Formulary
Bemiparin sodium: Indications, Dosing, Side Effects and Interactions
Bemiparin sodium is a low molecular weight heparin that acts as an anticoagulant by enhancing the effect of antithrombin III to primarily inhibit activated...
MedNext Academy | 3 min read
Bemiparin sodium: Indications, Dosing, Side Effects and Interactions
Bemiparin sodium is a low molecular weight heparin that acts as an anticoagulant by enhancing the effect of antithrombin III to primarily inhibit activated...
Drug action
Bemiparin sodium is a low molecular weight heparin that acts as an anticoagulant by enhancing the effect of antithrombin III to primarily inhibit activated factor X (factor Xa), with a lesser effect on thrombin.
Indications and dose
**Prophylaxis of deep-vein thrombosis [general surgery]**
- **Adult** (By Subcutaneous Injection): 2500 units for 1 dose, dose to be given 2 hours before or 6 hours after surgery, then 2500 units every 24 hours.
**Prophylaxis of deep-vein thrombosis [orthopaedic surgery]**
- **Adult** (By Subcutaneous Injection): 3500 units for 1 dose, dose to be given 2 hours before or 6 hours after surgery, then 3500 units every 24 hours.
Cautions
Elderly; risk of bleeding; severe hypertension
Contraindications
Acute bacterial endocarditis; after major trauma; avoid injections containing benzyl alcohol in neonates; epidural anaesthesia with treatment doses; haemophilia or other haemorrhagic disorders; peptic ulcer; recent cerebral haemorrhage; recent surgery to eye; recent surgery to nervous system; spinal anaesthesia with treatment doses; thrombocytopenia (including history of heparin-induced thrombocytopenia) Contra-indications For bemiparin sodium Recent surgery to ear; severe impairment of pancreatic function
Side effects
Common or very common Haemorrhage; heparin-induced thrombocytopenia; skin reactions Rare or very rare Alopecia; hyperkalaemia; osteoporosis (following long term use); spinal haematoma Side-effects, further information Haemorrhage If haemorrhage occurs it is usually sufficient to withdraw heparin or a low molecular weight heparin, but if rapid reversal of the effects of the heparin is required, protamine sulfate is a specific antidote (but only partially reverses the effects of low molecular weight heparins). Heparin-induced thrombocytopenia Clinically important heparin-induced thrombocytopenia is immune-mediated and can be complicated by thrombosis. Signs of heparin-induced thrombocytopenia include a 30% reduction of platelet count, thrombosis, or skin allergy. If heparin-induced thrombocytopenia is strongly suspected or confirmed, the heparin should be stopped and an alternative anticoagulant, such as danaparoid, should be given. Ensure platelet counts return to normal range in those who require warfarin. Hyperkalaemia Inhibition of aldosterone secretion by heparin or a low molecular weight heparin can result in hyperkalaemia; patients with diabetes mellitus, chronic renal failure, acidosis, raised plasma potassium or those taking potassium-sparing drugs seem to be more susceptible. The risk appears to increase with duration of therapy. Side-effects For bemiparin sodium Frequency not known Epidural haematoma
Pregnancy
Caution-limited information available (no toxicity in animal studies and not known if bemiparin sodium crosses the placenta). M
Breast feeding
Avoid-no information available. M
Hepatic impairment
Avoid in severe impairment. M
Renal impairment
When used for Prophylaxis of deep-vein thrombosis [general and orthopaedic surgery]: Caution if creatinine clearance less than 80 mL/minute (limited information available). M Consider measuring anti-Factor Xa levels at about 4 hours after dosing if creatinine clearance less than 30 mL/minute. M Dose adjustments See Prescribing in renal impairment . When used for Prophylaxis of deep-vein thrombosis [orthopaedic surgery]: A dose of 2500 units once daily could be considered if creatinine clearance less than 30 mL/minute (limited information available). M
Medicinal forms
Medicinal forms No licensed medicines listed.
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Bemiparin sodium in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

