Accession Number
Small Molecule
Approved, Investigational

Bemiparin is an antithrombotic and belongs to the group of drugs known as the low molecular weight heparins (LMWH). Like semuloparin, bemiparin is classified as an ultra-LMH because of its low mean molecular mass of 3600 daltons, which is a unique property of this class 1. These heparins have lower anti-thrombin activity than the traditional low molecular weight heparins and act mainly on factor-Xa, reducing the risk of bleeding due to selectivity for this specific clotting factor. Interestingly, current research is underway for the potential benefit of bemiparin in the treatment of tumors and diabetic foot ulcers 12,1.

Not Available
Product Ingredients
IngredientUNIICASInChI Key
Bemiparin sodiumP59JKU02CENot AvailableNot applicable
International/Other Brands
Badyket / Heporax / Hibor / Zibor
CAS number
Not Available
Chemical Formula
Not Available
InChI Key
Not Available
Not Available
Not Available
Not Available



Bemiparin is indicated in the following cases: To prevent blood clots in the veins after general abdominal surgery in patients with a moderate risk of venous thromboembolism; in the prevention of the thromboembolic disease in non-surgical patients; prevention of clotting in the extracorporeal circuit during hemodialysis; to prevent blood clots in the veins after a major orthopedic surgery in patients with high risk of venous thromboembolism; secondary prevention of venous thromboembolism; recurrence in patients with deep vein thrombosis; transient prevention and treatment of deep vein thrombosis (DVT) 8.


Bemiparin is an anticoagulant classified under the broad category of low molecular weight heparins. In humans, bemiparin has been proven to possess antithrombotic activity and, at therapeutic doses, does not significantly prolong global clotting laboratory tests 9.

Mechanism of action

This drug is a second-generation low molecular weight heparin (LMWH). It has a very low mean molecular weight (3600 Dalton), a long half-life (5.3 hrs) and a large anti-Xa: anti-IIa ratio (8:1)8. The mechanism of action of bemiparin is inhibition of factor Xa, which is a necessary step in the clotting cascade. Factor-Xa is necessary for the propagation of a thrombus. Combined with various co-factors that bind to activated platelets, Factor-Xa increases coagulation by converting prothrombin to thrombin 11. Activated Factor-X, bound as part of the prothrombinase complex on the external surface of activated platelets, converts significant amounts of prothrombin to thrombin, promoting the so-called ‘thrombin burst’, referring to a burst of thrombin release 11.

A secondary but less potent mechanism of action of this drug is binding to antithrombin III and activated factor II (Factor IIa), which further prevents the propagation of thrombi 14.

Due to its excellent pharmacological profile-the second-generation LMWH with the lowest molecular weight, the longest half-life and the highest anti-Factor Xa/anti-Factor IIa activity ratio-it can be safely used in special categories of patients (children, elderly, patients with renal impairment and congestive heart failure). Several studies demonstrated its safety and efficacy, while cost analyses show the economic benefits of bemiparin treatment as compared to other heparins 1,2.

ACoagulation factor X
UHeparin cofactor 2

Hemiparin sodium is rapidly absorbed following its subcutaneous dose of injection, and the bioavailability is estimated to be 96% 7.

Volume of distribution

5.1 L 4.

Protein binding

There are currently no data available with regards to plasma protein binding, metabolism and excretion of bemiparin in humans 9.


In a study of healthy volunteers, bemiparin 3500 IU achieved more anti-Xa activity than enoxaparin 4000 IU, measured by the area under the curve. The peak of anti-Xa activity was reached at 3h post-administration, and there were anti-Xa measurable levels up to 16 h after subcutaneous injection 6.

Route of elimination

This drug is eliminated by the renal and hepatic routes. Elimination is prolonged in those with renal or hepatic impairment 10.

Half life

Bemiparin, when administered in the dose range of 2,500 IU to 12,500 (therapeutic dosing), it has an approximate half-life of 5-6 hours 7.


Elimination occurs in a linear fashion, with a mean clearance time of over 7 h and total clearance of 0.9 L/h 4.


Bemiparin, like other drugs in its class, may suppress adrenal secretion of aldosterone, leading to elevated potassium (hyperkalemia). This may occur more frequently in patients with conditions such as diabetes mellitus, chronic renal failure, metabolic acidosis, an increased plasma potassium, and those ingesting potassium sparing drugs. There is a linear relationship between duration of therapy and adverse effects, but this is usually reversible with cessation of treatment. Serum electrolytes should be measured in at-risk patients before starting bemiparin, and these patients should be monitored regularly thereafter particularly if treatment is prolonged beyond 1 week.

