Fraxiparin in pregnancy

It is well known that during pregnancy, numerous changes occur in a woman's body. First of all, these changes affect the circulatory system and hemostasis. This is not surprising, since the circulatory system is one of the first systems that adapts to the new conditions of functioning of the body. So, if previously a woman had two circles of blood circulation, then in pregnancy there is a need for a third circle - providing blood flow in the uterus and placenta. Accordingly, the properties of blood and blood vessels change. Many women have a tendency to thrombosis. In such a case, both for therapeutic and prophylactic purposes, fraxiparin in pregnancy is prescribed. [1], [2]

Fraxiparin in planning pregnancy

Faxiparin is prescribed in planning pregnancy for women with an increased tendency to clot formation, as well as increased blood viscosity and clotting. In this case, intravascular thrombi are quickly formed, excessively viscous blood significantly disrupts the trophics of surrounding tissues, microcirculation is impaired and the outflow of waste metabolites outside. All this can adversely affect the reproductive function of women. Many women with such problems have long-term infertility, inability to conceive, or spontaneous abortions and miscarriages in the early stages of pregnancy.

Fraxiparin, whose active ingredient is calcium nadroparin, acts in a similar way to heparin. It thins the blood, returning it to its natural state so that it can fully perform its functions in the body. Fraxiparin maintains hemostasis in the body (normal blood circulation), which ensures homeostasis - the stability and constancy of the internal environment of the body. As a result, optimal conditions are created in all systems, including the reproductive system, and a high level of functional activity is maintained. All this ensures a woman's ability to conceive and bear a child. [3]

Indications Fraxiparin in pregnancy

Often pregnant women and their relatives, family members are concerned about the prescription of any medication, see it as a threat. Every second patient asks the question: "What is it prescribed for?". Indications for the use of fraxiparin - treatment and prevention of thromboembolic complications. In pregnancy, there is an increased risk of thrombus formation, blood thickening, increasing its viscosity, violation of basic physical and chemical properties, so women with a history of varicose veins, problems with increased blood coagulation, heart and blood diseases, fraxiparin is indicated. For prophylaxis, it is prescribed if there is a probability of blood clots, if a woman has a genetic predisposition, if her parents, close relatives by blood, had thromboembolic disease, atherosclerosis, varicose veins.

Appointed in diseases of the respiratory and cardiovascular system, as an aid to relieve the extra load from these systems, arising in connection with pregnancy.

Fraxiparin helped you carry a pregnancy to term.

Many women claim that Fraxiparin has helped them to carry a pregnancy. It was prescribed to many when planning pregnancy, thanks to which it became possible to conceive in a relatively short time, as well as quite safely carry and give birth to a healthy child. The drug is prescribed at any term of pregnancy, both at the appearance of the first signs of pathology on the part of the circulatory and respiratory system, and for the prevention of complications. Following the prescribed treatment regimen, the risk of thrombosis significantly decreased, patients began to feel much better, complaints of breathing difficulties, shortness of breath, palpitations, weakness disappeared. In addition to cardiovascular system disorders, performance, activity, and well-being (according to objective data and subjective feelings) improved significantly.

Release form

The only form of release of fraxiparin is a solution for injection. Ampoules with the drug are packed in special blisters, which are placed in cardboard packages. Also attached to the solution are syringes of 1 ml. Depending on the manufacturer, the package contains one or ten syringes. The solution is transparent, slightly opalescent. It may be completely colorless or have a slight yellow color.

Fraxiparin 0.3, 0.6.

For the preparation of fraxiparin there is a dosage - 0.3 and 0.6 ml. The dose of fraxiparin is calculated in accordance with the table presented in the instructions for the drug, as well as in accordance with special pharmacological reference books. So, the dosage of 0.3 ml is prescribed for patients whose body weight does not exceed 50 kg. This volume of the drug contains 2850 IU of anti-Xa. The dosage of 0.6 ml is prescribed for patients whose body weight exceeds 70 kg. This volume of the preparation contains 5700 IU of anti-Xa. These are extreme dosages and there are also intermediate dosages, e.g. 0.4 and 0.5 ml.

Pharmacodynamics

In order to understand the mechanism of action of fraxiparin in pregnancy, it is necessary to study the pharmacodynamics of this drug. The active substance is calcium nadroparin. It is obtained by depolarization. In the process of obtaining depolarize standard heparin. As a result of the reaction, glycosoaminoglycan is formed. A characteristic feature is that calcium nadroparin forms a complex that inhibits factor Xa quite rapidly. Therefore, the formed complex is often called anti-Xa. The processes of fibrinolysis are also activated. All this contributes to the resorption of already formed blood clots, and the prevention of the formation of new blood clots.

