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Monday 19 May 2008

Guidelines to manage heparin shortage

By: Dr Linda Calabresi

Guidelines have been released to help manage patients needing anti-coagulation if there are shortages of heparin-based products.

The recent TGA recall of five batches of enoxaparin (Clexane) found to contain a contaminant, raised the prospect of a shortage of heparin-based products in Australia.

This possibility prompted the development of the guidelines  to prioritise the use of the available supplies of enoxaparin based on clinical need and provide advice as to alternatives where there is no compromise of the quality of care.

The Consensus Guidelines for Australian Clinicians for the use of anti-coagulants during heparin based product shortages set out a staged approach according to the availability of the different products.

At present, while supplies remain available, patients currently taking enoxaparin for a DVT, for example, can remain on the drug. However if supplies become difficult to obtain alternatives such as the low molecular weight heparin, Fragmin, or unfractionated heparin administered subcutaneously, or an oral anticoagulant such as warfarin might need to be considered.

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