In rare cases, mild transient thrombocytopenia (HIT type I) at the beginning of therapy with heparin with platelet counts between 100,000/mm3 and 150,000/mm3 due to temporary platelet activation has been noted in clinical studies.

On rare occasions, antibody-mediated severe thrombocytopenia (HIT type II) with platelet counts clearly below 100,000/mm3 has been observed (see section 4.8). This effect usually occurs within 5-21 days after the initiation of treatment, although in patients with a history of heparin-induced thrombocytopenia this may occur more rapidly.

Platelet count studies are recommended before the administration of bemiparin, on the first day of therapy and then every 3-4 days, in addition to repeating platelet studies at the end of therapy. Treatment must be discontinued immediately and an alternate therapy initiated if significant reductions in platelet counts are observed ( 30% decrease and above) 7.

As with other heparin products, cases of cutaneous necrosis, often preceded by purpura or painful erythematous, ecchymose-like lesions have been reported with bemiparin. In these cases, treatment should cease immediately 7.

Overdosage after subcutaneous or other routes of administration of bemiparin may lead to hemorrhagic complications. Neutralization can be obtained by slow intravenous of a suitable dose of the antidote protamine sulphate 8.

Affected organisms
  • Humans
Not Available
Pharmacogenomic Effects/ADRs
Not Available


Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
(1,2,6,7-3H)Testosterone(1,2,6,7-3H)Testosterone may increase the anticoagulant activities of Bemiparin.
(R)-warfarinThe risk or severity of bleeding can be increased when Bemiparin is combined with (R)-warfarin.
(S)-WarfarinThe risk or severity of bleeding can be increased when Bemiparin is combined with (S)-Warfarin.
1-Testosterone1-Testosterone may increase the anticoagulant activities of Bemiparin.
18-methyl-19-nortestosterone18-methyl-19-nortestosterone may increase the anticoagulant activities of Bemiparin.
3,5-Diiodotyrosine3,5-Diiodotyrosine may increase the anticoagulant activities of Bemiparin.
4-hydroxycoumarinThe risk or severity of bleeding can be increased when Bemiparin is combined with 4-hydroxycoumarin.
4-Hydroxytestosterone4-Hydroxytestosterone may increase the anticoagulant activities of Bemiparin.
5beta-dihydrotestosterone5beta-dihydrotestosterone may increase the anticoagulant activities of Bemiparin.
7,8-Dichloro-1,2,3,4-tetrahydroisoquinolineThe risk or severity of bleeding and hemorrhage can be increased when 7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline is combined with Bemiparin.
Additional Data Available
  • Extended Description
    Extended Description

    Extended description of the mechanism of action and particular properties of each drug interaction.

    Learn more
  • Severity

    A severity rating for each drug interaction, from minor to major.

    Learn more
  • Evidence Level
    Evidence Level

    A rating for the strength of the evidence supporting each drug interaction.

    Learn more
  • Action

    An effect category for each drug interaction. Know how this interaction affects the subject drug.

