Bemiparin sodium

How it works

It potentiates antithrombin, producing predominantly anti-factor Xa activity with relatively little effect on thrombin, thereby inhibiting clot formation.

Prescribing in practice

• The main risk is bleeding, so use with caution where bleeding risk is high and avoid in active major haemorrhage.
• Dose is reduced in renal impairment because of accumulation, and it is given by subcutaneous injection.
• Heparin-induced thrombocytopenia can occur, and it should be avoided in those with a history of it.

Monitoring

Routine anticoagulant monitoring is not usually required, but check platelet count and renal function, with anti-Xa levels considered in selected patients.

Counselling the patient

• The injection is given under the skin and you can be taught to do this yourself.
• Report any unusual bleeding or bruising.
• Do not stop treatment early without medical advice.

Evidence & guidelines

Low molecular weight heparins such as bemiparin have a well-established evidence base for the prevention and treatment of venous thromboembolism.