Ivor (Bemiparin Sodium)

Bemiparin Sodium is used in the prevention and treatment of venous thromboembolism.

• Deep vein thrombosis (DVT) prophylaxis: reduces the risk of clot formation in patients undergoing surgery or immobilisation.
• Pulmonary embolism treatment: helps dissolve existing clots and prevents new ones in acute cases.
• Post‑operative thrombosis prevention: lowers incidence of venous clots after orthopedic or abdominal surgery.
• Acute coronary syndrome adjunct: provides anticoagulation support when combined with antiplatelet therapy.

• Bemiparin Sodium potentiates antithrombin III, enhancing its inhibition of activated factor Xa and, to a lesser extent, factor IIa (thrombin). This selective blockade reduces thrombin generation and fibrin clot formation, providing anticoagulant activity while preserving a relatively predictable pharmacokinetic profile compared with unfractionated heparin. Its low molecular weight contributes to a longer half‑life and more reliable dose‑response.

Bemiparin Sodium may be associated with a range of adverse reactions, varying from mild to serious.

Common Side Effects

• Injection site pain or erythema: mild discomfort at the subcutaneous site.
• Bruising or hematoma: localized bleeding under the skin.
• Minor bleeding: such as gum or nosebleeds.

Serious or Rare Side Effects

• Major hemorrhage: life‑threatening internal bleeding.
• Heparin‑induced thrombocytopenia (HIT): immune‑mediated platelet drop.
• Spinal or epidural hematoma: bleeding in the spinal canal after neuraxial procedures.

When using Bemiparin Sodium, several precautions should be observed to minimise risk.

• Renal impairment: dose adjustment or close monitoring may be required.
• History of bleeding: assess risk‑benefit before initiating therapy.
• Concomitant anticoagulants: avoid combined use unless specifically directed.
• Antiplatelet therapy: monitor for increased bleeding when used together.
• Surgical procedures: discontinue before invasive surgery as advised.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Bemiparin Sodium can interact with other medicines, affecting its anticoagulant effect.

Major Interactions (Avoid)

• Concurrent use with other anticoagulants (e.g., warfarin, direct oral anticoagulants): markedly increased bleeding risk.
• Combination with antiplatelet agents (aspirin, clopidogrel): heightened hemorrhagic potential.
• Use with fibrinolytic therapy (e.g., alteplase): severe bleeding complications.

Moderate Interactions (Monitor Closely)

• Non‑steroidal anti‑inflammatory drugs (NSAIDs): may augment bleeding tendency.
• Selective serotonin reuptake inhibitors (SSRIs) or SNRIs: can increase risk of gastrointestinal bleeding.
• Herbal supplements containing ginkgo, garlic or ginger: potential additive anticoagulant effect.