Monitoring anti-Xa levels

Monitoring anti-Xa levels

Not routinely required, but should be considered for specific patients including those with renal faliure1

Some patient populations, including those with renal failure, will require monitoring of anti-Xa levels when using Fragmin®1

The Need:

Monitoring of anti-Xa levels in patients using Fragmin® is not usually required but should be considered for specific patient populations such as paediatrics, those with renal failure, those who are very thin or morbidly obese, pregnant or at increased risk for bleeding or rethrombosis1

Patients with severely disturbed hepatic function may need a reduction in dosage and should be monitored accordingly1

Haemodialysis:

Patients undergoing chronic haemodialysis with Fragmin® need as a rule fewer dosage adjustments and as a result fewer controls of anti-Xa levels. Patients undergoing acute haemodialysis may be more unstable and should have a more comprehensive monitoring of anti-Xa levels2

References

1. Fragmin SmPC [Surgical Thromboprophylaxis (2,500 IU and 5,000 IU syringes)]. Available at: https://www.medicines.org.uk/emc/product/4246 and https://www.medicines.org.uk/emc/product/4247
2. Fragmin SmPC [Haemodialysis/Haemofiltration (10,000 IU/1 ml & 10,000 IU/4 ml ampoules)]. Available at: https://www.medicines.org.uk/emc/product/4251 and https://www.medicines.org.uk/emc/product/4244

*Including, but not limited to: congestive cardiac failure (NYHA class III or IV), acute respiratory failure or acute infection, who also have a predisposing risk factor for VTE such as age over 75 years, obesity, cancer or previous history of VTE.~
†In patients with chronic renal insufficiency or acute renal failure.

Renally Impaired Patients

PP-FRA-GBR-0173.  June 2019