Pharmacokinetics

If we analyze the pharmacokinetics of the drug, then first of all, the fact that the drug is based on the active substance - calcium nadroparin - attracts attention. It is this substance that determines the anti-Xa activity of blood plasma. The substance is injected subcutaneously, and its maximum activity is observed after 3-5 hours.

The substance begins to be gradually excreted after 3.5 hours (at a dose of 1900 IU). It should be taken into account that excretion of the drug is slowed down in case of kidney pathology. In addition, an increased load on the kidneys is created. In renal pathology, it is necessary to reduce its dosage by at least 25%, because there is an active accumulation of the substance in the kidneys.

Dosing and administration

Depending on the patient's condition, the doctor selects the optimal method of administration and dose of the drug. Thus, the drug is administered subcutaneously. It is recommended to inject the drug when a person is in the supine position. Most often injected into the anterolateral or zednebokovaya area of the abdomen. Less often - in the thigh area. In this case, it is necessary to alternate between the left and right sides. In order to avoid loss of the drug, it is not recommended to remove small bubbles from the syringe. Dosage is determined by the patient's body weight, the purpose of drug administration, the patient's condition. At body weight up to 50 kg, or at the initial stages of treatment, 0.3 ml of the drug is administered. The maximum recommended dosage is 0.6 ml (mainly for body weight over 70 kg). The dosage can be adjusted by a doctor in each specific case.

Injections

Injections are the only way to administer Fraxiparin. The injections are given into the sides of the abdomen, less often into the thigh, symmetrically and alternately on different sides. This will prevent the formation of hematomas and bumps. The recommended dose is 0.3 ml of the drug once a day. At the same time, if necessary, the dose can be increased. If the drug is used for prophylactic purposes, the dosage can be reduced. The duration of treatment is determined by the doctor, and usually it varies within 7-10 days. But it can be extended for a much longer period.

How to inject fraxiparin in pregnancy

Often asked how to inject fraxiparin in pregnancy. This question is perplexing even for many nurses. It turns out that the way of administering the drug in pregnancy is no different from the way it is administered to all other patients. The drug is administered subcutaneously. The optimal way of administration - in the anterior or lateral wall of the abdomen. In extreme cases - in the thigh. The recommended standard dosage is 0.3 ml, which is 2850 anti-Xa IU of the active substance. Usually the drug is administered once a day. The minimum duration of treatment is 7 days, the maximum - 10 days. At the same time, if it is necessary to extend the course beyond 7 days, or in acute thromboembolic disease, hospitalization is required. The instructions do not recommend to continue treatment for more than 10 days, but in some cases, if indicated and there is an increased risk of blood clots, the course of treatment can be extended.

Fraxiparin in the abdomen

Fraxiparin is actually injected into the stomach, even in pregnancy. It must be injected subcutaneously. At the same time, the needle is held at an angle of 40 degrees. A minimal syringe is used - insulin syringe, for 1 ml. Its needle is thin and short. The abdomen is the most convenient place for such injections, because it contains a thick layer of subcutaneous fatty tissue. There is no risk of damage to the uterus, internal organs, much less the fetus with this method of drug administration.

Fraxiparin in early pregnancy

Fraxiparin can be prescribed early in pregnancy, at the first signs of thrombosis, at increased risk of thromboembolic complications, and even for prevention, if the patient has a history of a tendency to blood clots, or there is a genetic predisposition. Fraxiparin normalizes blood circulation, improves hemostasis and hemodynamics, physicochemical and rheological properties of blood, which is very important for normal pregnancy, to ensure normal fetal blood flow. The drug helps many women to safely transfer pregnancy, especially if there have been cases of miscarriage, miscarriages, spontaneous abortions associated with impaired hemostasis.

How do you discontinue fraxiparin in pregnancy?

There are no special instructions on how to cancel the drug in the instructions for use of the drug. Information on how to cancel fraxiparin in pregnancy in instructions, special reference books and medical literature is also not found. This allows each practitioner to use his own way of canceling the drug. Some doctors cancel the drug immediately after the end of the course of treatment. Others are of the opinion that it is better to cancel the drug gradually. Thus, it is recommended to inject injections first every other day, then several times a week, until the drug is completely canceled. Still other doctors recommend gradually reducing the dosage of the drug (by 0.1-0.2 ml), until complete withdrawal of the drug.

Contraindications

The drug has quite a few contraindications to use. For example, it should not be used when the absolute number of platelets is reduced. Also, it can not be prescribed for bleeding. This is due to the fact that the drug reduces blood viscosity, promotes its liquefaction. Accordingly, the probability of bleeding increases manifold. With any disorders of hemostasis, the presence of erosions and ulcers, with injuries, in preparation for surgery, the drug can not be prescribed. Do not prescribe it and when planning a cesarean section. The presence of inflammatory heart disease is also a contraindication.

