Nadroparin Calcium

Indications
 Subcutaneous
Prophylaxis of venous thromboembolism during surgical procedures
Adult: Moderate-risk patients: 2850 units daily for 7 days or until the patient is ambulant; give the 1st dose 2-4 hr before surgery. High-risk patients: 38 units/kg 12 hr before surgery, 12 hr post-operatively and then daily until 3 days after surgery; increase dose by 50% to 57 units/kg daily. Total duration of treatment: At least 10 days.
Renal impairment: Moderate to severe: Dose reduction may be required.
Subcutaneous
Thromboembolic disorders
Adult: 85 units/kg every 12 hr for up to 10 days or 171 units/kg/day once daily.
Renal impairment: Moderate to severe: Dose reduction may be required.
Intra-arterial
Prophylaxis of clotting in the extracorporeal circulation during haemodialysis sessions of <4 hr
Adult: <50 kg: 2850 units; 50-69 kg: 3800 units; ≥70 kg: 5700 units. Administer in the arterial line of the circuit at the start of dialysis. Patients at high risk of haemorrhage: Reduce dose.
Parenteral
Unstable angina
Adult: 86 units/kg SC every 12 hr for about 6 days. An initial dose of 86 units/kg may be given IV. Low-dose aspirin should also be given.
Renal impairment: Dose reduction may be required.

Special Populations: Reduce dose in renal impairment. Reduce dose to 50% in patients at high risk of haemorrhage.
Contraindications
 Acute infective endocarditis; haemorrhage or haemostasis disorder; active peptic ulceration; haemorrhagic cerebrovascular event; severe uncontrolled hypertension; diabetic or haemorrhagic retinopathy; injuries to or operations on the CNS, eyes or ears; history of thrombocytopenia with nadroparin. Lactation. Not for IM admin.
Warnings / Precautions
 Patients with recent or anticipated neuraxial anaesthesia; history of heparin-induced thrombocytopenia, congenital or drug-induced thrombocytopenia or platelet defects; patients at increased risk of bleeding; severe hepatic or renal disease. Monitor for signs of bleeding; hyperkalaemia. Pregnancy.
Adverse Reactions
 Hypoaldosteronism; bleeding, thrombocytopenia; rash; haematoma and pain at inj site; allergic reactions; osteopaenic effects; increased ALT/AST.
Overdose Reactions
 Symptoms: Haemorrhage. Management: Monitor platelet count and other coagulation parameters. Protamine sulfate may be used in severe cases; 6 mg (0.6 ml) neutralises approx 0.1 ml of nadroparin. Do not exceed a rate of 20 mg/min.
Drug Interactions
 Increased risk of bleeding with thrombolytic agents, oral anticoagulants and antiplatelet drugs.
See Below for More nadroparin calcium Drug Interactions
Food Interactions
 Additive anticoagulant or antiplatelet effects may occur with cat's claw, dong quai, evening primrose, garlic and ginseng.
Mechanism of Actions
 Nadroparin possesses high anti-factor Xa activity but has low anti-factor IIa (antithrombin) activity, potentially providing equivalent antithrombotic efficacy with less bleeding complications.
Duration: 18 hr.
Absorption: ≥89% of dose is absorbed (subcutaneous). Peak plasma concentrations in 3-5 hr.
Excretion: Via urine. Elimination half-life: 3.5 hr; prolonged to 6 hr in renal impairment.
Storage Conditions
 Intra-arterial: Store at 15-30°C (59-86°F). Do not freeze or refrigerate. Parenteral: Store at 15-30°C (59-86°F). Do not freeze or refrigerate. Subcutaneous: Store at 15-30°C (59-86°F). Do not freeze or refrigerate.
ATC Classification
 B01AB06 - nadroparin ; Belongs to the class of heparin group. Used in the treatment of thrombosis.
Storage
 Intra-arterial: Store at 15-30°C (59-86°F). Do not freeze or refrigerate. Parenteral: Store at 15-30°C (59-86°F). Do not freeze or refrigerate. Subcutaneous: Store at 15-30°C (59-86°F). Do not freeze or refrigerate.
Available As
  • Nadroparin Calcium 2500 iu
  • Nadroparin Calcium 2850 iu
  • Nadroparin Calcium 3075 iu
  • Nadroparin Calcium 3800 iu
  • Nadroparin Calcium 4000 iu
  • Nadroparin Calcium 4100 iu
  • Nadroparin Calcium 5700 iu
  • Nadroparin Calcium 6000 iu
  • Nadroparin Calcium 6150 iu
  • Nadroparin Calcium 8200 iu

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