Heparin is an effective, relatively safe, inexpensive parenteral antithrombotic agent widely used in the prevention and treatment of thromboembolic disorders, but it has several limitations such as the marked intra- and inter-patient variability in its anticoagulant response, its poor bioavailability at low doses and its relatively narrow risk to benefit ratio. Low molecular weight heparins ( LMWHs), ultra LMWHs and synthetic pentasaccharides have been developed from heparin to overcome its limitations. The characteristics of these compounds are reviewed along with the description of their approved clinical uses.
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