Heparin and low-molecular-weight heparin.
Heparin is one of the oldest biological medicines, and has an established place in the prevention and treatment of venous thrombosis. Low-molecular-weight heparins (LMWH) have been developed by several manufacturers and have advantages in terms of pharmacokinetics and convenience of administration. They have been shown to be at least as effective and safe as unfractionated heparin and have replaced the latter in many indications. In this article the chemistry, mechanisms of action, measurement of anticoagulant activities, and clinical status of heparin and LMWH are reviewed.
Gray
Elaine
E
National Institute for Biological Standards & Control (NIBSC), Blanche Lane, South Mimms, Potters Bar, Herts EN6 3QG, UK. egray@nibsc.ac.uk
Mulloy
Barbara
B
Barrowcliffe
Trevor W
TW
D000818:Animals; D000925:Anticoagulants / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects*; D001780:Blood Coagulation Tests; D003324:Coronary Artery Disease / Q000097:blood / Q000188:drug therapy; D016903:Drug Monitoring; D065427:Factor Xa Inhibitors; D006493:Heparin / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D006801:Humans; D015394:Molecular Structure; D008970:Molecular Weight; D009369:Neoplasms / Q000097:blood / Q000188:drug therapy; D018579:Patient Selection; D013329:Structure-Activity Relationship; D013917:Thrombin / Q000378:metabolism; D013927:Thrombosis / Q000097:blood / Q000188:drug therapy*; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000097:blood / Q000188:drug therapy; D020246:Venous Thrombosis / Q000097:blood / Q000188:drug therapy
D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D006495:Heparin, Low-Molecular-Weight; D006493:Heparin; D013917:Thrombin