Reviparin Sodium

Indications
Subcutaneous
Prophylaxis of venous thromboembolism during moderate-risk surgical procedures
Adult: 1750 anti-Xa IU, given 2 hr prior to surgery. Continue once daily dosing until patient is fully mobile.
Subcutaneous
Prophylaxis of venous thromboembolism during high-risk surgical procedures
Adult: 4200 anti-Xa IU, given 12 hr before surgery. Continue once daily dosing until patient is fully mobile and for at least 14 days.
Subcutaneous
Thromboembolic disorders
Adult: Initiate treatment upon confirmation of diagnosis. 35-45 kg: 3500 anti-Xa IU; 46-60 kg: 4200 anti-Xa IU and >60 kg: 6300 anti-Xa IU. Doses to be given bid with an oral anticoagulant. Usual treatment duration with reviparin: 5-7 days.
Contraindications
Patients at serious risk of haemorrhage including blood disorders, thrombocytopaenia, peptic ulcer disease, cerebrovascular disorders, bacterial endocarditis, severe hypertension, oesophageal varices, patients who have recently undergone surgery, severe renal or hepatic impairment. IM admin. Patients who have developed thrombocytopenia with heparin. Patients with prosthetic heart valves.
Warnings / Precautions
Elderly (women in particular); lactation; children; renal failure; diabetes mellitus. Platelet count done before and during reviparin therapy. Monitor anti-factor-Xa activity in patients with increased risk of bleeding such as elderly, renally impaired patients and patients with active bleeding.
Adverse Reactions
Vomiting, constipation, epistaxis, conjunctivitis, asthma, rhinitis. Bleeding from skin, mucosa, GI tract, wounds and genital tract; thrombosis; thromboembolism; consumption coagulopathy; Inj site necrosis; melena; petechiae; purpura; allergic features like pruritus, urticaria; nausea, headache, fever, body pain, dyspnoea and hypotension; transient alopoecia, hyperkalaemia, hypoaldosteronism; metabolic acidosis; priapism.
Potentially Fatal: Severe thrombocytopaenia with severe thromboembolic disorders and haemorrhage.
Overdose Reactions
Overdosage may lead to haemorrhage. Severe bleeding may be decreased by slow IV admin of protamine sulfate.
Drug Interactions
Nitroglycerin infusion may diminish reviparin effect. May displace propranolol from protein-binding sites. Increased risk of haemorrhage when used with aspirin. Increased risk of hyperkalaemia when used with ACE inhibitors or angiotensin II receptor antagonists.
Potentially Fatal: Serious GI bleeding may occur when used with ketorolac.
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Mechanism of Actions
Reviparin sodium, like heparin, inhibits blood clotting in vitro and in vivo by enhancing the action of antithrombin III. Antithrombin III inhibits the activity of activated clotting factors including thrombin (factor IIa) and activated factor X (factor Xa).
Absorption: Absorbed from systemic circulation (SC); peak plasma concentrations after 3 hr. Bioavailability: about 95%.
Excretion: Excreted mainly in the urine. Elimination half-life: about 3 hr.
Available As
  • Reviparin Sodium 1432 anti-xa iu
  • Reviparin Sodium 3436 anti-xa iu
  • Reviparin Sodium 5726 anti-xa iu
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