Anticoagulant

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• QWhat is drotrecogin alfa?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  The manufacturer of this drug has withdrawn it from the market, and it is not currently available.

  Drotrecogin alfa is a recombinant form of human activated protein C, a natural anticoagulant enzyme with potent anti-clot and anti-inflammatory properties. It is administered to hospitalized adults with severe sepsis and multiple organ system failures to decrease the mortality rate. Sepsis is a bacterial infection in the bloodstream that affects the whole body by causing inflamation and clot formation in various organs. Drotrecogin alpha works by decreasing the production of inflammatory chemicals, preventing clot formation and increasing clot breakdown. This drug is given slowly by continuous intravenous infusion and may take as long as four days to administer.  Drotrecogin alfa is available only under the brand name Xigris.
  
  

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• QWhat is Dalteparin sodium injection?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Dalteparin is the name of the active ingredient in a drug sold under the brand name Fragmin. It is an injectable anticoagulant; it prevents dangerous blood clots from forming. In other words, this is a drug that "thins the blood." Dalteparin is often taken with aspirin. This combination prevents clotting problems in blood vessels. It’s effective for treating deep vein thrombosis. This is a serious blood clot that can occur after surgery, when someone is bed-ridden for a long-term illness, or is sitting and not mobile during long car rides or plane flights. It also treats heart attacks and angina (chest pain).
  
  
• QWhat is dalteparin injection?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Fragmin is the brand name of dalteparin. It is an anticoagulant, which prevents dangerous blood clots by thinning the blood. Dalteparin is often taken with aspirin to prevent blood vessel complications in patients with angina (chest pain) or heart attacks. Dalteparin is also used to prevent a type of blood clot called deep vein thrombosis (DVT), which can lead to blood clots in the lungs (pulmonary embolism). A DVT can occur after certain types of surgery, or in people who are bedridden due to a long-term illness. Dalteparin is also used long term to treat a blood clot called a venous thromboembolism.
  
  
• QWhat is Innohep?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Innohep is the brand name for the drug tinzaparin, classified as a low molecular weight heparin. It is an anticoagulant used to treat blood clots. This medicine is administered by injection, often in a medical facility.
  
  
• QWhat are the side effects of Innohep?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Side effects of Innohep can occur. Discomfort at the injection site is common, and need only be reported to your doctor if it is severe or if it is accompanied by bleeding. More serious side effects are possible and you should contact your doctor right away if you experience them. These include symptoms of an allergic reaction to Innohep, including severe itching, a rash or hives, swelling of the face or mouth and trouble breathing. Other serious side effects include:

  • faintness
  • dizziness
  • lightheadedness
  • fever
  • headaches
  • constipation
  • nausea and vomiting
  • chest pain
  • urinary tract infection
  • unusually heavy menstrual flow

  Since this drug can cause bleeding, be aware of side effects that would indicate bleeding problems, such as:

  • nosebleeds
  • bruising
  • bleeding gums
  • red skin spots
  • black stools
  • coughing blood
  • bloody urine
  • back and stomach pain

• QWhat should I know about Innohep before using it?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Innohep may cause problems for people with certain other health conditions. These include:

  • bleeding disorders
  • intestinal bleeding or ulcers
  • stomach bleeding or ulcers
  • bleeding of the brain
  • hemophilia
  • liver disease
  • bowel disease
  • aneurism
  • certain heart infections
  • kidney disease
  • high blood pressure
  • diabetic retinopathy
  • those who have previously suffered a stroke or a negative reaction to heparin

  People who have recently given birth or had surgery on their eye, spine or brain may not be able to receive this medication. Although this medicine is pregnancy Category B, it does contain benzyl alcohol, a preservative that is harmful for premature babies. If you are pregnant or breastfeeding, you should check with your doctor to see if this drug is safe enough for use. In addition, this drug can cause side effects, including an allergic reaction. Before you receive it, you should be aware of the possible side effects and what to do if they occur.
  
  

• QHow does Innohep interact with other medications or foods?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Innohep should not be given with aspirin, drugs related to aspirin, blood thinners, mifepristone or other blood clot medications. It also may interact with:

  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
  • some heart attack medications
  • clopidogrel
  • dextran
  • dipyridamole
  • sulfinpyrazone
  • ticlopidine
  • tromethamine
  • dasatinib
  • ibritumomab
  • pentosan
  • pentoxifylline
  • tositumomab
  • tirofiban

  Make sure you tell your doctor about all of the other medications, vitamins and herbal supplements you take. Your doctor can determine whether or not these may produce harmful side effects when combined with Innohep.

• QWho should not use Innohep?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  People who are allergic to Innohep, pork, benzyl alcohol, sulfites or any ingredient in this medication should not use it. People who have had low platelets due to heparin drugs, a condition called heparin-induced thrombocytopenia (HIT), should not use this medication. In addition, people with significant, ongoing bleeding or kidney disease, those older than 90, and pregnant women may not be able to take this medication.
  
  
• QWhat should I know about Hep-Lock U/P before using it?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Before using Hep-Lock U/P you should know some safety information about heparin, the active ingredient. Heparin is an anticoagulant; it helps prevent blood clots from forming. Hep-Lock U/P is used only for preventing clots from forming in intravenous (IV) lines, not for regular anticoagulant therapy. A small amount of the heparin solution is injected into the IV catheter to just fill the volume of the catheter. The amount of drug contained in the amount injected is so small that few side effects are expected.
  
  
• QWho should not receive dalteparin?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  You should not receive dalteparin if you are allergic to pork products, heparin, benzyl alcohol, enoxaparin or any of the ingredients listed on the prescription label. Dalteparin is not for people with severe high blood pressure, excessive bleeding or a personal history of low platelet levels or other complications due to heparin treatment. If you are prescribed dalteparin to treat chest pain or a heart attack, do not use it if you are also scheduled to receive local anesthesia. Because little is known about its effects on children, use extreme caution when administering dalteparin to children.

  Talk to your doctor about the risks and benefits of receiving dalteparin during pregnancy. Dalteparin contains benzyl alcohol that can harm a fetus, and pregnant women who decide to receive dalteparin must be prescribed a version of dalteparin without this added preservative. Check with your doctor if you are breastfeeding during dalteparin treatment, as it can pass to your baby through breast milk. Dalteparin should be used with caution in elderly people, as they may experience more severe side effects. Also, it is important to avoid activities that may cause injury or bodily damage during dalteparin treatment.