DrugindexOnline^{2nd edition}

Generic Name: ardeparin (are duh PEH rin)
Brand Names: Normiflo

What is ardeparin?

Ardeparin was withdrawn from the U.S. market in March of 2000.

Ardeparin is an anticoagulant (blood thinner). Ardeparin prevents the formation of blood clots.

Ardeparin is used to prevent blood clot formation following knee replacement surgery.

Ardeparin may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about ardeparin?

Ardeparin was withdrawn from the U.S. market in March of 2000.

There is a risk of bleeding in the spinal or epidural space, possibly resulting in paralysis, when ardeparin is used along with spinal or epidural anesthesia or spinal puncture. This risk may be increased by the use of indwelling epidural catheters or by the concomitant use of drugs that affect blood clotting.

Do not inject this medication intramuscularly (into the muscle) or intravenously (into the vein). Do not take aspirin, ibuprofen (Motrin, Advil, Nuprin, and others), ketoprofen (Orudis KT, Orudis, Oruvail), naproxen (Aleve, Naprosyn, Anaprox, and others), indomethacin (Indocin), or any other nonsteroidal anti-inflammatory medication without first talking to your doctor. These medicines may lead to bleeding when taken with ardeparin. Ask your pharmacist or doctor before taking any prescription or over-the-counter medication.

Who should not use ardeparin?

Do not use this medication if you

• have a very low level of platelets in your blood,

• have uncontrolled active bleeding,

• have an allergy to pork products, or

• cannot have accurate blood testing done prior to and during dosing.

Before using ardeparin, tell your doctor if you

• have bacterial endocarditis,

• have high blood pressure that is not being controlled,

• need to have surgery or another invasive procedure,

• have hemophilia or another blood disorder,

• have a stomach ulcer,

• have eye problems due to diabetes or high blood pressure,

• have liver disease, or

• have kidney disease.

You may not be able to use ardeparin, or you may require a dosage adjustment or special monitoring during therapy if you have any of the conditions listed above.

Ardeparin (Normiflo) is in the FDA pregnancy category C. This means that it is not known whether ardeparin will harm an unborn baby. Do not use ardeparin without first talking to your doctor if you are pregnant. It is also not known whether ardeparin passes into breast milk. Do not use this medication without first talking to your doctor if you are breast-feeding a baby.

How should I use ardeparin?

Use ardeparin exactly as directed by your doctor. If you do not understand these directions, ask your doctor, nurse, or pharmacist to explain them to you.

Ardeparin must be used as a subcutaneous (under the skin) injection.

Do not inject this medication intramuscularly (into a muscle) or intravenously (into a vein).

Your doctor or nurse will give you detailed instructions on how to inject ardeparin. It can be injected into the fat of the stomach (avoid the bellybutton); the outer, upper arms; or the outer thighs. Follow your doctor's instructions.

Sit or lie down before receiving an injection. Lift a fold of skin and insert the needle completely into the fold at a 45 to 90 degree angle. Before injecting the medicine, pull back on the plunger a little to be sure that no blood is drawn back into the syringe. This will ensure that the needle is not in a vein or artery. Continue to pinch the skin until the injection is complete. To lessen bruising, do not rub the area after injecting the medication.

Do not use any medication that is discolored or that has particles in it.

Do not stop using this medication without first talking to your doctor. Store ardeparin at room temperature away from moisture and heat.

What happens if I miss a dose?

Use the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the dose you missed and use only your next regularly scheduled dose. Do not use a double dose of this medication.

Notify your doctor if you miss a dose of ardeparin.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of an overdose include unusual bleeding from wounds or injection sites; nosebleeds; black, bloody, or tarry stools; blood in the urine; and easy bruising or bleeding.

What should I avoid while using ardeparin?

Do not take aspirin, ibuprofen (Motrin, Advil, Nuprin, and others), ketoprofen (Orudis KT, Orudis, Oruvail), naproxen (Aleve, Naprosyn, Anaprox, and others), indomethacin (Indocin), or any other nonsteroidal anti-inflammatory medication without first talking to your doctor. These medicines may lead to bleeding when taken with ardeparin. Ask your pharmacist or doctor before taking any prescription or over-the-counter medication.

Ardeparin side effects

If you experience any of the following serious side effects, stop using ardeparin, and seek emergency medical attention or call your doctor immediately:

• an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

• any prolonged or unexplained bleeding;

• pain, warmth, or redness in an arm or leg, or difficulty breathing, which could indicate a blood clot; or

• ulceration at the injection site.

Other less serious side effects may be more likely to occur. Continue to use ardeparin and notify your doctor if you experience

• mild pain, redness, or warmth at the injection site;

• rash or itching;

• fever; or

• nausea.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect ardeparin?

There is a risk of bleeding in the spinal or epidural space, possibly resulting in paralysis, when ardeparin is used along with spinal or epidural anesthesia or spinal puncture. This risk may be increased by the use of indwelling epidural catheters or by the concomitant use of drugs that affect blood clotting.

Do not take ardeparin with any of the following medicines without first talking to your doctor:

• aspirin,

• ibuprofen (Motrin, Advil, Nuprin, and others), ketoprofen (Orudis KT, Orudis, Oruvail), naproxen (Aleve, Naprosyn, Anaprox, and others), indomethacin (Indocin), diclofenac (Cataflam, Voltaren), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), ketorolac (Toradol), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), tolmetin (Tolectin), or any other nonsteroidal anti-inflammatory medication;

• warfarin (Coumadin);

• aspirin and dipyridamole (Aggrenox);

• ticlopidine (Ticlid) or clopidogrel (Plavix); or

• dipyridamole (Persantine).

The drugs listed above may increase the effects of ardeparin, which could become dangerous. You may not be able to take ardeparin, or you may require a dosage adjustment or special monitoring during your treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with ardeparin. Talk to your doctor and pharmacist before using any prescription or over-the-counter medicines.

Where can I get more information?

• Your pharmacist has additional information about ardeparin written for health professionals that you may read.

What does my medication look like?

Ardeparin was withdrawn from the U.S. market in March of 2000.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 2.04. Revision Date: 2/22/07 2:07:24 PM.