Division of Hematology & Thromboembolism
Clinical Protocols (and Reversals):
Danaparoid sodium (Orgaran)
Each 0.6 mL ampule of danaparoid contains 750 anti-Xa units.
Loading Dose
2,250 U IV bolus*, followed by 400 U/hour x 4 hours,
then 300 U/hour x 4 hours, then use maintenance dose IV, as below.
*Adjust bolus dose for body weight:
< 60 kg 1500 U (2 ampules)
60-75 kg 2250 U (3 ampules)
75-90 kg 3000 U (4 ampules)
> 90 kg 3750 U (5 ampules)
Maintenance (IV)
200 U/hour*, with subsequent dose adjustments (bolus adjustments if
desired can be given in 50 cc minibags of D5W, NS or Ringer’s Lactate)
made using anti-Xa levels (target range 0.5-0.8 anti-Xa U/mL, if available.
Prepare danaparoid for intravenous infusion as follows: add 3 ampules
(2250 U) danaparoid to 250 mL D5W or NS or Ringer’s Lactate (ie. 9 anti-Xa
U/mL), and infuse at 44 mL/hr (=396 U/hr) x4 hours, then 33 mL/hr (=297
U/hr) x 4 hours, then 22 mL/hr (198 U/mL).
The half-life of anti-Xa activity is approximately 25 hours; when overlapping
danaparoid therapy with initiation of warfarin anticoagulation, the physician
should consider discontinuing the danaparoid when the INR begins to increase
on warfarin.
Maintenance (SC)
After initial IV therapy
2250 U subcutaneously bid*
*Adjust does for body weight
< 55 kg 1500 U subcutaneously bid
> 90 kg 1750 U subcutaneously tid
Prophylaxis
90 kg or less 750 U subcutaneously bid
> 90 kg 1250 U subcutaneously bid