    Learn more
Food Interactions
Not Available


General References
  1. Chapman TM, Goa KL: Bemiparin: a review of its use in the prevention of venous thromboembolism and treatment of deep vein thrombosis. Drugs. 2003;63(21):2357-77. [PubMed:14524738]
  2. Planes A: Review of bemiparin sodium--a new second-generation low molecular weight heparin and its applications in venous thromboembolism. Expert Opin Pharmacother. 2003 Sep;4(9):1551-61. [PubMed:12943485]
  3. Jeske WP, Hoppensteadt D, Gray A, Walenga JM, Cunanan J, Myers L, Fareed J, Bayol A, Rigal H, Viskov C: A common standard is inappropriate for determining the potency of ultra low molecular weight heparins such as semuloparin and bemiparin. Thromb Res. 2011 Oct;128(4):361-7. doi: 10.1016/j.thromres.2011.03.001. Epub 2011 Apr 2. [PubMed:21458847]
  4. Sanchez-Ferrer CF: Bemiparin: pharmacological profile. Drugs. 2010 Dec 14;70 Suppl 2:19-23. doi: 10.2165/1158581-S0-000000000-00000. [PubMed:21162606]
  5. Hoffman M, Monroe DM: Coagulation 2006: a modern view of hemostasis. Hematol Oncol Clin North Am. 2007 Feb;21(1):1-11. doi: 10.1016/j.hoc.2006.11.004. [PubMed:17258114]
  6. Antonijoan RM, Rico S, Martinez-Gonzalez J, Borrell M, Valcarcel D, Fontcuberta J, Barbanoj MJ: Comparative pharmacodynamic time-course of bemiparin and enoxaparin in healthy volunteers. Int J Clin Pharmacol Ther. 2009 Dec;47(12):726-32. [PubMed:19954711]
  7. Irish Medicines Board: Bemiparin [Link]
  8. Hibor-Bemiparin Sodium [Link]
  9. Zibor 2,500 IU Solution for Injection [Link]
  10. Injectable drugs guide [Link]
  11. Thrombosis Advisors- Factor Xa inhibitor [Link]
  12. Anti-tumor effects of bemiparin in HepG2 and MIA PaCa-2 cells [Link]
  13. Bemiparin, an effective and safe low molecular weight heparin: a review [Link]
  14. Bemiparin sodium [Link]
External Links
PubChem Substance
ATC Codes
B01AB12 — Bemiparin

Clinical Trials

Clinical Trials
0CompletedPreventionUnexplained Stillbirth1
1CompletedNot AvailableHealthy Volunteers1
1CompletedTreatmentImpaired kidney function1
2CompletedTreatmentPeritoneal Diseases1
2TerminatedTreatmentCarcinoma, Small Cell1
2, 3TerminatedTreatmentDiabetic Angiopathies / Diabetic Foot Ulcers (DFU)1
3Active Not RecruitingPreventionCirrhosis and Coagulation1
3CompletedPreventionMalignancies / Venous Thromboembolism1
3CompletedTreatmentDeep Vein Thrombosis1
3CompletedTreatmentDiabetic Foot Ulcers (DFU)1
3TerminatedPreventionMalignancies / Thrombotic events1
3TerminatedTreatmentNeoplasms / Venous Thromboembolism1
4CompletedTreatmentAcute Gastrointestinal Bleeding1
Not AvailableCompletedNot AvailableUnsuspected Pulmonary Embolism1
Not AvailableCompletedPreventionDeep Vein Thrombosis / Pulmonary Embolism1
Not AvailableCompletedPreventionVenous Thromboembolic Diseases1
Not AvailableCompletedTreatmentVenous Thromboembolism1
Not AvailableRecruitingNot AvailablePatients Undergoing Microvascular Surgery1


Not Available
Not Available
Dosage forms
Not Available
Not Available
Not Available


Experimental Properties
melting point (°C)>228
Predicted Properties
Not Available
Predicted ADMET features
Not Available


Mass Spec (NIST)
Not Available
Not Available


Not classified


Pharmacological action
General Function
Serine-type endopeptidase activity
Specific Function
Factor Xa is a vitamin K-dependent glycoprotein that converts prothrombin to thrombin in the presence of factor Va, calcium and phospholipid during blood clotting.
Gene Name
Uniprot ID
Uniprot Name
Coagulation factor X
Molecular Weight
54731.255 Da
Pharmacological action
General Function
Serine-type endopeptidase inhibitor activity
Specific Function
Most important serine protease inhibitor in plasma that regulates the blood coagulation cascade. AT-III inhibits thrombin, matriptase-3/TMPRSS7, as well as factors IXa, Xa and XIa. Its inhibitory a...
Gene Name
Uniprot ID
Uniprot Name
Molecular Weight
52601.935 Da
Pharmacological action
General Function
Serine-type endopeptidase inhibitor activity
Specific Function
Thrombin inhibitor activated by the glycosaminoglycans, heparin or dermatan sulfate. In the presence of the latter, HC-II becomes the predominant thrombin inhibitor in place of antithrombin III (AT...
Gene Name
Uniprot ID
Uniprot Name
Heparin cofactor 2
Molecular Weight
57070.16 Da

Drug created on October 26, 2015 10:50 / Updated on March 01, 2020 23:29

Logo pink
Are you a
new drug developer?
Contact us to learn more about our customized products and solutions.
Logo pink
Stay in the know!
As part of our commitment to providing the most up-to-date drug information, we will be releasing #DrugBankUpdates with our newly added curated drug pages.