Danaparoid sodium is an anticoagulant with an antithrombotic action due to inhibition of thrombin generation by two mechanisms: indirect inactivation of Factor Xa via AT and direct inhibition of thrombin activation of Factor IX. It also possesses a minor anti-thrombin activity, mediated equally via AT and Heparin Co-factor II producing a ratio of anti-Xa:IIa activity >22. Danaparoid is a low molecular weightheparinoid devoid of heparin. It consists of a mixture of heparan sulfate, dermatan sulfate, and chondroitin sulfate. It is chemically distinct from heparin, has different protein-binding properties because of its low degree of sulphation and low surface charge density and thus has little cross-reactivity in heparin-intolerant patients. The TGI activity, considered by Fernandes et al. deep venous clots, particularly in situations with a high risk of [clot formation">deep venous thrombosis">deep venous clots, particularly in situations with a high risk of [clot formation, such as after hip surgery. It is also used as a heparin substitute in heparin-induced thrombocytopenia which may otherwise cause paradoxical thrombosis. Danaparoid is used for thrombosis prophylaxis and treatment in heparin-induced thrombocytopenia patients. Although pre-treatment serological cross-reactivity with heparin-induced antibodies can occur in 5.2% of the patients it bears no systematic relationship with clinical cross-reactivity, 3.2% in the same study of 1478 patients with acute HIT . It is also approved for the treatment of DIC in Japan and although not approved for the following it has shown efficacy and safety in case reports of paediatric use , pregnancy , patients in renal failure requiring intermittent or continuous renal replacement therapy and in patients with hepatic disorders associated with cirrhosis such as portal vein thrombosis and the sinusoidal obstruction syndrome and thrombotic micro-angiopathy that occur after haemopoietic stem-cell transplantation in patients with haematogenous and solid malignancies. It has also been used in Kasabach-Merritt syndrome in one case report.
Discontinuation
On August 14, 2002, this drug was withdrawn by Organon International. from the US market, due to a shortage in drug substance. The manufacturer has continued providing the medication in all other locales where it is approved for marketing. The drug is now owned and distributed by Aspen Pharma.
Bleeding Heparin-induced thrombocytopenia A report of 1478 clinical outcomes of patients treated with danaparoid from 1982 to mid 2004." Thromb Haemost 2006; 95: 967-871> found in 4.6% of medical patients, 6.1% after major general and vascular surgery, but 42.3% after CPBS for which it is now contraindicated.
Low platelets, due to a low level of structural similarity between danaparoid and heparin, i.e.only in some patients sensitive to heparin or a LMWH but to date never developed spontaneously. Platelet count recovery was more frequent than in the control group in 2 comparative studies in patients with HIT
Possibly Asthma exacerbations, due to allergies to sulfites contained within the medicine.
