Comparative Pharmacology
Head-to-head clinical analysis: FRAGMIN versus MIRADON.
Peer-Reviewed Evidence
Head-to-head clinical analysis: FRAGMIN versus MIRADON.
FRAGMIN vs MIRADON
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
MIRADON (anagrelide) inhibits cyclic nucleotide phosphodiesterase and the release of arachidonic acid from phospholipids, possibly by inhibiting phospholipase A2. It also suppresses megakaryocyte maturation and platelet production.
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.
2.5 mg orally twice daily (total daily dose 5 mg)
None Documented
None Documented
2-4 hours (anti-Xa activity) after subcutaneous administration; prolonged in renal impairment (creatinine clearance <30 mL/min: up to 6-12 hours)
Terminal elimination half-life is 8-12 hours in adults with normal renal function. In patients with creatinine clearance <30 mL/min, half-life may extend to 20-30 hours. The half-life supports twice-daily dosing in most patients.
Primarily renal excretion (up to 70% as unchanged drug via glomerular filtration); minor biliary/fecal elimination (<15%)
Renal excretion of unchanged drug accounts for 60-70% of the administered dose. Fecal/biliary excretion accounts for 20-25%, with the remainder as oxidative metabolites. Up to 10% is eliminated as glucuronide conjugates.
Category C
Category C
Anticoagulant
Anticoagulant