Pharmacokinetics
After subcutaneous injection of Clexane®, it enters the bloodstream where it reaches its average maximum activity level after three to five hours. Clexane® is broken down both in the liver (hepatic elimination) and in the kidney (renal elimination), with the majority being taken over by the liver. The plasma half-life – the time after which 50% of the original highest plasma quantity is still present – is about 4 hours after a single administration.
Interactions
If several drugs are taken at the same time, there may be interactions between the different active ingredients. In order to minimise interactions, it is therefore always important that the doctor treating you provides information about all the medicines you are taking – even over-the-counter. In the case of Clexane® the effect can be enhanced by taking other anticoagulant drugs, for example Marcumar® or Clopidogrel, so that the risk of bleeding increases.
The effect of Clexane® can be enhanced by taking other drugs such as loop diuretics (etacrynic acid), gout medications (Probenecid), cytostatics and penicillins. Drugs that increase potassium levels (e.g. ACE inhibitors) can lead to hyperkalemia in combination with Clexane®. The effect of Clexane® can be weakened by the simultaneous intake of allergy medicines, cardiac glycosides, tetracyclines and vitamin C preparations.
Contraindications
As with any other drug, there are contraindications for the use of Clexane® despite good tolerability. Clexane® must not be used if allergies to the active ingredient or any additives contained therein are known or if a HIT II has already occurred in the past when using Clexane®. Furthermore, Clexane® must not be used for recent injuries or operations (within the last 6 weeks) on the brain, spinal cord, eyes or ears.
Clexane® increases the risk of bleeding and must therefore not be used in cases of bleeding requiring treatment, such as severe gastrointestinal bleeding, abnormally dilated veins of the oesophagus (oesophageal varices), visible bleeding of the reproductive organs or urinary tract or bleeding tendencies. Other contraindications include severe liver and kidney dysfunction, severe high blood pressure, bacterial inflammation of the heart valves, vascular dilatation (aneurysms) and vascular malformation (arteriovenous malformation). Clexane® is also contraindicated in cases of imminent miscarriage. Clexane® must also not be used in cases of suspected non-inflammatory disease of the retinal vessels and bleeding in the eye.
Clexane and alcohol – is that compatible?
Although Clexane® and alcohol are basically not metabolized by the same organs, since alcohol is largely broken down by the liver and Clexane® is more likely to be excreted via the kidneys, the consumption of alcohol is not compatible with Clexane® therapy. This basically applies to any drug therapy. Alternating and side effects due to the additional consumption of alcohol can never be predicted one hundred percent. Heavy alcohol consumption also leads to liver damage, which can be associated with an increased risk of bleeding. This condition is a contraindication for therapy with Clexane, as life-threatening bleeding can sometimes occur.
