Порой случается, что семейной паре очень сложно родить малыша. По этой причине они вынуждены применять альтернативные способы зачатия. Но в таком случае нужно будет поддерживать организм матери медикаментозно, ведь перед ЭКО она принимает гормональное лечение. Так как у беременной женщины кровь сгущается, это чревато последствиями не только для нее, но и для кровообращения плода. Поэтому ей назначают антикоагулянты. Но что лучше Клексан или Фраксипарин — поможет разобраться следующая информация.
Показания и противопоказания
В большинстве случаев врачи назначают Флексан или Фраксипарин. Препараты в принципе равнозначные, разница между Фраксипарином и Клексаном в количестве действующего вещества в одной дозе. Клексан вполовину сильнее Фраксипарина.
Ведь, как известно, кровь беременной сильно сгущается, предостерегая организм от обильной кровопотери при родах. Но при ЭКО, показатели выше нормы вообще неприемлемы, из-за этого возможны мутации клеток.
Клексан и Фраксипарин назначают многим беременным, но зачем делают инъекции, знает не каждая. Оба лекарства помогают предотвратить появление тромбов.
Для чего назначают Клексанпри ЭКО:
- для разжижения крови;
- профилактики тромбообразования;
- во избежание мутации клеток из-за постоянных хирургических вмешательств в организм;
- восстановления нормального кровотока плода.
Клексан при ЭКО поможет избавиться от проблем с кровью. Важно, перед началом применения препарата, лучше посоветоваться с гематологом, ведь организм женщины может не только вылечиться, но и пострадать от лекарства.
Образование тромбов всегда несёт тяжёлые последствия и является крайне нежелательным в организме человека.
В наше время существует достаточно большое количество препаратов, которые способствуют предотвращению их появления.
К таким лекарствам очень часто прибегают беременные в целях профилактики, больные тромбозом для терапии и т. д. В этой статье будут рассмотрены более подробно два таких препарата, а именно Фраксипарин и Клексан.
Фармакологическое действие
Фраксипарин является препаратом, относящимся к группе прямых антикоагулянтов, оказывающих противотромботическое действие.
Улучшает кровообращение и приводит в норму содержание холестерина. Активным веществом Фраксипарина является надропарин кальций. Это низкомолекулярный гепарин, который разработан путём деполимеризации обычного гепарина.
Антитромботическая активность достигается за счёт активации фибринолиза способом высвобождения активатора плазминогена ткани из клеток эндотелия и стимуляции ингибитора пути тканевого фактора.
Надропарин оказывает малое влияние на первичный гемостаз. Обладает повышенным уровнем соотношения между анти-IIа и анти-Ха активностью. Оказывает незамедлительное и пролонгированное противотромботическое действие.
Препарат Клексан 40 мг
Клексан является низкомолекулярным гепарином, а также антикоагулянтом прямого действия. Действующим компонентом препарата является эноксапарин Na, который относится к низкомолекулярным гепаринам.
Действие вещества обусловлено активацией антитромбина III, в результате чего происходит угнетение ингибирования и образования активности фактора IIa и X. Препарат оказывает длительный противотромботический эффект, который не оказывает негативного влияния на связывание фибриногена с рецепторами тромбоцитов и на агрегацию тромбоцитов.
Показания к применению
Медицинский препарат Фраксипарин рекомендуется к применению в следующих случаях:
- профилактики тромбоэмболических осложнений после каких-либо операций;
- лечения тромбоэмболических осложнений;
- лечения стенокардии, а также инфаркта миокарда.
Медицинский препарат Клексан рекомендуется к применению для:
- превенции тромбоэмболий и венозных тромбозов;
- лечения тромбоза глубоких вен;
- лечения стенокардии, а также инфаркта миокарда.
Способ применения
Медицинский препарат Фраксипарин применяется исключительно подкожно и внутривенно:
- общая хирургия. Использовать данный препарат рекомендуется не менее семи дней в дозе, которая составляет 0,3 миллилитра. Самую первую дозу пациентам вводят за два-четыре часа до операционного вмешательства;
- ортопедическая хирургия. Самую первую дозу Фраксипарина пациентам вводят за двенадцать часов до операции, а также через такой же промежуток времени после неё. Данный препарат рекомендуется применять в течение десяти дней.
Медицинский препарат Клексан применяется исключительно для подкожного введения, при этом стоит знать о том, что данное средство запрещено вводить внутримышечно:
- при абдоминальных операциях. Применяется в дозировке 20-40 миллилитров один раз в сутки однократно. Начальная доза до операционного вмешательства вводится за два часа;
- при ортопедических операциях. Используется доза в 40 миллиграммов один раз в сутки однократно. Изначально препарат вводится за двенадцать часов до оперативного вмешательства. При этом также существует альтернативная схема для введения, и составляет она по 30 миллилитров два раза в сутки, а начальная доза вводится через 12-24 часа после операционного вмешательства.
