2.8.1 Parenteral anticoagulants
- Parenteral anticoagulants are for specialist initiation in secondary care only.
- Refer to NICE NG158 Venous thromboembolic diseases
- Refer to shared care guidelines
- Heparin use in the elderly – caution is required in the frail/very elderly, in whom daily doses of 20,000 units may be sufficient for full heparinisation.
- There is an increased risk of bleeding when enoxaparin is administered to patients with low body weight. Refer to the BNF or the Shared Care Guideline for dosage adjustments required.
- There may be an increased risk of bleeding in patients with renal impairment – refer to BNF or SmPC for further information.