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. 2015 Aug 4;4(3):202–212. doi: 10.5492/wjccm.v4.i3.202

Table 4.

Dosage and availability of anticoagulation agents for heparin induced thrombocytopenia syndrome

Drug Bolus Dosage Dosage in renal impairment Dosage in hepatic impairment Availability in Australia
Lepirudin Only if life or limb threatening thrombosis. 0.4 mg/kg iv 0.1-0.15 mg/kg per hour Cr. Cl. 45-60: 50% of original infusion rate. Cr. Cl. 30-44: 30% of original infusion rate. Cr. Cl. 15-29: 15% of original infusion rate according to body weight. Avoid if Cr. Cl. Lower or use 0.005 mg/kg per hour if on haemofiltration No change Discontinued
Desirudin None 15-30 mg sc bd. Limited data Not recommended given paucity of data No change Not available
Danaparoid IV according to body weight. < 60 kg: 1500 U; 60-75 kg: 2250 U; 75-90 kg: 3000 U; > 90 kg: 3750 U 400 U/h IV × 4 h followed by 300 U/h IV × 4 h followed by 200 U/h iv Reduce dose by 30% and monitor antiXa activity No change Available
Bivalirudin None 0.15-0.2 mg/kg per minute Cr. Cl 10-29: 0.06 mg/kg per minute; Cr. Cl < 10: 0.015 mg/kg per minute iv No change Available
Fondaparinux None < 50 kg: 5 mg sc; 50-100 kg: 7.5 mg sc; > 100 kg: 10 mg sc Cr. Cl 30-50: monitor closely. Cr. Cl < 30: Contraindicated No change Available
Argatroban None 2 mcg/kg per minute iv No change 0.5 mcg/kg per minute Not available

Cr. Cl.: Creatinine clearance in mL/min; sc: Subcutaneous; iv: Intravenous.