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Table 1 Overview of Different Anticoagulatory Drugs, Their Way of Application and Testing, Cross-Reactivity With Other Substances and Documented Clinical Features

From: Delayed-Type Heparin Allergy: Diagnostic Procedures and Treatment Alternatives--A Case Series Including 15 Patients

Anticoagulant

Substance Class

Way of Application

Way of Testing

Cross-Reactivity With

Documented Clinical Features

Heparin calcium

UFH

(sulfated mucopolysaccharide)

IV or SC

Undiluted

LMWH, heparin sodium

Skin necrosis, urticaria, bronchospasm, anaphylaxis, HIT type II, DTHR

Heparin sodium

UFH

(sulfated mucopolysaccharide)

IV or SC

Undiluted

LMWH, heparin calcium

Skin necrosis, urticaria, bronchospasm, anaphylaxis, HIT type II, DTHR

Dalteparin

LMWH

SC

Undiluted

UFH, other LMWH

Skin necrosis, urticaria, bronchospasm, anaphylaxis, HIT type II, DTHR

Nadroparin

LMWH

SC

Undiluted

UFM, other LMWH

Skin necrosis, urticaria, bronchospasm, anaphylaxis, HIT type II, DTHR

Enoxaparin

LMWH

SC

Undiluted

UFM, other LMWH

Skin necrosis, urticaria, bronchospasm, anaphylaxis, HIT type II, DTHR

Repivarin

LMWH

SC

Undiluted

UFM, other LMWH

Skin necrosis, urticaria, bronchospasm, anaphylaxis, HIT type II, DTHR

Tinzaparin

LMWH

SC

Undiluted

UFM, other LMWH

Skin necrosis, urticaria, bronchospasm, anaphylaxis, HIT type II, DTHR

Certoparin

LMWH

SC

Undiluted

UFM, other LMWH

Skin necrosis, urticaria, bronchospasm, anaphylaxis, HIT type II, DTHR

Pentosan polysulfate

Semisynthetic heparinoid

SC

Undiluted

UFM, LMWH

Skin necrosis, urticaria, bronchospasm, anaphylaxis, fever, chills, HIT type II, DTHR

Danaparoid

Semisynthetic heparinoid

IV or SC

Undiluted

LMWH

Rash, maculopapular exanthemas, pustulosis, pruritus, DTHR

Lepirudin

Recombinant hirudin

IV

Undiluted

Bivalirudin

Anaphylactic and anaphylactoid reactions (including fatal outcome), DTHR, exanthemas, fever, chills

Fondaparinux

Synthetic pentasaccharide

SC (IV possible)

Undiluted

UFM, LMWH

Urticaria, edema, anaphylaxis, rash, DTHR

Bivalirudin

Synthetic thrombin inhibitor

IV

Undiluted

Not reported

Urticaria, anaphylaxis (including fatal outcome)

Argatroban

Synthetic thrombin inhibitor

IV

Undiluted

Not reported

Rash, urticaria, bullous dermatitis, edema

  1. IV indicates intravenous; SC, subcutaneous.