Formulary
Danaparoid sodium: Indications, Dosing, Side Effects and Interactions
Danaparoid sodium clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Danaparoid sodium: Indications, Dosing, Side Effects and Interactions
Danaparoid sodium clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Prevention of deep-vein thrombosis in general or orthopaedic surgery**
- **Adult** (By Subcutaneous Injection): 750 units twice daily for 7-10 days, initiate treatment before operation, with last pre-operative dose 1-4 hours before surgery.
**Thromboembolic disease in patients with history of heparin-induced thrombocytopenia for danaparoid sodium**
- **Neonate** (Initially by intravenous injection): Initially 30 units/kg, then (by continuous intravenous infusion) 1.2-2 units/kg/hour, infusion dose to be adjusted according to coagulation activity.
- **Child 1 month-15 years (body-weight up to 55 kg)** (Initially by intravenous injection): Initially 30 units/kg (max. per dose 1250 units), then (by continuous intravenous infusion) 1.2-2 units/kg/hour, infusion dose to be adjusted according to coagulation activity.
- **Child 1 month-15 years (body-weight 55 kg and above)** (Initially by intravenous injection): Initially 30 units/kg (max. per dose 2500 units), then (by continuous intravenous infusion) 1.2-2 units/kg/hour, infusion dose to be adjusted according to coagulation activity.
- **Child 16-17 years (body-weight up to 55 kg)** (Initially by intravenous injection): Initially 1250 units, then (by continuous intravenous infusion) 400 units/hour for 2 hours, then (by continuous intravenous infusion) 300 units/hour for 2 hours, then (by continuous intravenous infusion) 200 units/hour for 5 days, infusion dose to be adjusted according to coagulation activity.
- **Child 16-17 years (body-weight 55-90 kg)** (Initially by intravenous injection): Initially 2500 units, then (by continuous intravenous infusion) 400 units/hour for 2 hours, then (by continuous intravenous infusion) 300 units/hour for 2 hours, then (by continuous intravenous infusion) 200 units/hour for 5 days, infusion dose to be adjusted according to coagulation activity.
- **Child 16-17 years (body-weight 91 kg and above)** (Initially by intravenous injection): Initially 3750 units, then (by continuous intravenous infusion) 400 units/hour for 2 hours, then (by continuous intravenous infusion) 300 units/hour for 2 hours, then (by continuous intravenous infusion) 200 units/hour for 5 days, infusion dose to be adjusted according to coagulation activity.
Cautions
Antibodies to heparins (risk of antibody-induced thrombocytopenia); body-weight over 90 kg; recent bleeding; risk of bleeding
Contraindications
Active peptic ulcer (unless this is the reason for operation); acute bacterial endocarditis; diabetic retinopathy; epidural anaesthesia (with treatment doses); haemophilia and other haemorrhagic disorders; recent cerebral haemorrhage; severe uncontrolled hypertension; spinal anaesthesia (with treatment doses); thrombocytopenia (unless patient has heparin-induced thrombocytopenia)
Side effects
Common or very common Haemorrhage; heparin-induced thrombocytopenia; skin reactions; thrombocytopenia Uncommon Post procedural haematoma Rare or very rare Anastomotic haemorrhage
Interactions
**Other interactions (2):**
- Danaparoid sodium may be used together with oral anticoagulants vitamin K antagonists (VKA), drugs which interfere with platelet function (such as aspirin and non-steroidal anti-inflammatory drugs)...
- Monitoring of anticoagulant activity of oral anticoagulants by prothrombin time and thrombotest is unreliable within 5 hours after danaparoid sodium administration.
Pregnancy
Manufacturer advises avoid-limited information available but not known to be harmful.
Breast feeding
Amount probably too small to be harmful but manufacturer advises avoid.
Hepatic impairment
Manufacturer advises caution in moderate impairment with impaired haemostasis-increased risk of bleeding; avoid in severe hepatic failure unless patient has heparin-induced thrombocytopenia and no alternative available.
Renal impairment
Use with caution in moderate impairment. Avoid in severe impairment unless patient has heparin-induced thrombocytopenia and no alternative available. Monitoring Increased risk of bleeding in renal impairment, monitor anti-Factor Xa activity.
Medicinal forms
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.
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