Laboratory Medicine Program

Low Molecular Weight Heparin (LMWH)
(Fragmin/Tinzaparin, Enoxaparin)

Clinical Decription:
Low molecular weight heparins (LMWH) such as Enoxaparin, Fragmin, Tinzaparin are anticoagulants used for the prevention and treatment of arterial and venous thromboembolic diseases. LMWH have greater anti-Xa:IIa than unfractionated heparin making them insensitive to the aPTT. LMWH are cleared renally. Monitoring of LMWH levels by anti-Xa level is not normally recommended due to their stable pharmacokinetics. Monitoring is advised though in the presence of renal failure, pregnancy and pediatrics.

Method: Chromogenic; Siemens Sysmex CS-5100

Component Tests Used: n/a

Reference Ranges Used:
0.60-1.10 IU/mL: twice per day injection; 1.00-2.00 IU/mL: once per day injection

Specimen Type: Citrated plasma
Collected In: 3.2% Sodium Citrate
Volume: 1.0 mL (minimum: 1.0 mL)

Shipping: Send frozen on dry ice.

Special Instructions: Patient should be fasting, if possible. The specimen must be double-centrifuged to obtain a platelet-poor plasma specimen (Plt <10x10E9/L): 1. Immediately centrifuge specimen at 1500xG for 10 minutes. 2. Separate the plasma from the platelet/buffy coat and transfer into a clean plastic tube. 3. Centrifuge the separated plasma at 1500xG for 10 minutes. 4. Transfer 1.0 to 2.0 mL of the double-centrifuged plasma into a clean plastic tube, leaving approx. 200 uL for discard. 5. Freeze plasma aliquot immediately for storage. Maintain frozen for shipping and handling.

Testing Schedule(s): Daily.

Turnaround Time: 1 day

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For more information, call 416.340.5227 or 1.866.865.5227

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