Ivormax (Bemiparin Sodium)

• Bemiparin Sodium is used to manage thromboembolic conditions within the venous circulation.
• Deep vein thrombosis: prevents clot formation in patients undergoing prolonged immobilisation or surgery.
• Venous thromboembolism: treats acute pulmonary embolism and associated deep vein clotting.
• Post‑operative prophylaxis: reduces the incidence of venous clots after major orthopaedic or abdominal surgery.

• Bemiparin Sodium enhances the activity of antithrombin III, leading to selective inhibition of factor Xa while exerting a lesser effect on thrombin (factor IIa). This results in reduced generation of fibrin and limits propagation of the coagulation cascade, thereby decreasing the likelihood of thrombus formation in the venous system.

Adverse reactions may occur with any anticoagulant therapy.

Common Side Effects

• Injection site erythema or pain.
• Minor bruising or hematoma at the injection site.
• Nausea or mild gastrointestinal discomfort.
• Transient headache.
• Mild elevation of liver enzymes.

Serious or Rare Side Effects

• Major bleeding, including intracranial or gastrointestinal hemorrhage.
• Thrombocytopenia, potentially immune‑mediated (heparin‑induced thrombocytopenia).
• Allergic reactions such as urticaria, angioedema, or anaphylaxis.
• Spinal or epidural hematoma when used with neuraxial anesthesia.
• Severe liver dysfunction.

• Use Ivormax only under medical supervision with appropriate monitoring of coagulation parameters.
• Renal impairment: adjust dose or monitor anti‑Xa levels in patients with reduced kidney function.
• Pregnancy: evaluate risk‑benefit ratio; use only if clearly indicated.
• Concurrent anticoagulants: avoid combining with other parenteral anticoagulants unless directed.
• Surgery or invasive procedures: discontinue before high‑risk procedures to minimise bleeding.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze.

Bemiparin Sodium may interact with several drug classes that affect haemostasis.

Major Interactions (Avoid)

• Other anticoagulants (e.g., unfractionated heparin, warfarin, direct oral anticoagulants).
• Antiplatelet agents (e.g., aspirin, clopidogrel).
• Thrombolytic therapy (e.g., alteplase).
• Non‑steroidal anti‑inflammatory drugs (NSAIDs) that increase bleeding risk.
• Neuraxial anesthesia or spinal puncture due to risk of hematoma.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs that may enhance anticoagulant effect.
• Diuretics that can alter plasma volume.
• Certain antibiotics (e.g., quinolones) that may affect platelet function.
• Herbal supplements such as ginkgo or garlic that have antiplatelet properties.