Peringatan Keamanan

Bemiparin, like other drugs in its class, may suppress adrenal secretion of aldosterone, leading to elevated potassium (hyperkalemia). This may occur more frequently in patients with conditions such as diabetes mellitus, chronic renal failure, metabolic acidosis, an increased plasma potassium, and those ingesting potassium sparing drugs. There is a linear relationship between duration of therapy and adverse effects, but this is usually reversible with cessation of treatment. Serum electrolytes should be measured in at-risk patients before starting bemiparin, and these patients should be monitored regularly thereafter particularly if treatment is prolonged beyond 1 week.

In rare cases, mild transient thrombocytopenia (HIT type I) at the beginning of therapy with heparin with platelet counts between 100,000/mm3 and 150,000/mm3 due to temporary platelet activation has been noted in clinical studies.

On rare occasions, antibody-mediated severe thrombocytopenia (HIT type II) with platelet counts clearly below
100,000/mm3 has been observed (see section 4.8). This effect usually occurs within 5-21 days after the initiation of treatment, although in patients with a history of heparin-induced thrombocytopenia this may occur more rapidly.

Platelet count studies are recommended before the administration of bemiparin, on the first day of therapy and then every 3-4 days, in addition to repeating platelet studies at the end of therapy. Treatment must be discontinued immediately and an alternate therapy initiated if significant reductions in platelet counts are observed ( 30% decrease and above) L1462.

As with other heparin products, cases of cutaneous necrosis, often preceded by purpura or painful erythematous, ecchymose-like lesions have been reported with bemiparin. In these cases, treatment should cease immediately L1462.

Overdosage after subcutaneous or other routes of administration of bemiparin may lead to hemorrhagic complications. Neutralization can be obtained by slow intravenous of a suitable dose of the antidote protamine sulphate L1463.

Bemiparin

DB09258

small molecule approved investigational

Deskripsi

Bemiparin is an antithrombotic and belongs to the group of drugs known as the low molecular weight heparins (LMWH). Like semuloparin, bemiparin is classified as an ultra-LMH because of its low mean molecular mass of 3600 daltons, which is a unique property of this class A7866. These heparins have lower anti-thrombin activity than the traditional low molecular weight heparins and act mainly on factor-Xa, reducing the risk of bleeding due to selectivity for this specific clotting factor. Interestingly, current research is underway for the potential benefit of bemiparin in the treatment of tumors and diabetic foot ulcers L1468, A7866.

Struktur Molekul 2D

Struktur tidak tersedia

Peta Jejaring Molekuler
Legenda: Obat • Target • Gen • Enzim • (Panah → menunjukkan arah efek / relasi) • Transporter • Carrier

Profil Farmakokinetik

Waktu Paruh (Half-Life) Bemiparin, when administered in the dose range of 2,500 IU to 12,500 (therapeutic dosing), it has an approximate half-life of 5-6 hours [L1462].
Volume Distribusi 5.1 L [A32018].
Klirens (Clearance) Elimination occurs in a linear fashion, with a mean clearance time of over 7 h and total clearance of 0.9 L/h [A32018].

Absorpsi

Hemiparin sodium is rapidly absorbed following its subcutaneous dose of injection, and the bioavailability is estimated to be 96% L1462.

Metabolisme

In a study of healthy volunteers, bemiparin 3500 IU achieved more anti-Xa activity than enoxaparin 4000 IU, measured by the area under the curve. The peak of anti-Xa activity was reached at 3h post-administration, and there were anti-Xa measurable levels up to 16 h after subcutaneous injection A32030.

Rute Eliminasi

This drug is eliminated by the renal and hepatic routes. Elimination is prolonged in those with renal or hepatic impairment L1466.

Interaksi Makanan

1 Data
  • 1. Avoid herbs and supplements with anticoagulant/antiplatelet activity. Examples include garlic, ginger, bilberry, danshen, piracetam, and ginkgo biloba.

