Therapeutic dosage
Clexane® is administered in therapeutic doses for diseases such as deep vein thrombosis, pulmonary embolism, atrial fibrillation or heart attacks. The therapeutic dosage is weight dependent and is calculated according to the formula 1 mg/kg. Thus, a woman with a body weight of 60 kg receives Clexane 60 mg (Clexane 0.6). If Clexane is administered in therapeutic dosage, it is given twice a day. It is applied subcutaneously, i.e. under the skin, in the area of the abdomen or thigh.
Clexane® for atrial fibrillation
Clexane® can be used for blood thinning in patients with atrial fibrillation. Patients with atrial fibrillation have a significantly increased risk of stroke, therefore blood thinning is necessary. Usually atrial fibrillation is not treated permanently with Clexane® as this would mean that patients would have to inject twice a day for a lifetime.
However, it is precisely at the beginning, i.e. when atrial fibrillation is first diagnosed, that Clexane® is used. The therapeutic dosage, i.e. 1 mg/kg 2 times daily, is applied. As a rule, patients are switched to an oral blood thinner as the disease progresses. Either to Marcumar (phenprocoumon) or to one of the direct oral anticoagulants. These include Xarelto (rivaroxaban) or Eliquis (Apixaban).
Clexane® for deep vein thrombosis
Clexane® is approved for the blood-thinning treatment of deep vein thrombosis in the leg. The blood must be thinned to prevent the formation of more clots. Clexane® must be administered in therapeutic doses, i.e. twice daily at a dose of 1 mg/kg. The duration of use depends on the cause of the thrombosis and whether it is a first event or a recurrence of the thrombosis.
Clexane® for pulmonary embolism
Clexane is also used to treat pulmonary embolism twice a day at a dose of 1 mg/kg. Here too, the duration of therapy varies and depends on several individual factors
Can Clexane® be taken longer?
Patients receiving Clexane® therapeutically should generally receive a blood-thinning therapy over a longer period of time. It is therefore the rule that these patients do not receive injections for the entire period but are switched to tablet therapy. Here, blood thinners can be either relatively new drugs from the group of so-called direct oral anticoagulants (DOAKs) or the older drug Marcumar (phenprocoumon).
Marcumar is adjusted on the basis of a blood value, the INR. The INR should be in a range of 2-3 for most of the diseases to be treated under therapy. In patients who do not take blood-thinning medication, it is around 1.
In the first few days when Marcumar is given, the INR slowly increases, but is not yet in the target range. This means that the patient does not have enough thin blood during this time and is therefore not protected. For this reason, Clexane is given overlapping during this time to bridge the time until the Marcumar level is high enough to make the blood as thin as desired. Clexane is given in therapeutic doses until the desired level is reached. Usually an INR of 1,8 or 2 is the threshold value from which Clexane does not have to be given overlapping.
