低分子量肝素 (達肝素, 依諾肝素)
Low Molecular Weight Heparin (Dalteparin, Enoxaparin)
Low Molecular Weight Heparin
別名: Clexane · Fragmin · LMWH · Dalteparin · Enoxaparin
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Thromboembolic complications and hypercoagulable syndromes | Target anti-Factor Xa activity of 0.35-0.7 IU/ml | SC/IV | variable | As directed | 🌍 EU |
- Thromboembolic complications and hypercoagulable syndromes: Doses are controversial. Requires sufficient AT III. May use constant IV infusions.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Thromboembolic complications and hypercoagulable syndromes | Target anti-Factor Xa activity of 0.35-0.7 IU/ml | SC/IV | variable | As directed | 🌍 EU |
- Thromboembolic complications and hypercoagulable syndromes: Cats appear to require higher dosages of LMWH to achieve proposed therapeutic targets.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
低分子量肝素 (LMWH)，包含達肝素 (dalteparin)與依諾肝素 (enoxaparin)，是一種抗凝血劑，用於治療血栓栓塞併發症及高凝血症候群（例如：肺血栓栓塞、免疫介導性溶血性貧血 IMHA）。
臨床警告： 其在瀰漫性血管內凝血 (DIC) 的使用具爭議性，目前已不再建議用於預防 DIC。肝素必須在有充足的抗凝血酶 III (AT III) 存在時才有效。
臨床提示： LMWH 具有比未分級肝素 (UFH) 更好的藥代動力學特性，其作用更可預測，但價格也相對昂貴許多。
作用機轉
LMWH is an anticoagulant that inhibits Factor Xa and thrombin.
- Compared with unfractionated heparin (UFH), LMWH has reduced anti-IIa activity relative to anti-Xa activity (ratio of anti-Xa to anti-IIa is 2-4:1 compared with UFH 1:1).
- → At therapeutic doses, LMWH has minimal effect on aPTT.
- → Therapeutic monitoring is performed by measuring anti-Xa activity.
安全性與警告
禁忌症
- Bleeding disorders
- Severe renal dysfunction
不良反應
- Haematoma formation (if administered IM)
- Haemorrhage (especially in thrombocytopenic patients or those with DIC)
注意事項
Do not administer intramuscularly (IM) as it may result in haematoma formation. Use with extreme caution in patients with DIC, as it may worsen haemorrhage, especially if the patient is thrombocytopenic. Do not mix other drugs in the same syringe as heparin.
藥物交互作用
Can cause changes in coagulation status, increasing bleeding risk
Can cause changes in coagulation status, increasing bleeding risk
Heparin may antagonize ACTH
Heparin may antagonize corticosteroids
Heparin may antagonize insulin
Heparin may increase plasma levels of diazepam
May partially counteract the actions of heparin
May partially counteract the actions of heparin
May partially counteract the actions of heparin
監測
- Anti-Factor Xa activity (target 0.35-0.7 IU/ml)
- aPTT (Activated partial thromboplastin time)
- PT (Prothrombin time)
- Fibrin degradation products
- Fibrinogen
- Clinical signs of bleeding
藥物動力學
吸收
Reliable and consistent absorption when administered subcutaneously compared to unfractionated heparin.
分佈
Remains primarily in the intravascular space.
代謝
Primarily metabolized by the liver and endothelial cells.
排除
Renal clearance is more significant for LMWH than for unfractionated heparin.
過量
If an overdosage occurs, protamine can be used as an antidote.
可用產品
劑型
- Injectable: 2,500 IU/ml, 100,000 IU/ml ampoules (dalteparin)
- Injectable: 25,000 IU/ml multidose vial (dalteparin)
- Injectable: 12,500 IU/ml and 25,000 IU/ml pre-filled syringes (dalteparin)
- Injectable: 100 mg/ml pre-filled syringes (enoxaparin) [Note: 100 mg enoxaparin = 10,000 IU anti-Factor Xa activity]
人用標示
- Clexane (enoxaparin)
- Fragmin (dalteparin)
各地核准狀態
Human authorized products used off-label in veterinary medicine under the cascade.
Human authorized products (POM) used off-label in veterinary medicine.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Normal precautions should be observed. Store according to manufacturer guidelines, typically at room temperature. Do not mix with other drugs in the same syringe.
飼主須知
低分子量肝素 (LMWH) 是一種注射藥物，用於預防或治療危險的血栓。
- 通常以皮下注射的方式給藥。您的獸醫師會指導您如何安全地進行注射。
- 請密切觀察是否有任何異常出血的跡象，例如瘀青、牙齦蒼白、流鼻血或出現黑色/柏油狀糞便。如果出現這些情況，請立即聯繫您的獸醫師。
- 未經獸醫師同意，請勿給您的寵物服用任何其他藥物，尤其是阿斯匹靈或非類固醇消炎止痛藥 (NSAIDs)，因為這會嚴重增加出血的風險。
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