Comparative Pharmacology
Head-to-head clinical analysis: ANGIOMAX versus FRAGMIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ANGIOMAX versus FRAGMIN.
ANGIOMAX vs FRAGMIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Direct thrombin inhibitor that reversibly binds to the active site of thrombin, blocking its interaction with substrates, thereby inhibiting fibrin formation and activation of coagulation factors V, VIII, and XIII.
Fragmin (dalteparin) is a low molecular weight heparin that binds to antithrombin III, potentiating its inhibition of factor Xa and, to a lesser extent, thrombin, thereby preventing thrombus formation.
1 mg/kg intravenous bolus followed by 0.1 mg/kg/hour continuous intravenous infusion for duration of procedure; alternatively, 0.75 mg/kg intravenous bolus followed by 1.75 mg/kg/hour continuous intravenous infusion for up to 4 hours during percutaneous coronary intervention.
Deep vein thrombosis prophylaxis: 2500 IU subcutaneously once daily, starting 1-2 hours before surgery and continuing postoperatively for 5-10 days or until ambulatory. Treatment of acute DVT: 200 IU/kg subcutaneously once daily, or 100 IU/kg twice daily. Unstable angina/NSTEMI: 120 IU/kg subcutaneously every 12 hours (max 10,000 IU per dose) with aspirin.
None Documented
None Documented
Terminal elimination half-life: 25-30 minutes in patients with normal renal function; increased to 2-3 hours in dialysis-dependent patients
2-4 hours (anti-Xa activity) after subcutaneous administration; prolonged in renal impairment (creatinine clearance <30 mL/min: up to 6-12 hours)
Renal: ~90% unchanged; biliary/fecal: negligible (<1%)
Primarily renal excretion (up to 70% as unchanged drug via glomerular filtration); minor biliary/fecal elimination (<15%)
Category C
Category C
Anticoagulant
Anticoagulant