Курс лечения данным средством составляет от недели до 10 дней, при этом он может быть продлён до определённого времени, пока сохраняется риск тромбоза. Обычно продлевается не более, чем на пять недель.
Противопоказания
Препарат Фраксипарин не следует применять в таких случаях:
- при наличии аллергии на компоненты препарата;
- если прошлое применение данного препарата вызвало развитие тромбоцитопении;
- при повышенном риске или присутствующем кровотечении;
- при обострении заболевания 12-перстной кишки или язвы;
- при цереброваскулярной геморрагической травме;
- при инфекционном эндокардите в острой стадии.
Препарат Клексан не следует применять в таких случаях:
- при непереносимости одного из компонентов препарата;
- при высоком риске кровотечений;
- беременным с искусственным клапаном сердца;
- при возрасте менее 18 лет.
Также с осторожностью необходимо принимать Клексан при:
- язве;
- ишемическом недавно перенесённом инсульте в анамнезе;
- геморрагической или диабетической ретинопатии;
- злокачественной артериальной гипертензии;
- недавних родах;
- нарушениях гемостаза;
- эндокардите;
- перикардите;
- нарушении функции почек и печени;
- сложной травме;
- в комплексе с препаратом, влияющем на гемостаз;
- применении внутриматочной спирали в целях контрацепции.
Побочные эффекты
При терапии Фраксипарином могут возникнуть следующие побочные действия:
- аллергические реакции;
- кровотечения;
- повышение уровня ферментов печени;
- небольшие гематомы в месте введения;
- плотные болезненные узелки в месте введения;
- тромбоцитопения;
- эозинофилия;
- гиперкалиемия.
При терапии Клексаном могут возникнуть следующие побочные действия:
- кровотечение;
- геморрагический синдром;
- развитие кровоизлияния в забрюшинное пространство;
- развитие кровоизлияния в полость черепа;
- летальный исход;
- развитие гематомы спинномозгового пространства;
- развитие неврологических нарушений;
- паралич;
- парез;
- тромбоцитопения;
- аллергические реакции в месте введения препарата;
- повышение уровня трансаминаз.
При кровотечении необходимо прекратить применение Клексана.
Передозировка
В случаях передозировки Фраксипарином при введении повышенных доз инъекций может возникнуть кровотечение.
В этом случае следующие применение лекарства необходимо перенести, но это касается только незначительного выделения крови.
Если же передозировка произошла после приёма внутрь, то даже большое количество лекарства не может вызвать серьёзных осложнений, потому что оно обладает очень низкой абсорбацией.
Случайная передозировка Клексаном при введении инъекции может привести к геморрагическим осложнениям. При приёме внутрь маловероятны какие-либо осложнения, потому что препарат не абсорбируется.
Отзывы
Однако таких пациенток смущает то, что укол происходит в живот.
Достоинством также отмечают то, что препарат предотвращает появление тромбов, улучшает кровообращение, действует достаточно быстро и удобен в применении.
Из минусов отмечают слишком высокую стоимость, гематомы после уколов, присутствие серьёзных побочных эффектов, но при этом проявляются они достаточно редко. В отзывах о Клексан указывается о том, что он допустим при беременности, и для многих это является плюсом. Отмечается хорошая эффективность, удобство и простота в использовании.
Из минусов наиболее часто выделяется то, что инъекции необходимо делать в живот, и в целом они являются крайне неприятными. Также отмечается слишком дорогая стоимость, и наличие большого количества тяжёлых побочных действий и противопоказаний.
Что лучше?
Определить, что лучше, Фраксипарин или Клексан достаточно сложно. К каждому пациенту необходим индивидуальный подход и назначение наиболее подходящего препарата.
Препарат Фраксипарин 0,3 мл
Фраксипарин имеет меньшее количество побочных действий и противопоказаний, а Клексан, в свою очередь, обладает множеством эффектов, несущих тяжёлые последствия, вплоть до летального исхода.
Если рассматривать ценовой сегмент, то Фраксипарин немного дешевле. Что касается эффективности в плане лечения, то оба препарата одинаково отлично зарекомендовали себя среди больных.
Вывод
Акушер-гинеколог о тромбофилии во сремя беременности:
Выбирая, какой препарат назначить пациенту, Фраксипарин или Клексан, врач должен в первую очередь ориентироваться на противопоказания, которыми они обладают. Рекомендуется даже при наличии тех показаний, которые дают возможность применять препарат под наблюдением и с крайней осторожностью, сделать выбор на то лекарство, которое не имеет такого противопоказания.