Interaksi Obat

860 Data
Apixaban Apixaban may increase the anticoagulant activities of Bemiparin.
Dabigatran etexilate Dabigatran etexilate may increase the anticoagulant activities of Bemiparin.
Dasatinib The risk or severity of bleeding and hemorrhage can be increased when Dasatinib is combined with Bemiparin.
Deferasirox The risk or severity of gastrointestinal bleeding can be increased when Bemiparin is combined with Deferasirox.
Ursodeoxycholic acid The risk or severity of bleeding and bruising can be increased when Bemiparin is combined with Ursodeoxycholic acid.
Glycochenodeoxycholic Acid The risk or severity of bleeding and bruising can be increased when Bemiparin is combined with Glycochenodeoxycholic Acid.
Cholic Acid The risk or severity of bleeding and bruising can be increased when Bemiparin is combined with Cholic Acid.
Glycocholic acid The risk or severity of bleeding and bruising can be increased when Bemiparin is combined with Glycocholic acid.
Deoxycholic acid The risk or severity of bleeding and bruising can be increased when Bemiparin is combined with Deoxycholic acid.
Taurocholic acid The risk or severity of bleeding and bruising can be increased when Bemiparin is combined with Taurocholic acid.
Obeticholic acid The risk or severity of bleeding and bruising can be increased when Bemiparin is combined with Obeticholic acid.
Chenodeoxycholic acid The risk or severity of bleeding and bruising can be increased when Bemiparin is combined with Chenodeoxycholic acid.
Taurochenodeoxycholic acid The risk or severity of bleeding and bruising can be increased when Bemiparin is combined with Taurochenodeoxycholic acid.
Tauroursodeoxycholic acid The risk or severity of bleeding and bruising can be increased when Bemiparin is combined with Tauroursodeoxycholic acid.
Bamet-UD2 The risk or severity of bleeding and bruising can be increased when Bemiparin is combined with Bamet-UD2.
Dehydrocholic acid The risk or severity of bleeding and bruising can be increased when Bemiparin is combined with Dehydrocholic acid.
Hyodeoxycholic Acid The risk or severity of bleeding and bruising can be increased when Bemiparin is combined with Hyodeoxycholic Acid.
Edoxaban The risk or severity of bleeding can be increased when Edoxaban is combined with Bemiparin.
Ibrutinib The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Bemiparin.
Obinutuzumab The risk or severity of bleeding and hemorrhage can be increased when Bemiparin is combined with Obinutuzumab.
Rivaroxaban Bemiparin may increase the anticoagulant activities of Rivaroxaban.
Sugammadex The risk or severity of bleeding and hemorrhage can be increased when Bemiparin is combined with Sugammadex.
Tibolone Tibolone may increase the anticoagulant activities of Bemiparin.
Tipranavir The risk or severity of bleeding and hemorrhage can be increased when Tipranavir is combined with Bemiparin.
Urokinase Urokinase may increase the anticoagulant activities of Bemiparin.
Vitamin E Vitamin E may increase the anticoagulant activities of Bemiparin.
Vorapaxar The risk or severity of bleeding and hemorrhage can be increased when Vorapaxar is combined with Bemiparin.
Trandolaprilat The risk or severity of hyperkalemia can be increased when Trandolaprilat is combined with Bemiparin.
Moexiprilat The risk or severity of hyperkalemia can be increased when Moexiprilat is combined with Bemiparin.
Cilazaprilat The risk or severity of hyperkalemia can be increased when Cilazaprilat is combined with Bemiparin.
Ginkgo biloba Ginkgo biloba may increase the anticoagulant activities of Bemiparin.
Ifosfamide The risk or severity of bleeding can be increased when Ifosfamide is combined with Bemiparin.
Quinine The therapeutic efficacy of Bemiparin can be increased when used in combination with Quinine.
Quinidine The therapeutic efficacy of Bemiparin can be increased when used in combination with Quinidine.
Tamoxifen The risk or severity of bleeding can be increased when Tamoxifen is combined with Bemiparin.
Toremifene The risk or severity of bleeding can be increased when Toremifene is combined with Bemiparin.
Corticorelin ovine triflutate The risk or severity of hypotension and sinus node depression can be increased when Bemiparin is combined with Corticorelin ovine triflutate.
Oritavancin The therapeutic efficacy of Bemiparin can be decreased when used in combination with Oritavancin.
Streptokinase Streptokinase may increase the anticoagulant activities of Bemiparin.
Telavancin The therapeutic efficacy of Bemiparin can be decreased when used in combination with Telavancin.
Palifermin The serum concentration of Palifermin can be increased when it is combined with Bemiparin.
Pentoxifylline The therapeutic efficacy of Bemiparin can be increased when used in combination with Pentoxifylline.
Pentosan polysulfate Pentosan polysulfate may increase the anticoagulant activities of Bemiparin.
Levocarnitine The therapeutic efficacy of Bemiparin can be increased when used in combination with Levocarnitine.
Diethylstilbestrol Diethylstilbestrol may decrease the anticoagulant activities of Bemiparin.
Chlorotrianisene Chlorotrianisene may decrease the anticoagulant activities of Bemiparin.
Conjugated estrogens Conjugated estrogens may decrease the anticoagulant activities of Bemiparin.
Mestranol The risk or severity of adverse effects can be increased when Mestranol is combined with Bemiparin.
Estrone sulfate Estrone sulfate may decrease the anticoagulant activities of Bemiparin.
