Nadroparin
Identification
- Name
- Nadroparin
- Accession Number
- DB08813
- Description
Nadroparin is a low molecular weight heparin (LMWH) which, when bound to antithrombin III (ATIII), accelerates the inactivation of factor II and factor Xa. Nadroparin halts the coagulation pathway by inhibiting the activation of thrombin (factor IIa) by factor Xa. The amplification of the fibrin clotting cascade is stopped once factors Xa and IIa are inactivated. It is derived from porcine sources and has a mean molecular size of 5000 daltons. Low molecular weight heparins are less effective at inactivating factor IIa due to their shorter length compared to unfractionated heparin.
- Type
- Small Molecule
- Groups
- Approved, Investigational
- Synonyms
- Nadroparina
- Nadroparine
Pharmacology
- Indication
Nadroparin is used for prophylaxis of thromboembolic disorders and general surgery in orthopedic surgery, treatment of deep vein thrombosis, prevention of clotting during hemodialysis and treatment of unstable angina and non-Q wave myocardial infarction.
- Associated Conditions
- Contraindications & Blackbox Warnings
Learn about our commercial Contraindications & Blackbox Warnings data.
Learn More- Pharmacodynamics
Nadroparin is a low molecular weight heparin that is composed of a heterogeneous mixture of sulfated polysaccaride glycosaminoglycan chains. Th mean molecular weight is approximately 4300 daltons. The ratio of anti-Xa activity to anti-IIa is 3.5:1 whereas it is about 1:1 for heparin. Its use should be avoided in patients with a creatinine clearance less than 40mL/min. In these patients, unfractionated heparin should only be used. As for monitoring, active partial thromboplastin time (aPTT) will only increase at high doses of low molecular weight heparins (LMWH). Therefore, monitoring aPTT is not recommended. However, anti-Xa activity can be measured to monitor the efficacy of the LMWH.
- Mechanism of action
The mechanism of action for nadroparin is similar to all other LMWHs. Like all LMWHs, nadroparin has a pentasaccharide sequence which binds to ATIII, which potentiates the action of ATIII. This complex greatly accelerates the inactivation of factor Xa and factor IIa. As a result, the coagulation cascade is inhibited.
Target Actions Organism AAntithrombin-III potentiatorHumans UP-selectin inhibitorHumans UProto-oncogene c-Fos inhibitorHumans UMyc proto-oncogene protein inhibitorHumans - Absorption
Absorption is linear. The bioavailability of nadroparin after subcutaneous administration is about 89%.
- Volume of distribution
3.59L
- Protein binding
Much lower compared to heparin, which has over 90% protein bound.
- Metabolism
Nadroparin is metabolized in the liver.
- Route of elimination
Nadroparin is eliminated via the kidneys through non-saturable mechanisms.
- Half-life
In healthy patients, the half life is between 3.5hrs to 11.2hrs following subcutaneous administration.
- Clearance
The clearance of nadroparin is 21.4 +/- 7.0mL/min
- Adverse Effects
Learn about our commercial Adverse Effects data.
Learn More- Toxicity
Osteopenia with extended use, skin necrosis, thrombocytosis, severe immunologically-mediated thrombocytopenia, eosinophilia (rare), calcinosis rarely occurs at the injection site, severe bleeding, transient elevation of liver transaminases.
- Affected organisms
- Not Available
- Pathways
- Not Available
- Pharmacogenomic Effects/ADRs
- Not Available
Interactions
- Drug Interactions
- This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Drug Interaction Unlock Additional DataAbciximab The risk or severity of bleeding can be increased when Abciximab is combined with Nadroparin. Acebutolol The risk or severity of hyperkalemia can be increased when Acebutolol is combined with Nadroparin. Aceclofenac The risk or severity of bleeding and hemorrhage can be increased when Aceclofenac is combined with Nadroparin. Acemetacin The risk or severity of bleeding and hemorrhage can be increased when Acemetacin is combined with Nadroparin. Acenocoumarol The risk or severity of bleeding can be increased when Acenocoumarol is combined with Nadroparin. Acetylsalicylic acid Acetylsalicylic acid may increase the anticoagulant activities of Nadroparin. Albutrepenonacog alfa The therapeutic efficacy of Albutrepenonacog alfa can be decreased when used in combination with Nadroparin. Alclofenac The risk or severity of bleeding and hemorrhage can be increased when Alclofenac is combined with Nadroparin. Aldesleukin The risk or severity of bleeding can be increased when Nadroparin is combined with Aldesleukin. Alemtuzumab The risk or severity of bleeding can be increased when Nadroparin is combined with Alemtuzumab. Additional Data Available- Extended DescriptionExtended DescriptionAvailable for Purchase
Extended description of the mechanism of action and particular properties of each drug interaction.
