Danaparoid

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Danaparoid
Clinical data
AHFS/Drugs.com Micromedex Detailed Consumer Information
MedlinePlus a602007
Identifiers
CAS Registry Number 308068-55-5 YesY
ATC code B01AB09
UNII BI6GY4U9CW N
ChEMBL CHEMBL1201684 N
 N (what is this?)  (verify)

Danaparoid sodium (Orgaran) is an anticoagulant[1] that works by inhibiting activated factor X (factor Xa).

Danaparoid is a heparinoid but considered to be a low molecular weight heparin by some sources. However it is chemically distinct from heparin, has different protein binding properties and thus has little cross-reactivity in heparin-intolerant patients.

It consists of a mixture of heparan sulfate, dermatan sulfate, and chondroitin sulfate.[2]

Uses[edit]

It is used to prevent deep venous clots, particularly in situations with a high risk of clot formation, such as after hip surgery.

It is also used as a heparinoid substitute in heparin-induced thrombocytopenia[3][4] (HIT) which may otherwise cause paradoxical thrombosis. Danaparoid is used for thrombosis prophylaxis and treatment in heparin-induced thrombocytopenia patients, although cross-reactivity with heparin-induced antibodies can occur in 10–20% of the patients (ESRA). It has been proposed for use in Kasabach-Merritt syndrome.[5]

Discontinuation[edit]

On August 14, 2002, this drug was withdrawn by Organon International.[6] Due to a shortage in drug substance, the manufacturer discontinued providing the medication in the United States. It is available in several other countries.[7]

On the Schering-Plough website, Orgaran is described as "Marketed outside the U.S."[8]

Administration[edit]

IV and SC

Side effects[edit]

  • Bleeding (solely restricted to patients undergoing cardio-pulmonmary surgery with by pass)<Magnani HN, Gallus AG. Heparin-induced thrombocytopenia (HIT) A report of 1478 clinical outcomes of patients treated with danaparoid (Orgaran) from 1982 to mid 2004." Thromb Haemost 2006; 95: 967-871>
  • Low platelets, due to a low level of structural similarity between danaparoid and heparin, i.e.only in some patients sensitive to heparin or a LMWH but to date never developed spontaneously.
  • possiblyAsthma exacerbations, due to allergies to sulfites contained within the medicine (no case has been reported to date).

References[edit]

  1. ^ Hagiwara S, Iwasaka H, Hidaka S, Hishiyama S, Noguchi T (2008). "Danaparoid sodium inhibits systemic inflammation and prevents endotoxin-induced acute lung injury in rats". Crit Care 12 (2): R43. doi:10.1186/cc6851. PMC 2447588. PMID 18380908. 
  2. ^ de Pont AC, Hofstra JJ, Pik DR, Meijers JC, Schultz MJ (2007). "Pharmacokinetics and pharmacodynamics of danaparoid during continuous venovenous hemofiltration: a pilot study". Crit Care 11 (5): R102. doi:10.1186/cc6119. PMC 2556745. PMID 17854496. 
  3. ^ Schindewolf M, Magnani HN, Lindhoff-Last E (May 2007). "[Danaparoid in pregnancy in cases of heparin intolerance - use in 59 cases]". Hamostaseologie (in German) 27 (2): 89–97. PMID 17479171. 
  4. ^ Magnani HN, Gallus A (June 2006). "Heparin-induced thrombocytopenia (HIT). A report of 1,478 clinical outcomes of patients treated with danaparoid (Orgaran) from 1982 to mid-2004". Thromb. Haemost. 95 (6): 967–81. doi:10.1160/TH05-07-0489. PMID 16732376. 
  5. ^ Ontachi Y, Asakura H, Omote M, Yoshida T, Matsui O, Nakao S (November 2005). "Kasabach-Merritt syndrome associated with giant liver hemangioma: the effect of combined therapy with danaparoid sodium and tranexamic acid". Haematologica. 90 Suppl: ECR29. PMID 16266920. 
  6. ^ "Danaparoid (Subcutaneous Route) - MayoClinic.com". Retrieved 2007-08-23. 
  7. ^ "Heparin Induced Thrombocytopenia" Uptodate www.uptodate.com retrieved on 2/6/2009
  8. ^ "Schering-Plough - Products and Care - A-Z Product Listing". Retrieved 2008-08-23. 

External links[edit]