Quinestrol Quinestrol may decrease the anticoagulant activities of Bemiparin.
Hexestrol Hexestrol may decrease the anticoagulant activities of Bemiparin.
Synthetic Conjugated Estrogens, A Synthetic Conjugated Estrogens, A may decrease the anticoagulant activities of Bemiparin.
Synthetic Conjugated Estrogens, B Synthetic Conjugated Estrogens, B may decrease the anticoagulant activities of Bemiparin.
Polyestradiol phosphate Polyestradiol phosphate may decrease the anticoagulant activities of Bemiparin.
Esterified estrogens Esterified estrogens may decrease the anticoagulant activities of Bemiparin.
Zeranol Zeranol may decrease the anticoagulant activities of Bemiparin.
Equol Equol may decrease the anticoagulant activities of Bemiparin.
Methallenestril Methallenestril may decrease the anticoagulant activities of Bemiparin.
Epimestrol Epimestrol may decrease the anticoagulant activities of Bemiparin.
Moxestrol Moxestrol may decrease the anticoagulant activities of Bemiparin.
Estradiol acetate Estradiol acetate may decrease the anticoagulant activities of Bemiparin.
Estradiol benzoate Estradiol benzoate may decrease the anticoagulant activities of Bemiparin.
Estradiol cypionate Estradiol cypionate may decrease the anticoagulant activities of Bemiparin.
Estradiol valerate Estradiol valerate may decrease the anticoagulant activities of Bemiparin.
Biochanin A Biochanin A may decrease the anticoagulant activities of Bemiparin.
Formononetin Formononetin may decrease the anticoagulant activities of Bemiparin.
Estriol Estriol may decrease the anticoagulant activities of Bemiparin.
Limaprost The risk or severity of adverse effects can be increased when Limaprost is combined with Bemiparin.
Icosapent The risk or severity of bleeding and hemorrhage can be increased when Icosapent is combined with Bemiparin.
Mesalazine The risk or severity of bleeding can be increased when Mesalazine is combined with Bemiparin.
Indomethacin The risk or severity of bleeding and hemorrhage can be increased when Indomethacin is combined with Bemiparin.
Nabumetone The risk or severity of bleeding and hemorrhage can be increased when Nabumetone is combined with Bemiparin.
Ketorolac The risk or severity of bleeding and hemorrhage can be increased when Ketorolac is combined with Bemiparin.
Tenoxicam The risk or severity of bleeding and hemorrhage can be increased when Tenoxicam is combined with Bemiparin.
Celecoxib The risk or severity of bleeding and hemorrhage can be increased when Celecoxib is combined with Bemiparin.
Tolmetin The risk or severity of bleeding and hemorrhage can be increased when Tolmetin is combined with Bemiparin.
Rofecoxib The risk or severity of bleeding and hemorrhage can be increased when Rofecoxib is combined with Bemiparin.
Piroxicam The risk or severity of bleeding and hemorrhage can be increased when Piroxicam is combined with Bemiparin.
Fenoprofen The risk or severity of bleeding and hemorrhage can be increased when Fenoprofen is combined with Bemiparin.
Valdecoxib The risk or severity of bleeding and hemorrhage can be increased when Valdecoxib is combined with Bemiparin.
Diclofenac The risk or severity of bleeding and hemorrhage can be increased when Diclofenac is combined with Bemiparin.
Sulindac The risk or severity of bleeding and hemorrhage can be increased when Sulindac is combined with Bemiparin.
Flurbiprofen The risk or severity of bleeding and hemorrhage can be increased when Flurbiprofen is combined with Bemiparin.
Etodolac The risk or severity of bleeding and hemorrhage can be increased when Etodolac is combined with Bemiparin.
Mefenamic acid The risk or severity of bleeding and hemorrhage can be increased when Mefenamic acid is combined with Bemiparin.
Naproxen The risk or severity of bleeding and hemorrhage can be increased when Naproxen is combined with Bemiparin.
Sulfasalazine The risk or severity of bleeding and hemorrhage can be increased when Sulfasalazine is combined with Bemiparin.
Phenylbutazone The risk or severity of bleeding and hemorrhage can be increased when Phenylbutazone is combined with Bemiparin.
Meloxicam The risk or severity of bleeding and hemorrhage can be increased when Meloxicam is combined with Bemiparin.
Carprofen The risk or severity of bleeding and hemorrhage can be increased when Carprofen is combined with Bemiparin.
Diflunisal The risk or severity of bleeding and hemorrhage can be increased when Diflunisal is combined with Bemiparin.
Salicylic acid The risk or severity of bleeding and hemorrhage can be increased when Salicylic acid is combined with Bemiparin.
Meclofenamic acid The risk or severity of bleeding and hemorrhage can be increased when Meclofenamic acid is combined with Bemiparin.
Oxaprozin The risk or severity of bleeding and hemorrhage can be increased when Oxaprozin is combined with Bemiparin.
Ketoprofen The risk or severity of bleeding and hemorrhage can be increased when Ketoprofen is combined with Bemiparin.
Balsalazide The risk or severity of bleeding and hemorrhage can be increased when Balsalazide is combined with Bemiparin.
Olsalazine The risk or severity of bleeding can be increased when Bemiparin is combined with Olsalazine.
Lumiracoxib The risk or severity of bleeding and hemorrhage can be increased when Lumiracoxib is combined with Bemiparin.
Magnesium salicylate The risk or severity of bleeding and hemorrhage can be increased when Magnesium salicylate is combined with Bemiparin.
Salsalate The risk or severity of bleeding and hemorrhage can be increased when Salsalate is combined with Bemiparin.