Learn more - SeveritySeverityAvailable for Purchase
A severity rating for each drug interaction, from minor to major.
Learn more - Evidence LevelEvidence LevelAvailable for Purchase
A rating for the strength of the evidence supporting each drug interaction.
Learn more - ActionActionAvailable for Purchase
An effect category for each drug interaction. Know how this interaction affects the subject drug.
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- Food Interactions
- Avoid herbs and supplements with anticoagulant/antiplatelet activity. Examples include garlic, ginger, bilberry, danshen, piracetam, and ginkgo biloba.
Products
- Product Ingredients
Ingredient UNII CAS InChI Key Nadroparin calcium LIA7Z4002P 37270-89-6 Not applicable - Brand Name Prescription Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image Unlock Additional DataFraxiparine Solution Intravenous; Subcutaneous Aspen Pharmacare Canada Inc. 1998-02-05 Not applicable Canada 
Fraxiparine Solution Intravenous; Subcutaneous Aspen Pharmacare Canada Inc. 1998-02-05 Not applicable Canada Fraxiparine Solution Intravenous; Subcutaneous Aspen Pharmacare Canada Inc. 1998-02-05 Not applicable Canada Fraxiparine Solution Intravenous; Subcutaneous Aspen Pharmacare Canada Inc. 1998-02-05 Not applicable Canada Fraxiparine Solution Intravenous; Subcutaneous Aspen Pharmacare Canada Inc. 1998-02-05 Not applicable Canada Fraxiparine Forte Solution Intravenous; Subcutaneous Aspen Pharmacare Canada Inc. 1999-06-22 Not applicable Canada Fraxiparine Forte Solution Intravenous; Subcutaneous Aspen Pharmacare Canada Inc. 1999-06-22 Not applicable Canada Fraxiparine Forte Solution Intravenous; Subcutaneous Aspen Pharmacare Canada Inc. 1999-06-22 Not applicable Canada Additional Data Available- Application NumberApplication NumberAvailable for Purchase
A unique ID assigned by the FDA when a product is submitted for approval by the labeller.
Learn more - Product CodeProduct CodeAvailable for Purchase
A governmentally-recognized ID which uniquely identifies the product within its regulatory market.
