All patients should be evaluated for bleeding disorders before administration of INNOHEP®. Since coagulation parameters are unsuitable for monitoring INNOHEP® activity, routine monitoring of coagulation parameters is not required (see PRECAUTIONS, Laboratory Tests).
Adult Dosage
The recommended dose of INNOHEP® for the treatment of DVT with or without PE is 175 anti-Xa IU/kg of body weight, administered SC once daily for at least 6 days and until the patient is adequately anticoagulated with warfarin (INR at least 2.0 for two consecutive days). Warfarin sodium therapy should be initiated when appropriate (usually within 1-3 days of INNOHEP® initiation). Pregnancy has little or no influence on the pharmacokinetics of INNOHEP® and no dosing adjustment is needed for pregnancy.
As INNOHEP® may theoretically affect the PT/INR, patients receiving both INNOHEP® and warfarin should have blood for PT/INR determination drawn just prior to the next scheduled dose of INNOHEP®.
Table 8 provides INNOHEP® doses for the treatment of DVT with or without PE. It is necessary to calculate the appropriate INNOHEP® dose for patient weights not displayed in Table 8.
An appropriately calibrated syringe should be used to assure withdrawal of the correct volume of drug from INNOHEP® vials.
Table 8 INNOHEP® Weight-based Dosing for Treatment of Deep Vein Thrombosis With or Without Symptomatic Pulmonary Embolism
DVT Treatment
Patient Body Weight in Pounds
175 IU/kg SC Once Daily 20,000 IU per mL
Patient Body Weight inKilograms
Dose (IU)
Amount (mL)
68-80
6,000
0.3
31-36
81-94
7,000
0.35
37-42
95-107
8,000
0.4
43-48
108-118
9,000
0.45
49-53
119-131
10,000
0.5
54-59
132-144
11,000
0.55
60-65
145-155
12,000
0.6
66-70
156-168
13,000
0.65
71-76
169-182
14,000
0.7
77-82
183-195
15,000
0.75
83-88
196-206
16,000
0.8
89-93
207-219
17,000
0.85
94-99
220-232
18,000
0.9
100-105
233-243
19,000
0.95
106-110
244-256
20,000
1
111-116
257-270
21,000
1.05
117-122
271-283
22,000
1.1
123-128
284-294
23,000
1.15
129-133
295-307
24,000
1.2
134-139
308-320
25,000
1.25
140-145
321-331
26,000
1.3
146-150
332-344
27,000
1.35
151-156
345-358
28,000
1.4
157-162
To calculate the volume (mL) of an INNOHEP® 175 anti-Xa IU per kg SC dose for treatment of deep vein thrombosis:
Patient weight (kg) X 0.00875 mL/kg = volume to be administered (mL) subcutaneously
Administration
INNOHEP® is a clear, colorless to slightly yellow solution, and as with other parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration.
INNOHEP® is administered by SC injection. It must not be administered by intramuscular or intravenous injection.
Subcutaneous Injection Technique: Patients should be lying down (supine) or sitting and INNOHEP® administered by deep SC injection. Administration should be alternated between the left and right anterolateral and left and right posterolateral abdominal wall. The injection site should be varied daily. The whole length of the needle should be introduced into a skin fold held between the thumb and forefinger; the skin fold should be held throughout the injection. To minimize bruising, do not rub the injection site after completion of the injection.