Hematological Agents : Anticoagulants
ICLEX1 “Clexane injection” 100 mg/ml; 0.6 ml/syringe
適應症：治療深部靜脈血栓、與Ａspirin併用以治療不穩定狹心症及非Ｑ波之急性心肌梗塞。適用於年齡75歲以下，腎功能（Ccr）大於60 ml/min，ST-波段升高的急性心肌梗塞的病患，不論患者隨後是否接受冠狀動脈血管成形術，皆可與血栓溶解劑併用。
Usual dose: SC
Deep venous thrombosis (DVT): 1 mg/kg q12h or 1.5 mg/kg q24h, continue for 5-17 days.
Acute ST segment elevation myocardial infarction: (< 75 yrs) initial, a single IV bolus dose of 30 mg and 1 mg/kg; maintenance, 1 mg/kg q12h; max. 100 mg for the first 2 doses only.
Abdominal surgery- Prevention of DVT: 40 mg q24h; give initial dose 2 h before surgery, and then for 7-10 days.
Unstable angina: 1 mg/kg q12h for 2-8 days in conjunction with aspirin therapy.
Dose adjustment:
Renal impairment: (CrCl < 30 ml/min)
Prevention of DVT following abdominal surgery: 30 mg SC qd, give initial dose 2 h before surgery and continue for 7-10 days.
ST-segment elevation MI (< 75 yrs): 30 mg IV bolus plus 1 mg/kg SC followed by 1 mg/kg qd.
Prevention of DVT, restricted mobility during acute illness: 30 mg SC qd for 14 days.
Precaution: diabetic retinopathy, bleeding diathesis.
Adverse effect:
Common: edema, diarrhea, nausea, hematoma, normocytic hypochromic anemia, confusion, pain, dyspnea, fever, local irritation symptom.
Serious: atrial fibrillation, heart failure, eczematous drug eruption, skin necrosis, hemorrhage, thrombocytopenia, increased liver function test, anaphylactoid reaction, spinal hematoma, pneumonia, pulmonary edema.