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Categories
- ATC Codes
- B01AB06 — Nadroparin
- Drug Categories
- Classification
- Not classified
Chemical Identifiers
- UNII
- 1K5KDI46KZ
- CAS number
- Not Available
References
- General References
- Collignon F, Frydman A, Caplain H, Ozoux ML, Le Roux Y, Bouthier J, Thebault JJ: Comparison of the pharmacokinetic profiles of three low molecular mass heparins--dalteparin, enoxaparin and nadroparin--administered subcutaneously in healthy volunteers (doses for prevention of thromboembolism). Thromb Haemost. 1995 Apr;73(4):630-40. [PubMed:7495071]
- Frydman A: Low-molecular-weight heparins: an overview of their pharmacodynamics, pharmacokinetics and metabolism in humans. Haemostasis. 1996;26 Suppl 2:24-38. [PubMed:8707165]
- Lai KN, Wang AY, Ho K, Szeto CC, Li M, Wong LK, Yu AW: Use of low-dose low molecular weight heparin in hemodialysis. Am J Kidney Dis. 1996 Nov;28(5):721-6. [PubMed:9158210]
- Boneu B, Navarro C, Cambus JP, Caplain H, d'Azemar P, Necciari J, Duret JP, Gaud C, Sie P: Pharmacodynamics and tolerance of two nadroparin formulations (10,250 and 20,500 anti Xa IU x ml(-1)) delivered for 10 days at therapeutic dose. Thromb Haemost. 1998 Feb;79(2):338-41. [PubMed:9493587]
- Laporte S, Mismetti P, Piquet P, Doubine S, Touchot A, Decousus H: Population pharmacokinetic of nadroparin calcium (Fraxiparine) in children hospitalised for open heart surgery. Eur J Pharm Sci. 1999 May;8(2):119-25. [PubMed:10210734]
- Ng HJ, Lee LH: Heparin-induced thrombocytopenia: acknowledging its presence in low-molecular weight heparin therapy. Int J Hematol. 2003 Feb;77(2):185-7. [PubMed:12627856]
- Breddin HK: Prophylaxis and treatment of deep-vein thrombosis. Semin Thromb Hemost. 2000;26 Suppl 1:47-52. [PubMed:11011806]
- Haas SK: Venous thromboembolic risk and its prevention in hospitalized medical patients. Semin Thromb Hemost. 2002 Dec;28(6):577-84. [PubMed:12536351]
- Davis R, Faulds D: Nadroparin calcium. A review of its pharmacology and clinical use in the prevention and treatment of thromboembolic disorders. Drugs Aging. 1997 Apr;10(4):299-322. [PubMed:9108990]
- Iaremchuk AIa, Zotov AS, Cheshuk VE, Anikuc'ko NF, Zakhartseva LM, Diatel MV, Kravchenko AV, Lobanova OE, Sidorchuk OI: [Clinical effectiveness of nadroparin calcium in the surgical treatment of breast cancer]. Vopr Onkol. 2003;49(2):205-8. [PubMed:12785206]
- Vitale FV, Rotondo S, Sessa E, Antonelli G, Colina P, Parisi A, Giamo V, Ferrau F: Successful administration of a low dose of calcium nadroparin in patients suffering from pulmonary embolism and brain metastases: a report of two cases. J Oncol Pharm Pract. 2011 Jun;17(2):141-4. doi: 10.1177/1078155209353465. Epub 2009 Dec 16. [PubMed:20015933]
- Agnelli G, Gussoni G, Bianchini C, Verso M, Mandala M, Cavanna L, Barni S, Labianca R, Buzzi F, Scambia G, Passalacqua R, Ricci S, Gasparini G, Lorusso V, Bonizzoni E, Tonato M: Nadroparin for the prevention of thromboembolic events in ambulatory patients with metastatic or locally advanced solid cancer receiving chemotherapy: a randomised, placebo-controlled, double-blind study. Lancet Oncol. 2009 Oct;10(10):943-9. doi: 10.1016/S1470-2045(09)70232-3. Epub 2009 Aug 31. [PubMed:19726226]
- External Links
- PubChem Substance
- 347910374
- 67031
- Wikipedia
- Nadroparin_calcium
- AHFS Codes
- 20:12.04.16 — Heparins
Clinical Trials
- Clinical Trials