Target Protein

Coagulation factor X F10
Antithrombin-III SERPINC1
Heparin cofactor 2 SERPIND1

Referensi & Sumber

Artikel (PubMed)
  • PMID: 14524738
    Chapman TM, Goa KL: Bemiparin: a review of its use in the prevention of venous thromboembolism and treatment of deep vein thrombosis. Drugs. 2003;63(21):2357-77.
  • PMID: 12943485
    Planes A: Review of bemiparin sodium--a new second-generation low molecular weight heparin and its applications in venous thromboembolism. Expert Opin Pharmacother. 2003 Sep;4(9):1551-61.
  • PMID: 21458847
    Jeske WP, Hoppensteadt D, Gray A, Walenga JM, Cunanan J, Myers L, Fareed J, Bayol A, Rigal H, Viskov C: A common standard is inappropriate for determining the potency of ultra low molecular weight heparins such as semuloparin and bemiparin. Thromb Res. 2011 Oct;128(4):361-7. doi: 10.1016/j.thromres.2011.03.001. Epub 2011 Apr 2.
  • PMID: 21162606
    Sanchez-Ferrer CF: Bemiparin: pharmacological profile. Drugs. 2010 Dec 14;70 Suppl 2:19-23. doi: 10.2165/1158581-S0-000000000-00000.
  • PMID: 17258114
    Hoffman M, Monroe DM: Coagulation 2006: a modern view of hemostasis. Hematol Oncol Clin North Am. 2007 Feb;21(1):1-11. doi: 10.1016/j.hoc.2006.11.004.
  • PMID: 19954711
    Antonijoan RM, Rico S, Martinez-Gonzalez J, Borrell M, Valcarcel D, Fontcuberta J, Barbanoj MJ: Comparative pharmacodynamic time-course of bemiparin and enoxaparin in healthy volunteers. Int J Clin Pharmacol Ther. 2009 Dec;47(12):726-32.

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