Clexane

Description overdue on 07/10/2014

• Latin name: Clexane
• ATC code: B01AB05
• Active substance: Enoxaparin Sodium (Enoxaparin sodium)
• Manufacturer: SANOFI WINTHROP INDUSTRIE (France)

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• Composition
• Product form
• Pharmacological action
• Pharmacodynamics and pharmacokinetics
• Indications
• Contraindications
• Side effects
• Instructions for use Clexane
• Overdose
• Cooperation
• Terms of sale
• Storage conditions
• Shelf life
• Cautions
• Analogs
• Babies
• During pregnancy (and lactation)
• Reviews
• Price, where to buy

Composition

One syringe contained in a dose-dependent: 10,000 anti-Xa IU 2000 anti-Xa IU, 8,000 anti-Xa IU, 4,000 anti-Xa IU or 6,000 anti-Xa IU enoxaparin sodium .

Product form

The medicine is a clear solution for injection colorless or yellowish.

1.0 ml, 0.8 ml, 0.6 ml, 0.4 ml or 0.2 ml of this solution in a glass syringe, two such syringe blister, one or five such blister packs in the paper bundle.

Pharmacological action

Clexane (Clexane) has antithrombotic action.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Clexane INN (International Nonproprietary Name) enoxaparin . The drug is a low molecular weight Heparin   with a molecular mass of about 4500 daltons. Obtained by alkaline hydrolysis heparin benzyl ester Extracted from porcine intestinal mucosa.

When used as a preventive drug doses little change APTT Almost no effect on platelet aggregation and binding of fibrinogen. For therapeutic doses enoxaparin   increases APTT   1, 5-2, 2 times.

Pharmacokinetics

After systematic hypodermic enoxaparin sodium   at 1.5 mg per kilogram of body weight per day equilibrium concentration occurs within 2 days. The bioavailability after subcutaneous administration of 100%.

Enoxaparin sodium   metabolized in the liver via desulfation   and depolymerization . Thus formed metabolites have very low activity.

The half-life - 4 hours (single administration) or 7 hours (multiple doses). 40% of the drug is excreted through the kidneys. Withdrawal enoxaparin   in elderly patients is delayed due to the deterioration of renal function.

In patients with renal clearance enoxaparin   reduced.

Indications

This drug has the following contraindications:

• prevention thrombosis   and embolism   veins after surgery;
• therapy deep vein thrombosis   complicated or not complicated pulmonary embolism ;
• prevention thrombosis   veins and embolism in patients who are on long-term bed rest due to acute therapeutic diseases (chronic and acute heart failure , Heavy infection . respiratory insufficiency , Acute rheumatic disease );
• prevention thrombosis   in the extracorporeal blood flow hemodialysis ;
• therapy angina   and heart attack   without tooth Q;
• Acute Therapy heart attack   with an increase in the ST segment in individuals in need of medical treatment.

Contraindications

• Allergies   to the drug and other low molecular weight heparins .
• Diseases with increased risk of bleeding, such as aneurysm Threatening abortion, bleeding, hemorrhagic stroke .
• Prohibited use of Clexane in pregnancy in women with artificial heart valves.
• Age less than 18 years (safety and efficacy not established).

With care to apply in the following cases:

• diseases associated with impaired hemostasis ( hemophilia . hypocoagulation, thrombocytopenia, von Willebrand's disease ) Expressed in vasculitis ;
• stomach ulcers and 12 duodenal ulcer, erosive and ulcerative lesions of the digestive tract;
• recent ischemic stroke ;
• heavy arterial hypertension ;
• hemorrhagic or diabetic retinopathy ;
• diabetes   severe;
• recent generations;
• recent neurological or ophthalmological intervention;
• execution Epidural   or spinal anesthesia cn INNO-brain puncture ;
• bacterial endocarditis ;
• intrauterine contraception;
• pericarditis ;
• kidney disease or liver disease;
• severe trauma, extensive open wounds;
• a joint reception with affecting hemostasis drugs.

Side effects

As with other anticoagulants the risk of bleeding, especially during invasive procedures, or the use of drugs affecting hemostasis. If any bleeding should stop administering medication, find the cause of complications and start appropriate treatment.

When using the drug in the background Epidural   or spinal anesthesia   postoperative use of penetrating catheters revealed sightings neuraxial hematoma Leading to neurological disorders of varying severity, including irreversible paralysis .