It is necessary to take into account the fact that many patients may have individual intolerance to the drug or its individual components, especially in pregnancy. In this case, the drug should be administered with caution.

Side effects Fraxiparin in pregnancy

When prescribing fraxiparin, you should take into account the possibility of side effects. Quite often there are bleeding of various localizations. In rare cases, complications occur, such as thrombocytopenia, eosinophilia. However, these are reversible conditions that recover fairly quickly. Some allergic reactions may be observed. Reactions of delayed or immediate type such as rash, anaphylactic shock may occur.

Some local reactions are not excluded. Very rarely necrosis of tissues at the injection site occurs. However, it is very difficult to allow necrosis to develop. First, purpura or erythematous spot should develop. As a rule, these conditions are extremely painful, accompanied by various somatic symptoms, systemic signs of inflammation and intoxication. Immediate withdrawal of the drug is required.

How to remove bumps from fraxiparin in pregnancy?

First of all, in order to avoid bumps, it is necessary to periodically change the injection site: inject symmetrically, in different areas of the skin. In addition, before injecting the drug, it should be preheated by holding it in your hand for a few minutes. The drug should be administered slowly.

If you still cannot avoid the appearance of bumps, you should treat the injection site with an emollient cream or glycerin. If possible, it is better to warm glycerin to a temperature of 35-40 degrees. It is also recommended to apply a compress (warming). As a basis for a compress, you can use camphor oil, glycerin, turpentine oil. Additionally, you can treat the places of formation of the bump with baby cream, sea buckthorn oil. If the bump does not go away for 2-3 days, or is painful, it is recommended to use ketanol cream, levomekol, sabelnik, livestock, or levomecitin ointment.

Overdose

An overdose of fraxiparin is dangerous, because it can cause bleeding. This is primarily due to the thrombolytic effect of the drug: under its action, the viscosity and density of blood decreases, it becomes more fluid, viscosity is significantly reduced. Therefore, during treatment with fraxiparin it is necessary to monitor the level of platelets in the blood, as well as monitor the main parameters of the coagulation system of the blood. As a rule, special help is not required for minor bleeding (except for withdrawal of the drug). In case of severe overdose, promamine sulfate is used as a neutralizer.

Interactions with other drugs

The drug may cause hyperkalemia when used with those drugs that increase the level of potassium in the blood, when combined with drugs aimed at treatment of hypokalemia. The risk of hyperkalemia and development of bleeding occurs when coadministered with heparin. Mutual enhancement of the effect occurs when coadministered with acetylsalicylic acid, indirect anticoagulants, fibrinolytics, dextran. The risk of bleeding increases when used in combination with antiaggregants.

Storage conditions

As a rule, storage conditions of the drug are prescribed on the package. It should be stored in the original package, at a temperature not exceeding 30 degrees Celsius. The place should be inaccessible to children and animals. It is also better to choose a place that will be protected from direct sunlight, from high temperatures, heat sources. Freezing the drug is also not recommended.

Shelf life

The drug is stored for 3 years from the date of manufacture. The expiration date is indicated on the package. An opened ampoule is stored for no more than a day. After the expiration date, the drug should not be used, as it may cause side effects and complications, and may simply be ineffective.

Analogs

As analogs of fraxiparin, you can use the drug Xarelto, which is used for the treatment and prevention of arterial and venous thrombosis. You can also use rivaroxaban, clexane. Sometimes heparin acts as an analog.

• Clexane

Acts as an analog of fraxiparin. Clexane also to patients who have an increased tendency to clot formation, increased viscosity and clotting of blood is noted. It thins the blood, supports hemostasis in the body.

Unlike fraxiparin, the drug has many more contraindications to use. It is also not always prescribed in pregnancy. Since there is a high risk of bleeding. In the last trimester, the drug is contraindicated. It also has the ability to reduce immunity, which adversely affects the condition of the pregnant woman.

Testimonials

If you analyze the reviews, it can be noted that among all patients who were prescribed fraxiparin in pregnancy, positive reviews prevail. The drug is prescribed both for treatment and prevention. It affects the basic functions of the blood, the coagulation system. It is prescribed at various stages of pregnancy, and even when planning pregnancy. Negative reviews are extremely rare. Of those negative reviews that we managed to find, almost all of them are associated with the incorrect use of the drug, as well as with a violation of the dosing regimen. In one case, the dosage was underestimated. As a result, the treatment was ineffective. In the other two cases there was a complication in the form of rectal bleeding (in a patient with hemorrhoids in the anamnesis), and bleeding from the oral cavity (in a patient with bleeding gums). This once again confirms the importance and significance of the correct calculation of the scheme and tactics of treatment, dosage.