Which medications in the drug class Low Molecular Weight Heparins are used in the treatment of Deep Venous Thrombosis (DVT)?

Updated: Jul 05, 2017
  • Author: Kaushal (Kevin) Patel, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Low Molecular Weight Heparins

Low-molecular-weight-heparin (LMWH) is prepared by selectively treating unfractionated heparin (UFH) to isolate the low molecular weight (<9000 Da) fragments. Its activity is measured in units of factor X inactivation, and monitoring of the activated partial thromboplastin time (aPTT) is not required. The dose is weight adjusted. Enoxaparin (Fragmin), dalteparin (Lovenox), and tinzaparin (Innohep) have received US Food and Drug Administration (FDA) approval for the treatment of deep venous thrombosis (DVT) in the United States. Enoxaparin is approved for inpatient and outpatient treatment of DVT.

Dalteparin (Fragmin)

Dalteparin enhances inhibition of factor Xa and thrombin by increasing antithrombin III activity. In addition, it preferentially increases inhibition of factor Xa. Except in overdoses, no utility exists in checking prothrombin time (PT) or activated partial thromboplastin time (aPTT) because aPTT does not correlate with anticoagulant effect of fractionated low-molecular-weight heparin (LMWH). The average duration of treatment is 7-14 days.

Enoxaparin (Lovenox)

Enoxaparin is a low-molecular-weight (LMWH) used in treatment of deep venous thrombosis (DVT) and pulmonary embolism (PE) as well as DVT prophylaxis. It enhances inhibition of factor Xa and thrombin by increasing antithrombin III activity, it slightly affects thrombin and clotting time, and it preferentially increases inhibition of factor Xa. The average duration of treatment is 7-14 days.

Tinzaparin (Innohep)

Tinzaparin enhances inhibition of factor Xa and thrombin by increasing antithrombin III activity. In addition, it preferentially increases inhibition of factor Xa. The average duration of treatment is 7-14 days.


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