Cibor

Tsibor has anticoagulant therapeutic activity. The drug is a low-molecular heparin, which is part of a group of anticoagulants with a direct form of medicinal effect. When using the drug, the severity of blood clotting decreases.

The principle of the medicinal action of the active element of bemiparin Na is associated with the potentiation of the suppressive effect of antithrombin 3, which is exerted on existing blood coagulation factors. [ 1 ]

Indications Cibor

It is used for the following disorders:

• prevention of thromboembolism in case of general or orthopedic operations;
• prevention of thromboembolism in individuals with an increased risk of thrombus formation (without surgery);
• during hemodialysis to prevent blood clotting;
• prevention of the development of recurrent venous thromboembolism in cases where the patient has DVT.

Release form

The medicinal element is released in the form of a liquid for subcutaneous injections, inside 0.2 ml syringes. 10 or 30 syringes inside a box.

Pharmacokinetics

After a subcutaneous injection, the drug is well absorbed. Bioavailability values are 96%. The term for achieving plasma Cmax of the anti-Xa factor effect is determined by the size of the drug dosage. With a portion within 2500-3500 IU, this indicator is noted after 3 hours after the drug administration; it should be noted that when using the specified portions, the anti-2a factor effect does not develop. For it to appear at the 0.01 IU/ml mark, higher dosages (7500-12,500 IU) are required.

The half-life of bemiparin is approximately 6 hours (at doses of 2500-12,500 IU), which is why the drug is administered once a day. There is no information on the metabolic processes, protein synthesis and excretion of the drug. [ 2 ]

Dosing and administration

The drug is used in orthopedic and surgical procedures, as well as in hemodialysis and for prevention, taking into account the degree of intensity of risks.

In case of low probability of venous thromboembolism, on the day of the orthopedic procedure or surgery, the patient is given a subcutaneous injection of 2500 IU, 2 hours before the procedure or 6 hours after its completion. Subsequently, during the period of high probability of thromboembolism (7-10 days), 2500 IU are used at 24-hour intervals.

If the likelihood of developing a disorder is high, it is necessary to increase the dosage to 3500 IU.

To prevent blood clotting during dialysis, when the risk of bleeding is low or absent, the drug is administered into the arterial bed through a bolus injection - once, before the start of hemodialysis. The dose size is determined taking into account the patient's weight: if the weight is below 60 kg, 2500 IU of anti-factor Xa is used; if the weight is above 60 mg, 3500 IU is required.

Tsibor should be administered in the posterolateral lumbar region or the anterolateral abdominal region, left and right in turn. The needle should be inserted into the skin fold exclusively perpendicularly. Rubbing the injection area is prohibited.

• Application for children

Not for use in pediatrics.

Use Cibor during pregnancy

Tsibor can be prescribed to breastfeeding or pregnant women only in extreme cases, taking into account the possible risks.

Contraindications

Main contraindications:

• increased intolerance to the drug, heparin and products obtained from pig organs;
• severe blood clotting disorder and frequent active bleeding;
• suspected or diagnosed history of thrombocytopenia immunologically associated with heparin;
• severe liver dysfunction;
• injuries or operations in the area of the auditory and visual organs, as well as the brain;
• active form of endocarditis of bacterial origin;
• diseases that increase the risk of bleeding (peptic ulcer, hemorrhagic stroke and cerebral aneurysm).

Caution is required when used in individuals with renal insufficiency, high blood pressure, urolithiasis, diseases of the retina and iris, as well as in the presence of a history of gastric ulcer and a history of lumbar puncture.

Side effects Cibor

Most often, the use of drugs causes ecchymosis or pain and hematoma in the area of the injection.

Sometimes bleeding develops in the mucous membranes of the gastrointestinal tract and urogenital tract, as well as signs of allergy.

Occasionally, anaphylactic symptoms (itching, dyspnea, bronchial spasm, fever, swelling of the larynx and urticaria, as well as vomiting and nausea) appear.

Overdose

The main symptom of overdose is bleeding. In this case, taking into account the probability of thrombosis and the severity of hemorrhage, a decision is made to discontinue the drug. If hemorrhage is mild, no specific therapy is required, and if severe bleeding occurs, protamine sulfate should be administered in a dose of 1.4 mg/100 IU of antifactor-Xa.

Interactions with other drugs

It is prohibited to combine bemiparin with other drugs that have an anticoagulant effect and can reduce the rate of platelet aggregation.

The drug should not be used together with dextran and systemic GCS, because such a combination increases the risk of bleeding.

Cibor should be used with caution in combination with drugs that promote the development of hyperkalemia.

Administration of the drug in combination with intravenous injections of nitroglycerin leads to a weakening of the therapeutic activity of bemiparin Na.

The drug must not be mixed with other drugs that are administered parenterally.

Storage conditions

The cibor must be stored at temperatures no higher than 30°C.

Shelf life

Tsibor can be used for a period of 24 months from the date of sale of the pharmaceutical product.

Analogues

Analogues of the drug are Novoparin, Ecosanparin, Clexane with Flenox, and in addition to this, Axparin, Ekleksiya and Heparin with Fraxiparin. Also on the list are Fragmin, Gisende and Enoxarin.

Reviews

Cibor receives mostly positive reviews from patients who have used it.