Phase Status Purpose Conditions Count 4 Completed Treatment Acute Renal Failure (ARF) 1 4 Completed Treatment High Blood Pressure (Hypertension) / Liver Cirrhosis / Status;Splenectomy / Thrombosis, Venous 1 4 Completed Treatment Pulmonary Embolism / Thromboembolism / Thrombotic events / Vascular Diseases 1 4 Recruiting Prevention Coronavirus Disease 2019 (COVID‑19) / COVID / COVID - 19 / Deep Vein Thrombosis / Pulmonary Embolism / Thrombotic events 1 4 Recruiting Prevention Deep Venous Thrombosis / Pulmonary Embolism 1 4 Recruiting Prevention High Blood Pressure (Hypertension) / Liver Cirrhosis / Status;Splenectomy / Thrombosis, Venous 1 4 Recruiting Prevention Liver Cirrhosis / Portal Hypertension / Splenectomy; Status / Thrombosis, Venous 1 4 Unknown Status Prevention Bypass Complications / Obesity, Morbid / Thromboembolism 1 4 Unknown Status Treatment Acute Ischemic Stroke (AIS) 1 4 Unknown Status Treatment Endstage Renal Disease 1
Pharmacoeconomics
- Manufacturers
- Not Available
- Packagers
- Not Available
- Dosage Forms
Form Route Strength Injection, solution Parenteral 142500 UI/15ML Injection, solution Parenteral 19000 UI/2ML Injection, solution Parenteral 47500 UI/5ML Injection Parenteral 950 IU/0.1ml Injection, solution Parenteral 0.3 ML Injection, solution Parenteral 0.4 ML Injection, solution Parenteral 0.6 ML Injection, solution Parenteral 0.8 ML Injection, solution Parenteral Injection, solution Parenteral 1.0 ML Injection, solution Parenteral 9500 I.E./ml Injection, solution Parenteral 11400 UI/0.6ML Injection, solution Parenteral 15200 UI/0.8ML Injection, solution Parenteral 19000 UI/1ML Injection, solution Parenteral 2850 UI/0.3ML Injection, solution Parenteral 3800 UI/0.4ML Injection, solution Parenteral 5700 UI/0.6ML Injection, solution Parenteral 7600 UI/0.8ML Injection, solution Parenteral 9500 UI/1ML Injection, solution Parenteral 2850 IU Injection, solution Parenteral 3800 IU Injection, solution Parenteral 5700 IU Injection, solution Parenteral 7600 IU Injection 2850 IU/0.3ml Injection, solution Parenteral 2850 iu/0.3mL Injection, solution Parenteral 3800 iu/0.4mL Injection, solution Parenteral 5700 iu/0.6mL Injection, solution Parenteral 9500 iu/1mL Solution Intravenous; Subcutaneous Solution Hemodialysis; Intravenous; Subcutaneous 1900 IU Injection, solution Parenteral 0.2 ML Solution Hemodialysis; Intravenous; Subcutaneous 0.3 mL Injection Subcutaneous 2850 IU Solution Hemodialysis; Intravenous; Subcutaneous 3800 IU Solution Hemodialysis; Intravenous; Subcutaneous 5700 IU Solution Subcutaneous 7600 IU Injection, solution Parenteral 9500 IU Solution Subcutaneous 9500 IU Injection, solution Parenteral 1 ML Solution Subcutaneous 2850 IU Solution Subcutaneous 3800 IU Solution Subcutaneous 5700 IU Injection, solution Parenteral 19000 iu/1mL Injection Subcutaneous 1900 IU Injection Subcutaneous 3800 IU Injection Subcutaneous 5700 IU Injection Subcutaneous 7600 IU Injection Subcutaneous 9500 IU Injection, solution Parenteral 47500 iu/5mL Solution Subcutaneous 11400 iu Solution Subcutaneous 15200 iu Injection, solution Parenteral 19.000 I.E. Solution Subcutaneous 19000 iu Injection, solution Parenteral 11400 IU/0.6ml Injection, solution Parenteral 15200 IU/0.8ml Injection, solution Parenteral 19000 IU/ml Injection, solution Parenteral 2.85 IU/0.3ml Injection, solution Parenteral 7600 IU/0.8ml Injection, solution Parenteral 9500 IU/ml - Prices
- Not Available
- Patents
- Not Available
Properties
- State
- Solid
- Experimental Properties
- Not Available
- Predicted Properties
- Not Available
- Predicted ADMET Features
- Not Available
Spectra
- Mass Spec (NIST)
- Not Available
- Spectra
- Not Available
Targets
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Yes
- Actions
- Potentiator
- General Function
- Serine-type endopeptidase inhibitor activity
- Specific Function
- Most important serine protease inhibitor in plasma that regulates the blood coagulation cascade. AT-III inhibits thrombin, matriptase-3/TMPRSS7, as well as factors IXa, Xa and XIa. Its inhibitory a...
