Danaparoid
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| AHFS/Drugs.com | Micromedex Detailed Consumer Information |
| MedlinePlus | a602007 |
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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
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
On August 14, 2002, this drug was withdrawn by Organon International.[6] Due to a shortage in drug substance, the manufacturer discontinued providing the medication in the United States.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
Side effects
- 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.
- Possibly Asthma exacerbations, due to allergies to sulfites contained within the medicine (no case has been reported to date).
References
- ^ 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.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ 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.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ 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.
- ^ 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.
- ^ 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.
- ^ "Danaparoid (Subcutaneous Route) - MayoClinic.com". Retrieved 2007-08-23.
- ^ "Heparin Induced Thrombocytopenia" Uptodate www.uptodate.com retrieved on 2/6/2009
- ^ "Schering-Plough - Products and Care - A-Z Product Listing". Retrieved 2008-08-23.
External links
- danaparoid at the U.S. National Library of Medicine Medical Subject Headings (MeSH)