The Pharmaceutical Journal
Vol 277 No 7415 p244
26 August 2006

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Heparin for acute venous thromboembolism

Patients with acute venous thromboembolism can be treated as safely and effectively with fixed-dose weight-adjusted unfractionated heparin as with low-molecular-weight heparin and the regimen is suitable for outpatient treatment, say researchers.

The researchers compared the two regimens in 697 patients: unfractionated heparin was administered subcutaneously as an initial dose of 333U/kg followed by a fixed dose of 250U/kg every 12 hours (345 patients) and low-molecular-weight heparin (dalteparin or enoxaparin) was administered subcutaneously at a dose of 100IU/kg every 12 hours (352 patients). Both treatments could be given outside hospital and were overlapped with three months of warfarin therapy.

Recurrent venous thromboembolism occurred in 13 patients in the unfractionated heparin group (3.8 per cent) and 12 patients in the low-molecular-weight heparin group (3.4 per cent). Major bleeding was similar for both groups — 1.1 per cent and 1.4 per cent, respectively (JAMA 2006;296:935).