Thrombocytopenia   in the prevention thrombosis   veins in surgical patients, treatment deep venous thrombosis   and myocardial infarction   ST-segment elevation occurred in 1-10% of the time and at 0, 1-1% of cases in preventing thrombosis   veins in patients on bed rest and undergoing therapy myocardial infarction   and angina .

After the introduction of Clexane under the skin may cause hematoma   at the injection site. At 0, 001% of the cases developed local necrosis   skin.

Rarely appearing skin and systemic reactions hypersensitivity Including anaphylactic .

Also described asymptomatic transient increase in liver enzyme concentrations.

Instructions for use Clexane

Instructions for use Clexane reports that the drug is administered by deep subcutaneous patient in the supine position.

As stabbing Clexane?

The drug should be administered in the left and right lateral abdomen alternately. The injection is necessary to make such manipulation, opening the syringe needle to expose and put it vertically to its full length, pre-assembled with thumb and forefinger skin fold. Folds released after injection. It is not recommended to massage the place of the drug.

Video pounding Clexane:

The drug is administered intramuscularly prohibited.

Scheme administration. Produce 2 injections per day with an exposure of 12 hours. The dose for one administration should be 100 anti-Xa IU per kilogram of body weight.

In patients with an average risk of thrombosis   required dose of 20 mg once a day. The first administration is carried out for 2 hours before surgery.

Patients with a greater risk of occurrence thrombosis   recommended Clexane 40 mg administered once a day (first administration 12 hours before surgery), or 30 mg twice a day (the first 13-24 hours after administration after surgery). The duration of therapy is on average a week or 10 days. If necessary, treatment can be continued until there is risk thrombosis .

Treatment deep venous thrombosis . The drug is administered at the rate of 1, 5 mg per kilogram body weight per day. The course of treatment usually lasts for 10 days.

Prevention thrombosis   and embolism   veins in patients on bed rest due to acute therapeutic diseases. The required dose - 40 mg 1 time a day (duration of 6-14 days).

Overdose

Accidental overdose can cause serious haemorrhagic   complications. When administered orally, drug absorption into the systemic circulation is unlikely.

As the neutralizing agent shown in the slow introduction protamine sulphate   intravenously. One mg of protamine neutralizes one mg of enoxaparin. If overdose from the beginning more than 12 hours, the introduction of protamine sulphate   not required.

Cooperation

The drug Clexane should not be mixed with other drugs. Also, do not alternate the use of Clexane and other low molecular weight heparins.

When applied to acetylsalicylic acid , Dextran 40 kD, NSAIDs . clopidogrel   and ticlopidine . thrombolytic or   anticoagulants   may increase the risk of bleeding.

Terms of sale

Strictly prescription.

Storage conditions

Keep away from children. Keep at temperatures up to 25 ° C.

Shelf life

Three years.

Cautions

When using the drug for prevention of the tendency to increase the bleeding risk have been identified. When using the drug Clexane therapeutic purposes there is a risk of bleeding in the elderly. In these cases, close observation of the patient.

Clexane does not affect the ability to drive.

Analogs Clexane

Clexane Analogues with identical active substance: Clexane 300 . Novoparin . Enoksarin .

Is it better or Clexane Fraksiparin?

Frequently asked question patients about the comparative effectiveness of drugs. Fraksiparin   Clexane and belong to the same group and are analogues. Research reliably confirming the superiority of one drug over the other was carried out. Therefore, the choice between the drugs should exercise attending physician based on the clinical picture of the disease, the patient and their own experience.

Babies

Contraindicated in persons under 18 years of age.

Clexane Pregnancy and lactation

It is forbidden (except in cases where the benefits for the mother to the fetus higher risk) Clexane used during pregnancy. The consequences can be unpredictable, since precise data on the impact of the use of Clexane in pregnancy on her for not.

If necessary, use Clexane should stop breast-feeding during treatment.

Reviews Kleksane

Since the beginning of the use of the drug in clinical practice Clexane performed well both among doctors and among patients. Reports of allergy to the drug is extremely small.

Price Clexane

It should be noted that the cost of the drug is not always correlated with dosage. The average price of Clexane 0.2 ml (10 pcs.) In Russia is 3,600 rubles, Clexane 0.4 ml (10 pcs.) - 2960 rubles, 0.8 ml (10 pcs.) - 4100 rubles, and bought in Moscow preparation in the same doses will cost no much more expensive.

In Ukraine, the price of 0.2 ml of Clexane number 10 - 665 hryvnia, 0.4 ml of number 10 - 1045 hryvnia, and 0.8 ml of number 10 - 323 hryvnia.

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