Hemoxiparin injection solution 4000IU/0.4ml ampoule #10

Hemoxiparin Solution for Injection 4000 IU/0.4ml Ampoule Composition: Active substance: Enoxaparin sodium 40 mg; Excipients: Water for injection - up to 0.4 ml. Indications for use: Hemoxiparin is indicated for use in adults. Prevention of venous thrombosis and embolism during surgical interventions in patients at moderate and high risk, especially in orthopedic and general surgical interventions, including oncological ones. Prevention of venous thrombosis and embolism in bedridden patients with acute therapeutic diseases, including acute heart failure and decompensated chronic heart failure (NYHA class III or IV), respiratory failure, as well as during acute infections and in patients with an increased risk of venous thromboembolism from rheumatic diseases (see "Special Indications"). Treatment of deep vein thrombosis with or without pulmonary artery embolism, except for cases of pulmonary artery embolism requiring thrombolytic therapy or surgical intervention. Prevention of thrombosis in the extracorporeal circulation system during hemodialysis. Acute coronary syndrome: Treatment of unstable angina and myocardial infarction without ST-segment elevation with concomitant oral administration of acetylsalicylic acid; Treatment of acute myocardial infarction with ST-segment elevation in patients undergoing drug therapy or subsequent percutaneous coronary intervention. Method of administration and dosage: Dosage regimen Prevention of venous thrombosis and embolism during surgical interventions in patients at moderate and high risk For patients at moderate risk of developing thrombosis and embolism (e.g., abdominal surgery), the recommended dose of Hemoxiparin is 20 mg once daily subcutaneously. The first injection is administered 2 hours before surgery. For patients at high risk of developing thrombosis and embolism (e.g., orthopedic surgery, oncological surgery, patients with additional risk factors not related to surgery, such as congenital or acquired thrombophilia, malignant neoplasms, bed rest for more than three days, obesity, history of venous thrombosis, varicose veins of the lower extremities, pregnancy), the recommended dose of the drug is 40 mg once daily subcutaneously, the first injection is administered 12 hours before surgery. If early preoperative prophylaxis is required (e.g., in patients at high risk of developing thrombosis and thromboembolism awaiting delayed orthopedic surgery), the last injection should be given 12 hours before surgery and 12 hours after surgery. The duration of treatment with Hemoxiparin is on average 7-10 days. If necessary, therapy can be continued as long as the risk of thrombosis and embolism persists and until the patient is discharged. In major orthopedic surgery, it may be advisable to continue treatment after the initial therapy with Hemoxiparin at a dose of 40 mg once daily for five weeks. For patients at high risk of venous thromboembolism who have undergone surgery, abdominal and pelvic surgery due to oncological disease, it may be advisable to extend the duration of Hemoxiparin administration at a dose of 40 mg once daily for four weeks. Prevention of venous thrombosis and embolism in bedridden patients with acute therapeutic diseases The recommended dose of Hemoxiparin is 40 mg once daily subcutaneously for 6-14 days. Therapy should be continued until the patient is fully mobilized (maximum 14 days). Treatment of deep vein thrombosis with or without pulmonary artery embolism The drug is administered subcutaneously at a dose of 1.5 mg/kg body weight once daily or at a dose of 1 mg/kg body weight twice daily. The dosage regimen should be selected by the physician based on the assessment of thromboembolism and bleeding risk. In patients without thromboembolic complications and at low risk of developing venous thromboembolism, the drug is recommended subcutaneously at a dose of 1.5 mg/kg body weight once daily. For all other patients, including those with obesity, symptomatic pulmonary embolism, cancer, recurrent venous thromboembolism, and proximal thrombosis (vena cava), the recommended dose of the drug is 1 mg/kg twice daily. The duration of treatment is on average 10 days. It is advisable to start therapy with indirect anticoagulants immediately, while therapy with Hemoxiparin should be continued until the therapeutic anticoagulant effect is achieved (the International Normalized Ratio should be 2.0-3.0). Prevention of thrombus formation in the extracorporeal circulation system during hemodialysis The recommended average dose of Hemoxiparin is 1 mg/kg body weight. If there is a high risk of bleeding, the dose should be reduced to 0.5 mg/kg body weight with double vascular access or to 0.75 mg/kg with single vascular access. During hemodialysis, Hemoxiparin should be administered into the arterial segment of the shunt at the beginning of the hemodialysis session. One dose is usually sufficient for a two-hour session, but if fibrin rings are detected during prolonged hemodialysis, additional administration of 0.5-1 mg/kg body weight can be given. There is no data on patients using enoxaparin sodium for prophylaxis or treatment during hemodialysis sessions. Unstable angina and myocardial infarction without ST-segment elevation Hemoxiparin is administered subcutaneously at a dose of 1 mg/kg body weight every 12 hours, with concomitant antiplatelet therapy. The average duration of therapy is at least 2 days and continues until the patient's clinical condition stabilizes. Usually, administration of the drug lasts from 2 to 8 days. Acetylsalicylic acid is recommended for all patients without contraindications, at an initial dose of 150-300 mg orally, followed by a maintenance dose of 75-325 mg once daily. Treatment of acute myocardial infarction with ST-segment elevation, with drug therapy or percutaneous coronary intervention. Treatment is initiated with an intravenous bolus injection of enoxaparin sodium at a dose of 30 mg, followed immediately by subcutaneous administration at a dose of 1 mg/kg body weight. Then, the drug is administered subcutaneously every 12 hours at a dose of 1 mg/kg body weight (maximum 100 mg of enoxaparin sodium for the first two subcutaneous injections, then - 1 mg/kg body weight for the remaining subcutaneous doses, i.e., for body weight over 100 kg, a single dose cannot exceed 100 mg). As soon as possible after the onset of acute myocardial infarction with ST-segment elevation, acetylsalicylic acid should be started concomitantly, which, in the absence of contraindications, should be continued daily for at least 30 days (at a dose of 75 to 325 mg). The recommended duration of treatment with Hemoxiparin is 8 days or until patient discharge (if hospitalization period is at least 8 days). When combined with thrombolytics (fibrin-specific and non-fibrin-specific), enoxaparin sodium should be administered at intervals of 15 minutes before the start of thrombolytic therapy and up to 30 minutes after it. In patients aged 75 years and older, initial intravenous bolus injection is not used. The drug is administered subcutaneously at a dose of 0.75 mg/kg every 12 hours (with a maximum of 75 mg of enoxaparin sodium for the first two subcutaneous injections, then the remaining subcutaneous dose is administered at 0.75 mg/kg body weight, i.e., for body weight over 100 kg, a single dose cannot exceed 75 mg). For patients undergoing percutaneous coronary intervention, if the last subcutaneous injection of enoxaparin sodium was administered less than 8 hours before balloon inflation at the site of coronary artery stenosis, no additional enoxaparin sodium is required. If the last subcutaneous injection was administered more than 8 hours before balloon inflation, an additional intravenous bolus injection of enoxaparin sodium at a dose of 0.3 mg/kg should be administered. Storage conditions: Store at a temperature not exceeding 25 C. Do not freeze. Keep out of reach of children.