Parnaparin : a review of its use in the management of venous thromboembolism, chronic venous disease and other vascular disorders.

Parnaparin (Fluxum) is a low molecular weight heparin (LMWH) that is effective and generally well tolerated in the prevention of venous thrombosis, and in the treatment of chronic venous disease and venous and arterial thrombosis. Overall, the efficacy of parnaparin is at least as good as that of unfractionated heparin (UFH), but recent data indicate that parnaparin is more effective in preventing a triple composite endpoint of death, acute myocardial infarction (MI) and myocardial revascularisation in patients with unstable angina or acute ST-segment elevation myocardial infarction (STEMI). As with other LMWHs, parnaparin has a more convenient, once-daily, subcutaneous administration regimen and better local tolerability than UFH. Very little evidence comparing LMWHs is available but, because of similarities between these agents, very large studies would be needed to show significant differences. Meanwhile, data indicate that parnaparin is a useful option in the range of available LMWHs.