Danaparoid sodium

How it works

It exerts antithrombotic activity predominantly through antithrombin-mediated inhibition of factor Xa, with relatively little effect on thrombin, and has a low rate of cross-reactivity with HIT antibodies.

Prescribing in practice

• Bleeding is the main risk, and because there is no specific antidote and a long half-life, monitoring and careful patient selection are important.
• Cross-reactivity with heparin-induced thrombocytopenia antibodies, though uncommon, can occur and should be considered if platelets fall.
• Anti-factor Xa activity (using a danaparoid-specific assay) is used to guide therapeutic dosing in higher-risk settings.

Monitoring

Monitor platelet count and, where therapeutic anticoagulation is needed, danaparoid-specific anti-factor Xa activity.

Counselling the patient

• This medicine is an alternative anticoagulant often used when there is a reaction to heparin.
• Report unusual bruising or bleeding promptly.
• Inform your team of any previous reaction to heparin or low molecular weight heparin.

Evidence & guidelines

Danaparoid is an established option for anticoagulation in heparin-induced thrombocytopenia; consult current prescribing references and specialist haematology advice.