ALERT 5: Low molecular weight heparin (LMWH) in renal impairment
This Alert was prompted by a review in 2004 by the New Zealand Pharmacovigilance Centre of 33 cases reports of enoxaparin related bleeding or haemorrhage and 3 case reports of major bleeding with dalteparin. There were five reports of death and four reports of life threatening haemorrhage with enoxaparin. Of these patients, six out of nine had renal impairment and seven out of nine patients were aged over 70 years. Haematological opinion at that time indicated that elderly patients are not more at risk of bleeding complications with the LMWHs providing the dose is adjusted for weight and renal function.