- Gene Name
- SERPINC1
- Uniprot ID
- P01008
- Uniprot Name
- Antithrombin-III
- Molecular Weight
- 52601.935 Da
References
- Davis R, Faulds D: Nadroparin calcium. A review of its pharmacology and clinical use in the prevention and treatment of thromboembolic disorders. Drugs Aging. 1997 Apr;10(4):299-322. [PubMed:9108990]
- Frydman A: Low-molecular-weight heparins: an overview of their pharmacodynamics, pharmacokinetics and metabolism in humans. Haemostasis. 1996;26 Suppl 2:24-38. [PubMed:8707165]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Unknown
- Actions
- Inhibitor
- General Function
- Sialic acid binding
- Specific Function
- Ca(2+)-dependent receptor for myeloid cells that binds to carbohydrates on neutrophils and monocytes. Mediates the interaction of activated endothelial cells or platelets with leukocytes. The ligan...
- Gene Name
- SELP
- Uniprot ID
- P16109
- Uniprot Name
- P-selectin
- Molecular Weight
- 90833.105 Da
References
- Simonis D, Christ K, Alban S, Bendas G: Affinity and kinetics of different heparins binding to P- and L-selectin. Semin Thromb Hemost. 2007 Jul;33(5):534-9. [PubMed:17629851]
- Ludwig RJ, Alban S, Bistrian R, Boehncke WH, Kaufmann R, Henschler R, Gille J: The ability of different forms of heparins to suppress P-selectin function in vitro correlates to their inhibitory capacity on bloodborne metastasis in vivo. Thromb Haemost. 2006 Mar;95(3):535-40. [PubMed:16525583]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Unknown
- Actions
- Inhibitor
- General Function
- Transcriptional activator activity, rna polymerase ii core promoter proximal region sequence-specific binding
- Specific Function
- Nuclear phosphoprotein which forms a tight but non-covalently linked complex with the JUN/AP-1 transcription factor. In the heterodimer, FOS and JUN/AP-1 basic regions each seems to interact with s...
- Gene Name
- FOS
- Uniprot ID
- P01100
- Uniprot Name
- Proto-oncogene c-Fos
- Molecular Weight
- 40694.855 Da
References
- Nagy Z, Turcsik V, Blasko G: The effect of LMWH (Nadroparin) on tumor progression. Pathol Oncol Res. 2009 Dec;15(4):689-92. doi: 10.1007/s12253-009-9204-7. [PubMed:19757196]
- Sustar V, Jansa R, Frank M, Hagerstrand H, Krzan M, Iglic A, Kralj-Iglic V: Suppression of membrane microvesiculation--a possible anticoagulant and anti-tumor progression effect of heparin. Blood Cells Mol Dis. 2009 May-Jun;42(3):223-7. doi: 10.1016/j.bcmd.2009.01.012. Epub 2009 Mar 3. [PubMed:19261492]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Unknown
- Actions
- Inhibitor
- General Function
- Transcriptional activator activity, rna polymerase ii core promoter proximal region sequence-specific binding
- Specific Function
- Transcription factor that binds DNA in a non-specific manner, yet also specifically recognizes the core sequence 5'-CAC[GA]TG-3'. Activates the transcription of growth-related genes.
- Gene Name
- MYC
- Uniprot ID
- P01106
- Uniprot Name
- Myc proto-oncogene protein
- Molecular Weight
- 48803.55 Da
References
- Nagy Z, Turcsik V, Blasko G: The effect of LMWH (Nadroparin) on tumor progression. Pathol Oncol Res. 2009 Dec;15(4):689-92. doi: 10.1007/s12253-009-9204-7. [PubMed:19757196]
- Sustar V, Jansa R, Frank M, Hagerstrand H, Krzan M, Iglic A, Kralj-Iglic V: Suppression of membrane microvesiculation--a possible anticoagulant and anti-tumor progression effect of heparin. Blood Cells Mol Dis. 2009 May-Jun;42(3):223-7. doi: 10.1016/j.bcmd.2009.01.012. Epub 2009 Mar 3. [PubMed:19261492]
Drug created on June 14, 2011 23:17 / Updated on January 26, 2021 22:45