Overdose
The greatest danger of overdose of Clexane® is bleeding complications. These manifest themselves for example as nosebleeds (epistaxis), bloody urine (haematuria), bruises (haematomas) of the skin, small bleedings of the skin (petechiae) or bloody tarry stools (melena). Signs of hidden, invisible bleeding are a drop in blood pressure or certain laboratory changes (haemoglobin drop, haemoglobin = red blood pigment).
In the event of such complications, measures to be taken include discontinuing the administration of Clexane® and, in the case of severe bleeding, injecting an antidote: protamine. This neutralising agent is dosed in the first 8 hours after Clexane® administration in the same way as Clexane® itself. If this time is exceeded, a lower protamine dosage is sufficient; if the period is longer than 12 hours, it is no longer indicated to give protamine.
However, protamine can only partially stop bleeding, as this substance predominantly attacks the anti-Factor IIa activity. The anti-Factor Xa activity, on the other hand, which is the main part of the effectiveness of Clexane®, can only be influenced with high doses and at most up to 60%.
