Possible symptoms of hemorrhagic syndrome. Treatment . Minor bleeding rarely require special treatment, a significant (at the risk of thrombosis) – may require the assignment of protamine sulfate..
Interaction with other drugs
bemiparin sodium should not be mixed in the same container with other drugs for parenteral administration.
Do not co-administration of sodium bemiparin is recommended with vitamin K antagonists and other anticoagulants, acetyl salicylic acid and other salicylates and equipoise definition, ticlopidine, clopidogrel and other aggregation inhibitors platelets, and systemic glucocorticosteroids dextran due to potentiation of the pharmacological action of bemiparin sodium and increased risk of bleeding. In the case of inevitability appropriate combination therapy bemiparin sodium should be used under close clinical and laboratory control.
Concomitant use of drugs that increase the concentration of potassium in serum, also need to be carried out only under careful medical supervision.
The use of sodium bemiparin, as well as other drugs heparin, together with nitroglycerin intravenous reduces the efficiency of the anticoagulant.
Bemiparin sodium can not be administered intramuscularly.
In order to avoid the risk of hematoma during therapy with not be used by the intramuscular route of administration other drugs.
Various low molecular weight heparins do not always have equivalent activity, so for each drug in this class is necessary to observe specific dosage regimen and the method of application.
bemiparin sodium, as well as other low molecular weight heparins can suppress adrenal secretion of aldosterone, which may cause hyperkalemia, especially in patients with diabetes mellitus, chronic renal insufficiency prior metabolic acidosis, increased concentration of potassium in plasma or in patients taking potassium-sparing drugs. The risk of hyperkalemia is increased in proportion to the duration of therapy, but such hyperkalemia is usually reversible. In high-risk patients before starting therapy with equipoise definition is necessary to determine plasma electrolytes and regular monitoring of the relevant indicators in the course of treatment, especially if the duration of therapy with more than seven days.
In rare cases at the beginning of heparin therapy, observed a light transient thrombocytopenia type I , associated with temporary platelet activation.
). This reaction generally occurs between 5 and 21 th days of therapy. In patients with heparin-induced thrombocytopenia in the history of this complication can develop at an earlier date.
It is recommended that platelet counts before starting therapy with equipoise definition the first day of therapy, then – on a regular basis with 3-4 day intervals and at the end of therapy with . In the event of a significant reduction in the number of platelets (from 30 to 50%), coupled with positive or unknown results of studies in vitro for the presence of anti-platelet antibody in the presence of sodium bemiparin or other low molecular weight heparins and / or heparins, you should immediately discontinue therapy drug equipoise definitionand assign alternative treatment.
As with other heparins appointment, the application of sodium bemiparin cases of skin necrosis have been observed, sometimes preceded by redness or painful erythematous patches.