Description

Simple

An anticoagulant or "blood thinner" used to treat serious blood clots which can occur as a rare side effect of heparin.

Clinical

A heparinoid with anticoagulant and antithrombotic activities used for the treatment of acute episode of Heparin-Induced Thrombocytopenia (HIT), and for prophylaxis in patients with a history of HIT.

Overview

Danaparoid is a low-molecular-weight heparinoid with an average molecular weight of 5500 Daltons consisting of a mixture of glycosaminoglycans [2]. The active constituents are heparan, dermatan and [DB09301] [4], and they are isolated from the porcine intestinal mucosa [FDA Label]. Danaparoid possesses a potent antithrombic activity that works by inhibiting activated factor X (Factor Xa) and activated factor II (Factor IIa). It is chemically distinct from heparin by containing different protein binding properties, thus has lower cross-reactivity in heparin-intolerant patients. Danaproid is used in the treatment of heparin-induced thrombocytopenia (HIT) as an off-label indication and prevention of post-operative deep venous thrombosis (DVT). While it was initially approved by the FDA as Orgaran™, danaparoid was withdrawn by Organon International on August 14, 2002, due to a shortage in drug substance by the manufacturer. The use of Orgaran™ was discontinued in the United States however it is available in several other countries including European countries and Japan. Danaparoid sodium is the common salt form in therapeutic... Read more

Pharmacology

Indication

Indicated for the prophylaxis of post-operative deep venous thrombosis (DVT), which may lead to pulmonary embolism (PE), in patients undergoing elective hip replacement surgery [FDA Label].

Pharmacodynamic

Danaparoid contains a mixture of heparan sulfate, dermatan sulfate and chondroitin sulfate in amounts of approximately 84%, 12% and 4%, respectively [ Read more

Mechanism of action

In the coagulation cascade leading to clot formation, factor X and factor II requires activation to promote subsequent conversion of fibrinogen to fibrin. The mechanism of action of danaparoid resulting in anticoagulant and antithrombic effects involves a complex interaction between 2 components, fa... Read more

Absorption

Pharmacokinetic studies on danaparoid are based on the kinetics of its anticoagulant activities, which are mostly antifactor Xa and antifactor IIa activities. The bioavailability of danaparoid is 100% following subcutaneous administration [FDA Label]. Following administration of single subcutaneous... Read more

Protein binding

Information currently not available.

Volume of distribution

Pharmacokinetic studies on danaparoid are based on the kinetics of its anticoagulant activities, which are mostly anti factor Xa and anti factor IIa activities. The volumes of distribution of anti-Xa and anti-IIa activities are 9.1 L and 7.3-9.0 L, respectively [ Read more

Clearance

Pharmacokinetic studies on danaparoid are based on the kinetics of its anticoagulant activities, which are mostly anti factor Xa and anti factor IIa activities. Total plasma clearance is about 0.36 L/h during anti-Xa activity, which may be accelerated with higher body surface area [FDA Label]. Total... Read more

Half life

Pharmacokinetic studies on danaparoid are based on the kinetics of its anticoagulant activities, which are mostly anti factor Xa and anti factor IIa activities. The elimination half-life ranges from 19.2 to 24.5 hours during anti-Xa activity and ranges from 1.8 to 4.3 hours during anti-IIa activity... Read more

Route of elimination

Renal excretion is the main route of elimination, accounting for approximately 40-50% of the total clearance of antifactor Xa activity following intravenous administration of danaparoid [ Read more

Toxicity

Subcutaneous administration of a single dose at 3800 anti-Xa units/kg, which is 20.5 times the recommended dose for humans based on body surface area, was found to be lethal to female rats. Lethal effects were seen in male rats when administering a single subcutaneous dose at 15200 anti-Xa units/kg,... Read more

Adverse Effects

Contraindications

Information currently not available.

Food Interactions

    Information currently not available.

Interactions

Type in a drug name to check for interaction with Danaparoid
Type a drug name in the box above to get started
  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
(1,2,6,7-3H)Testosterone
(1,2,6,7-3H)Testosterone may increase the anticoagulant activities of Danaparoid.
(R)-warfarin
The risk or severity of bleeding can be increased when Danaparoid is combined with (R)-warfarin.
(S)-Warfarin
The risk or severity of bleeding can be increased when Danaparoid is combined with (S)-Warfarin.
1-Testosterone
1-Testosterone may increase the anticoagulant activities of Danaparoid.
18-methyl-19-nortestosterone
18-methyl-19-nortestosterone may increase the anticoagulant activities of Danaparoid.
3,5-Diiodotyrosine
3,5-Diiodotyrosine may increase the anticoagulant activities of Danaparoid.
4-hydroxycoumarin
The risk or severity of bleeding can be increased when Danaparoid is combined with 4-hydroxycoumarin.
4-Hydroxytestosterone
4-Hydroxytestosterone may increase the anticoagulant activities of Danaparoid.
5beta-dihydrotestosterone
5beta-dihydrotestosterone may increase the anticoagulant activities of Danaparoid.
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline
The risk or severity of bleeding and hemorrhage can be increased when 7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline is combined with Danaparoid.
Abciximab
The risk or severity of bleeding can be increased when Abciximab is combined with Danaparoid.
Acebutolol
The risk or severity of hyperkalemia can be increased when Acebutolol is combined with Danaparoid.
Aceclofenac
The risk or severity of bleeding and hemorrhage can be increased when Aceclofenac is combined with Danaparoid.
Acemetacin
The risk or severity of bleeding and hemorrhage can be increased when Acemetacin is combined with Danaparoid.
Acenocoumarol
The risk or severity of bleeding can be increased when Acenocoumarol is combined with Danaparoid.
Acetylsalicylic acid
Acetylsalicylic acid may increase the anticoagulant activities of Danaparoid.
Agmatine
The risk or severity of hyperkalemia can be increased when Danaparoid is combined with Agmatine.
Alaproclate
The risk or severity of hemorrhage can be increased when Alaproclate is combined with Danaparoid.
Albutrepenonacog alfa
The therapeutic efficacy of Albutrepenonacog alfa can be decreased when used in combination with Danaparoid.
Alclofenac
The risk or severity of bleeding and hemorrhage can be increased when Alclofenac is combined with Danaparoid.
4 References
  1. 1 . Kodityal S, Manhas AH, Udden M, Rice L: Danaparoid for heparin-induced thrombocytopenia: an analysis of treatment failures. Eur J Haematol. 2003 Aug;71(2):109-13.PubMed: 12890149
  2. 2 . Ibbotson T, Perry CM: Danaparoid: a review of its use in thromboembolic and coagulation disorders. Drugs. 2002;62(15):2283-314.PubMed: 12381232
  3. 3 . Wilde MI, Markham A: Danaparoid. A review of its pharmacology and clinical use in the management of heparin-induced thrombocytopenia. Drugs. 1997 Dec;54(6):903-24.PubMed: 9421696
  4. 4 . 24. (2012). In Rang and Dale's Pharmacology (7th ed., pp. 299-300). Edinburgh: Elsevier/Churchill Livingstone.