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To the group,
It is my understanding that the enoxaparin VTE (pe and dvt) data submitted
to the FDA contained a large number of patients weighing > 100 kg (dose
1mg/kg sq q12h). It is also my understanding that weight was not a
significant covariate in regards to outcome.
Has anyone been monitoring AntiXa activity in obese (> 1.3 x there ideal
weight) patients receiving enoxaparin for VTE? If so, have you noticed that
they require < 1 mg/kg (based on total weight) sq q12h?
Jim Lane
UC San Diego Medical Center
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Look for data on the dose response for TFPI
WW
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[A few replies - db]
Date: Mon, 13 Mar 2000 10:30:08 -0500
From: "Bryan Facca"
To:
Subject:
Dear Jim,
I have wondered about the dose in large patients. If you examine the
PI, it restricts the dose to a max of 100mg at a single time. When I
asked RPR they also indicated a restriction of 100 mg as the single
largest dose. Other references have restricted doses to a range of
50 to 100mg. Very small or very large patients may not be candidates
when the dose falls outside of this range.
I have tried to get our lab to do anti-Xa levels. There is a
significant cost factor and these levels do not always correlate well
with clinical outcomes. Clinically speaking, I have tried to stay
away from very large doses or extremely small doses with active
treatment.
Bryan Facca RPh PharmD
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X-Originating-IP: [147.126.196.60]
Reply-To: qma1.-at-.luc.edu
From: "Qing Ma"
To: PharmPK.at.boomer.org
Subject: Re: PharmPK Enoxaparin dvt dosing in obesity
Date: Tue, 14 Mar 2000 21:09:54 GMT
We have the data that the patients' weight does not have a big
influence on the AXa activity of enoxaparin.
---
X-Originating-IP: [147.126.196.60]
Reply-To: qma1.-at-.luc.edu
From: "Qing Ma"
To: PharmPK.aaa.boomer.org
Subject: Re: PharmPK Re: Enoxaparin dvt dosing in obesity
Date: Tue, 14 Mar 2000 21:19:45 GMT
You may check with Dr. Jawed Fareed. He is in Loyola University
Medical Center. He and his colleagues have done a lot of basic
research on this issue. But not sure whether they have data on
patients.
---
From: "Stephen Duffull"
To:
Subject: RE: PharmPK Enoxaparin dvt dosing in obesity
Date: Wed, 15 Mar 2000 08:08:15 +1000
X-Priority: 3 (Normal)
Importance: Normal
Hi Jim
We have performed a pilot study on dalteparin in obese and
matched normal weight subjects and found a reasonable
correlation between V of dalteparin and total body weight
(r^2=0.52), but nothing particularly strong with CL. Our
mean (+/- SD) TBW for obese patients was 106 (+/- 22) kg.
I realise that this is not exactly what you were looking
for - but hope it is of some value.
Kind regards
Steve
=================
Stephen Duffull
School of Pharmacy
University of Queensland
Brisbane, QLD 4072
Australia
Ph +61 7 3365 8808
Fax +61 7 3365 1688
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Copyright 1995-2010 David W. A. Bourne (david@boomer.org)