- Стабилизирует уровень сахара надолго
- Восстанавливает выработку инсулина поджелудочной железой
Узнать больше. Не является лекарственным средством. —>
Фраксипарин или Клексан: что лучше выбрать при беременности
Фраксипарин относится к ЛС, которые входят в группу антикоагулянтов прямого действия, проявляет противотромботическое воздействие. Препарат способствует улучшению кровообращения, нормализует показатель холестерина. Действующее вещество ЛС — надропарин Ca, он является низкомолекулярным гепарином, получен благодаря деполимеризации гепарина.
Антитромботическое действие проявляется вследствие активизации фибринолиза путем выведения активатора плазминогена непосредственно из клеток эндотелия и специфической стимуляции самого ингибитора пути тканевого фактора. ЛС характеризуется длительным противотромботическим действием.
Многих интересует, в чем разница между Клексаном и Фраксипарином, ведь препараты оказывают схожее действие. Фраксипарин в отличие от Клексана – содержит эноксапарин Na. Кроме противотромботического действия вещества не наблюдается воздействия на связь фибриногена непосредственно с рецепторами тромбоцитов, а также процесс агрегации клеток-тромбоцитов.
Когда назначаются
Колоть Фраксипарин и Клексан следует в тех случаях, когда у женщины имеется склонность к тромбообразованию или же у будущей мамы установлен сердечный клапан. Также рекомендуется проведение терапии данными препаратами при тромбофилии, при формировании кровяных сгустков в глубоких венах, при ишемии и в том случае, когда диагностирована сердечная или же дыхательная недостаточность.
Обычно Клексан врачи советуют использовать с целью профилактики, он показан к применению во 2 триместре беременности. Если данное лекарство женщине не подходит, может использоваться Фраксипарин.
Также данные лекарственные препараты могут назначаться при первом протоколе ЭКО, применение ЛС должно проводиться под строгим контролем специалистов.
Особенности применения
Оба препарата предназначены для п/к введения, не допускается проведение внутримышечных инъекций.
Как делают инъекции
Постановку уколов рекомендуется проводить после того, как женщина заняла лежачее положение. Место введения следует чередовать (левую и правую часть переднелатеральной или заднелатеральной области живота). После захвата кожной складки между указательным и большим пальцем осуществляется введение иглы строго вертикально. Массировать область введения ЛС не следует. Длительность лечения обычно составляет 7-10 дн. После этого рекомендуется сдать кровь на анализ, чтобы удостоверится, что все показатель тромбоцитов в норме. Важно вести календарь записей введения лекарства по неделям беременности.
Дозировка Клексана или Фраксипарина определяется индивидуально. Для предупреждения тромбозов назначают 40 мг Клексана единоразово за сутки в течение 1-2 нед. При тромбозе глубоких вен необходимо вводить 1,5 мг препарата на 1 кг веса 1 р. на протяжении дня или же по 1 мг дважды в день. Если ампулы с лекарством остались после беременности, их можно использовать при необходимости в дальнейшем.
Обычно упаковки Фраксипарина хватает на курс лечения, минимальная доза ЛС составляет 0,3 мл, введение ЛС осуществляется единоразово за сутки. Если гематолог назначил применение препарата по определенной схеме, учитывается масса тела пациентки и срок беременности.
Противопоказания и побочные реакции
Перед тем как применять Клексан или Фраксипарин стоит ознакомиться с перечнем противопоказаний. Не назначается лечение при:
- Наличии чрезмерной чувствительности к составляющим лекарств
- Недостатке факторов свертываемости крови
- Слабовыраженном терапевтическом эффекте в случае применения антиагрегантов
С осторожностью назначаются препараты при нарушениях работы ЖКТ, диабете 1 типа, патологиях печени и почечной системы, повышенном АД.
Применение антикоагулянтов может привести к развитию следующей побочной симптоматики:
- Развитие кровоизлияния
- Снижение уровня тромбоцитов
- Нарушение функционирования печени
- Ангионевротический отек
- Появление зуда, гиперемии, крапивницы.
Аналоги
Гемапаксан — аналог Клексана и Фраксипарина, также является антикоагулянтом прямого действия. Терапевтический эффект от применения ЛС обусловлен наличием эноксапарином натрия. Препарат используется для лечения и профилактики тромбозов, тромбоэмболии, назначается в комбинации с аспирином в случае инфаркта миокарда и нестабильной стенокардии. Производится Гемапаксан итальянской фармацевтической компанией Италфармако, форма выпуска – инъекционный раствор. Стоимость пачки (6 шприцов с раствором) – 918-1578 руб.
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