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Commonly used low molecular weight heparins are enoxaparin, dalteparin, nadroparin and tinzaparin. [5] [6] In HIT, the platelet count in the blood falls below the normal range, a condition called thrombocytopenia. However, it is generally not low enough to lead to an increased risk of bleeding.
Enoxaparin is in the low molecular weight heparin family of medications. [11] Enoxaparin was first made in 1981 and approved for medical use in 1993. [12] [11] It is on the World Health Organization's List of Essential Medicines. [13] Enoxaparin is sold under several brand names and is available as a generic medication. [11]
Low-molecular-weight heparin (LMWH) is a class of anticoagulant medications. [1] They are used in the prevention of blood clots and, in the treatment of venous thromboembolism ( deep vein thrombosis and pulmonary embolism ), and the treatment of myocardial infarction .
Heparin and its low-molecular-weight derivatives (e.g., enoxaparin, dalteparin, tinzaparin) are effective in preventing deep vein thromboses and pulmonary emboli in people at risk, [24] [25] but no evidence indicates any one is more effective than the other in preventing mortality. [26]
The prevalence of antithrombin deficiency is estimated at ~0.02 to 0.2% of the general population, and 1-5% of patients with venous thromboembolism. [6] There is an elevated risk of thrombosis, whereby 50% patients with AT deficiency were found to have venous thromboembolism by age 50. [6]
Low-dose low molecular weight heparin (e.g. enoxaparin) may be used. [20] For life-threatening complications, the platelet count can be reduced rapidly using plateletpheresis, a procedure that removes platelets from the blood and returns the remainder to the patient. [20]
Patients undergoing PCI also need an anticoagulant to prevent catheter thrombosis. Options include unfractionated heparin, enoxaparin (a low molecular weight heparin), fondaparinux (a pentasaccharide antagonist of factor Xa) and bivalirudin (a direct thrombin inhibitor); all the above agents are given parenterally (subcutaneously or intravenously).
Low molecular weight heparin (LMWH, such as enoxaparin) is generally used as an alternative. [44] Warfarin and LMWH may safely be used in breastfeeding. [44] When women experience recurrent pregnancy loss secondary to thrombophilia, some studies have suggested that low molecular weight heparin reduces the risk of miscarriage.
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