Danaparoid

Danaparoid is an anticoagulant classified as a heparinoid, composed of a mixture of glycosaminoglycans derived from porcine intestinal mucosa. The main components are dermatan sulfate, heparan sulfate, and chondroitin sulfate. This composition gives danaparoid distinct anticoagulant properties compared with standard heparin.

Its anticoagulant effect is indirect. Danaparoid enhances the activity of antithrombin and, to a lesser extent, heparin cofactor II to inhibit coagulation factors, most notably factor Xa, with relatively little effect on thrombin (factor IIa). As a result, it provides mainly anti-Xa activity and has limited anti-IIa activity. Unlike unfractionated heparin, danaparoid contains little or no direct thrombin-inhibitory action.

Danaparoid is given parenterally, by intravenous infusion or subcutaneous injection, depending on the indication. It is cleared predominantly by the kidneys, and its half-life increases with reduced renal function. There is no specific antidote; protamine sulfate can partially reverse its effects, but reversal is incomplete.

Clinical use has focused on situations where heparin is unsuitable, particularly for patients with heparin-induced thrombocytopenia or a heparin allergy. It has also been used for postoperative DVT prophylaxis in some settings. Safety considerations include bleeding risk, the potential for hypersensitivity to porcine-derived products, and reduced usefulness in patients with significant renal impairment.

Regulatory status varies by country. Historically marketed under brands such as Orgaran, danaparoid use has diminished in many regions due to bleeding risk and the availability of alternative anticoagulants, though it remains available in some markets for specific indications.