No effect on thrombin; safe for use in HITS
    • Mechanism of Action
    • Binds to and activates antithrombin III, which as a heparin-ATIII complex inactivates factor Xa.
    • Pharmacology
    • More potent (2-4x) than unfractionated heparin due to higher activation of antithrombin III
    • Smaller molecules are able to bind only to factor Xa, with no effect on IIa
    • Better bioavailability and more predictable response than heparin

Clinical Use

    • Indications
    • Prevention of venous thromboembolism (DVT / PE)
    • Treatment of venous thromboembolism (DVT / PE)
    • ST elevation myocardial infarction (STEMI)
    • Bridging anticoagulation for initiation / withholding of warfarin
    • Adverse Effects
    • Haemorrhage
    • Hypersensitivity
    • Elevated LFTs
    • Thrombocytopaenia (less commonly than heparin)
    • Monitoring
    • Not monitored in most cases, though anti-factor Xa levels may be taken.
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