Nadroparyna

Nadroparyna, or nadroparin, is a low molecular weight heparin (LMWH) anticoagulant derived from heparin. It enhances the activity of antithrombin III, preferentially inhibits factor Xa and, to a lesser extent, thrombin (factor IIa), reducing the generation of thrombin and the formation of clots. Compared with unfractionated heparin, nadroparin has more predictable pharmacokinetics, enabling fixed, weight-based subcutaneous dosing without routine coagulation monitoring in most patients.

Indications include prophylaxis of venous thromboembolism after surgery, including orthopedic procedures, and treatment of established deep vein thrombosis (DVT) and pulmonary embolism (PE). It may also be used as part of therapy for certain acute coronary syndromes in some regions.

Administration and dosing are by subcutaneous injection. Dosing is typically weight-based and may be given once daily for prophylaxis or more frequent for treatment, with adjustments for renal function. Nadroparin is not intended for intravenous use. In renal impairment, dose adjustments may be required and monitoring considered.

Contraindications include active major bleeding, history of heparin-induced thrombocytopenia (HIT), known hypersensitivity to nadroparin or heparin, and conditions with a high risk of bleeding. Caution is advised in pregnancy and lactation; use is guided by clinical judgment and supervision.

Adverse effects consist mainly of bleeding (major and minor), local injection-site reactions and hematoma, and, rarely, HIT. Prolonged therapy may contribute to osteoporosis. Interactions with other anticoagulants, antiplatelet agents, and nonsteroidal anti-inflammatory drugs can increase bleeding risk.

Monitoring generally requires no routine coagulation tests, but platelet counts should be checked to screen for HIT. Anti-Xa activity testing may be employed in specific populations (e.g., renal impairment, extremes of body weight, pregnancy, pediatrics) to guide dosing.