2.8.1 Parenteral anticoagulants

Lyscine Acetylsalicyliate
  • 500mg vial (Unlicensed)

Indications

  • Use in intracranial aneurysms

Heparin

South Devon and Torbay patients
Dalteparin Sodium
  • Subcutaneous injection 2,500 units in 0.2ml, 5,000 units in 0.2ml
  • Pre-filled syringe 10,000 units in 0.4ml, 12,500 units in 0.5ml, 15,000 units in 0.6ml, 18,000 units in 0.72ml

Notes

  1. Dalteparin should be used for prophylaxis and treatment of thromboembolic disorders.
  2. Dalteparin should only be prescribed in the community in line with the guidelines in LMWH treatment in IV drug users and pregnant women. It remains a hospital only drug for all other indications.
Plymouth health community patients
Enoxaparin Sodium
  • Injection syringe 2,000 units (20mg), 4,000 units (40mg), 6,000 units (60mg), 8,000 units (80mg), 10,000 units (100mg)
  • Injection syringe 12,000 units (120mg), 15,000 units (150mg)
  • Injection multidose vial 30,000 units/ 3ml (300mg)

Notes

  1. Please refer to the shared care information – NEW Devon CCG - Western Locality
  2. Following discharge from hospital, the administration time of enoxaparin may be moved by a maximum of 4 hours to facilitate administration at a convenient regular time by primary care practitioners.
  3. Please refer to PHNT Guidelines for Venous Thromboembolism (VTE) Prophylaxis in Orthopaedics and Trauma
For use in renal patients
Tinzaparin Sodium
  • Prefilled syringe 2500 unit (0.25ml), 3500 unit (0.35ml), 4500 unit (0.45ml)

Notes

  1. Tinzaparin is included for the prevention of clotting in the extracorporeal circuit during haemodialysis in patients with chronic renal insufficiency only.
  2. For use within Plymouth Hospitals NHS Trust

Unfractionated heparin

Heparin sodium
  • 2 units/ml (1000 units/500ml bags)
  • 10 units/ml (50 units/5ml for I/V flush)
  • 100 units/ml (200 units/2ml for I/V flush – contains preservative)
  • 1000 units/ml (5000 units/5ml amps, 5000 units/5ml vials – contains preservative, 10,000 units/10ml amps, 20,000 units/20ml amps)
  • 5000 units/ml (25,000 units/5ml amps, 25,000 units/5ml vials – contains preservative)
  • 25000 units/ml (5000 units/0.2ml amps, 125,000 units/5ml vials – contains preservative)

Notes

  1. NPSA Rapid Response Report: Risk with Intravenous Heparin Flush Solutions (April 2008): Evidence on heparin flushes indicates no advantage over normal saline for maintaining peripheral intravenous catheters.

Heparinoids

Danaparoid
  • Injection 1250 unit/ml, 0.6ml amp (750 units)

Argatroban

Argatroban monohydrate
  • Concentrate for IV infusion 100mg/ml, 2.5ml vial

Notes

  1. For use within Plymouth Hospitals NHS Trust

Hirudins

Bivalirudin
  • Injection powder for reconstitution 250mg vial

Notes

  1. Please refer to NICE TA230 Bivalirudin for the treatment of ST-segment-elevation myocardial infarction (July 2011)

Heparin flushes

Epoprostenol
  • Flolan® infusion, powder for reconstitution 500micrograms

Fondaparinux

Fondaparinux
  • Injection pre-filled syringe 2.5mg

Notes

  1. Fondaparinux is included in the formulary for treatment of acute coronary syndrome (ACS) only. It is not approved for the treatment or prophylaxis of venous thromboembolism. See NICE CG94 Unstable angina and NSTEMI (March 2010) for further information.

 

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