molecular weight)
(Dalteparin, Enoxaparin) in Dogs and Cats

• Protamine can be used as an antidote in the event of an overdose.
• Heparin should not be given intravenously since it can cause haematoma formation.
• Its usage in DIC may exacerbate bleeding, particularly if the patient is thrombocytopenic.
• In humans, heparin-induced thrombocytopenia syndrome is a major concern, although it has not been observed in dogs or cats.

Contraindications of Heparin (low molecular weight)
(Dalteparin, Enoxaparin) in Dogs and Cats

• Bleeding disorders or severe renal dysfunction

Some Notes:

• Use with caution when used with other medications that can cause coagulation abnormalities (e.g., aspirin, NSAIDs).
• ACTH, corticosteroids, and insulin may be inhibited by heparin.
• Heparin may raise diazepam levels in the blood.
• Heparin’s effects may be mitigated in part by antihistamines, digoxin, and tetracyclines.
• Other medications should not be mixed in the same syringe as heparin.