Prophylaxis of clotting in the extracorporeal circulation during haemodialysis, Prophylaxis of clotting in the extracorporeal circulation during haemofiltration
Adult: 30-40 international units/kg via bolus inj, followed by 10-15 international units/kg/hour via infusion. A single dose of 5,000 international units, either via IV or into the arterial side of the extracorporeal system at the start of the procedure, may be given for haemodialysis or haemofiltration session lasting <4 hours. For patients at high risk of bleeding or in acute renal failure: 5-10 international units/kg via bolus inj, followed by 4-5 international units/kg/hour via infusion.
Subcutaneous
Venous thromboembolism
Adult: For the treatment of established DVT and/or pulmonary embolism: 200 international units/kg daily as a single inj, or in 2 divided doses in patients with increased risk of bleeding. Max: 18,000 international units daily. Patients with symptomatic VTE and cancer: 200 international units/kg once daily for the 1st 30 days, followed by 150 international units/kg once daily for up to 5 months. Max: 18,000 international units daily. If chemotherapy-induced thrombocytopenia develops, reduce total daily dose by 2,500 international units while platelet counts are below 100,000 cells/mm3; temporarily stop treatment if platelet counts are below 50,000 cells/mm3.
Subcutaneous
Prophylaxis of venous thromboembolism during surgical procedures
Adult: Patients with moderate risk of thrombosis: 2,500 international units given 1-2 hours before the procedure, followed by 2,500 international units once daily for 5-7 days or until the patient is fully ambulant. Patients with high risk of thrombosis (e.g. undergoing orthopaedic surgery): 2,500 international units given 1-2 hours before and 8-12 hours after the procedure, followed by 5,000 international units daily. Alternatively, 5,000 international units given on the evening before the surgery, then 5,000 international units each subsequent evening. Another alternative for orthopaedic surgery (e.g. hip replacement surgery): 2,500 international units given 4-8 hours after surgery, followed by 5,000 international units daily. Continue treatment until the patient is mobilised, generally 5-7 days, or up to 5 weeks after orthopaedic surgery (e.g. hip replacement surgery).
Subcutaneous
Non-Q wave myocardial infarction, Unstable angina
Adult: 120 international units/kg 12 hourly for 5-8 days with concomitant low-dose aspirin. Max: 10,000 international units 12 hourly. For patients who require treatment longer than 8 days while awaiting revascularisation procedure: 5,000 international units (7,500 international units in men weighing ≥70 kg and women weighing ≥80 kg) 12 hourly, given until the day of the procedure but not for >45 days.
Subcutaneous
Prophylaxis of deep vein thrombosis
Adult: In patients bedridden due to a medical condition (e.g. CHF, acute respiratory failure, acute infection) who may also have predisposing risk factors (e.g. age >75 years, obesity, cancer, or previous history of VTE): 5,000 international units once daily for up to 14 days or longer.