Treatment of deep venous thrombosis in pregnant women.
The recommended dosage of tinzaparin in the treatment of thromboembolism during pregnancy is 175 IU/kg/day, as for non-pregnant subjects. In clinical practice, we have experienced a need for a higher dosage, especially in the initial phase of the treatment of deep vein thrombosis, based on four-hour post-dose measurements of anti-Xa activity. Twenty-two pregnant patients with a confirmed deep venous thrombosis were treated with tinzaparin either in a once- or twice-daily regimen. Four-hour post-dosage plasma anti-Xa activity was measured in 357 sequential blood samples during treatment. An higher dosage than recommended, was required to maintain anti-Xa activity in the target range. We suggest that the starting dosage should be 250 IU/kg/day in a twice-daily regimen, and that the dose in the initial phase be adjusted by daily monitoring of anti-Xa.
Lykke
Jacob A
JA
Department of Obstetrics, Rigshospitalet, University of Copenhagen, Denmark. dr.lykke@dadlnet.dk
Grønlykke
Thor
T
Langhoff-Roos
Jens
J
D000328:Adult; D004305:Dose-Response Relationship, Drug; D065427:Factor Xa Inhibitors; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005865:Gestational Age; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D010298:Parity; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D018570:Risk Assessment; D000078222:Tinzaparin; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000188:drug therapy*
D065427:Factor Xa Inhibitors; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D000078222:Tinzaparin