Low-molecular-weight heparins for the prevention and treatment of venous thromboembolism

Low-molecular-weight heparins (LMWHs) are rapidly becoming the anticoagulants of choice for the prevention and treatment of venous thromboembolism. LMWHs are at least as safe and effective as unfractionated heparin, and they have the added advantage of improved pharmacokinetic and safety profiles. The result is that LMWHs are easier to use, provide a more predictable anticoagulant effect, and do not require routine laboratory monitoring in most circumstances. Currently, the LMWHs ardeparin, dalteparin, danaparoid, enoxaparin, and tinzaparin have Food and Drug Administration-approved indications in the United States. This paper reviews the clinical use and cost-effectiveness of the LMWHs for the prevention and treatment of venous thromboembolism.