parnaparin

Action and Spectrum

Actions and Spectrum: 

parnaparin, like other LMWHs, works primarily by enhancing the activity of antithrombin III, a natural anticoagulant protein in the body. Antithrombin III inactivates several clotting factors, including thrombin (factor IIa) and factor Xa, essential components in the coagulation cascade that leads to blood clot formation. 

LMWHs have a higher affinity for factor Xa compared to thrombin. parnaparin, being an LMWH, predominantly inhibits factor Xa. By binding to antithrombin III and accelerating its interaction with factor Xa, parnaparin inhibits the conversion of prothrombin to thrombin and reduces the formation of fibrin clots. 

The spectrum of activity of parnaparin primarily involves its anticoagulant effects. It’s used for various clinical indications where anticoagulation is required. These indications can include: 

• Prevention and Treatment of Deep Vein Thrombosis (DVT): parnaparin is used to prevent the formation of blood clots in deep veins, which can lead to conditions like deep vein thrombosis. 
• Prevention of Pulmonary Embolism (PE): parnaparin helps prevent the movement of blood clots from the veins, where they form, to the lungs, where they can cause pulmonary embolism. 
• Prophylaxis in Surgery: parnaparin can prevent blood clot formation after surgery, especially in situations where patients are at a higher risk of developing clots due to immobilization or surgical procedures. 
• Treatment of Unstable Angina and Non-ST Segment Elevation Myocardial Infarction: parnaparin might also be considered in some instances of cardiovascular diseases, where its anticoagulant effects can help manage clot formation associated with unstable angina and certain types of heart attacks. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Injection site reaction 

Bleeding 

Black Box Warning

Black box warning: 

None 

Contraindication / Caution

Contraindications/caution: 

Contraindications: 

• Hypersensitivity or Allergy: Individuals with a known hypersensitivity or allergic reaction to parnaparin or its components should avoid its use. 
• Active Major Bleeding: parnaparin is an anticoagulant, which can increase the risk of bleeding. It should be avoided in individuals with active major bleeding, including gastrointestinal bleeding, intracranial hemorrhage, or significant trauma. 
• Thrombocytopenia: parnaparin, like other anticoagulants, can further decrease the platelet count in individuals with thrombocytopenia (low platelet count), increasing the risk of bleeding. Therefore, it is generally contraindicated in such cases. 
• Bacterial Endocarditis: parnaparin is typically avoided in individuals with bacterial endocarditis, a serious infection of the heart lining and valves, due to the risk of emboli (clots or infected material) breaking off and causing further complications. 
• Uncontrolled Hypertension: Individuals with uncontrolled high blood pressure may be at an increased risk of bleeding complications if they receive anticoagulant therapy, including parnaparin. 

Pregnancy / Lactation

Pregnancy consideration: N/A 

Lactation: N/A 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

<b>Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

parnaparin works primarily by enhancing the activity of antithrombin III (ATI), a natural anticoagulant protein in the body. It binds to ATIII and accelerates its inactivation of several clotting factors, particularly factor Xa and, to a lesser extent, thrombin (factor IIa). The inhibition of factor Xa interrupts the coagulation cascade and reduces the conversion of prothrombin to thrombin, thus preventing the formation of fibrin clots. 

Pharmacokinetics: 

Absorption 

parnaparin is administered through subcutaneous injection. Upon injection, it is absorbed into the bloodstream from the injection site. Subcutaneous administration allows for a gradual and controlled release of the medication into the systemic circulation. 

Distribution 

parnaparin primarily distributed within the blood. As an anticoagulant, it must interact with clotting factors in the bloodstream to exert its effects. Parnaparin is designed to have a higher affinity for factor Xa, a key component in the coagulation cascade. 

Metabolism 

parnaparin undergoes both renal and hepatic metabolism. Some of the medication is metabolized by the kidneys and the liver, leading to the breakdown of its components. The metabolism of Parnaparin contributes to its elimination from the body. 

Elimination and Excretion 

parnaparin is primarily excreted via the urine. The kidneys play a crucial role in eliminating the medication and its metabolites from the body. The excretion of Parnaparin through the urine removes it from the bloodstream, which helps maintain proper coagulation balance. 

Adminstartion

Administration: 

It is administered through subcutaneous injection. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: parnaparin 

Why do we use parnaparin? 

parnaparin is a low molecular weight heparin (LMWH) used for various medical conditions requiring anticoagulation. Its main uses include: 

• Prevention and Treatment of Deep Vein Thrombosis (DVT): parnaparin is used to prevent the formation of blood clots in deep veins, particularly in situations where individuals are at a higher risk of developing DVT, such as after surgery or during prolonged periods of immobility. 
• Prevention of Pulmonary Embolism (PE): parnaparin is also used to prevent blood clots from traveling to the lungs and causing pulmonary embolism, a potentially life-threatening condition. 
• Prophylaxis in Surgery: parnaparin is commonly employed to prevent the formation of blood clots after surgical procedures. It is mainly used in orthopedic surgeries (like hip or knee replacements) where the risk of clot formation is elevated due to surgical trauma and immobility. 
• Treatment of Unstable Angina and Non-ST Segment Elevation Myocardial Infarction (NSTEMI): In some cardiovascular diseases, parnaparin might be used to manage clot formation associated with unstable angina and NSTEMI. 
• Management of Acute Ischemic Stroke: In some clinical situations, parnaparin might be considered to manage acute ischemic stroke, especially when the risk of bleeding is deemed manageable.