If the background of heparin (conventional or low molecular weight) there is thrombocytopenia. you should consider the possibility of appointing anticoagulants other groups. If other arimidex for men drugs are not available, it is possible to use other low molecular weight heparin. Thus it is necessary to observe the number of platelets in blood daily. If signs of initial thrombocytopenia continuing observed after replacement of the drug, it should be as soon discontinue treatment possible.
It must be remembered that the platelet aggregation control based on in vitro tests, is of limited value in the diagnosis of heparin-induced thrombocytopenia. Elderly patients before treatment necessary to evaluate kidney function. hyperkalemia heparins can inhibit the secretion of aldosterone, which may cause hyperkalemia, particularly in patients with elevated potassium in the blood or in patients with the risk of increasing the content of potassium in the blood, for example, patients with diabetes mellitus, chronic renal insufficiency, metabolic acidosis or patients taking drugs that may cause hyperkalemia. Hyperkalemia risk increases with long-term treatment, but it is usually reversible when you cancel. In patients at risk, should monitor the level of potassium in the blood. Spinal / epidural anesthesia / lumbar puncture and concomitant drugs The risk of spinal / epidural hematoma is increased in patients with established epidural catheters or concomitant use of other drugs that affect haemostasis such as nonsteroidal anti-inflammatory drugs arimidex for men , platelet inhibitors, or other anticoagulants. The risk is also apparently increases during traumatic or repeated epidural or spinal punctures.Thus, the question of the combined use of neuraxial blockade and anticoagulants should be decided individually after evaluating the efficiency / risk in the following situations:
- in patients who are already receiving anticoagulants, should be the necessity of spinal or epidural anesthesia;
- in patients undergoing elective surgery is planned using a spinal or epidural anesthesia, it must be justified by the need for anticoagulation.
If the patient is carried out a lumbar puncture, or spinal or epidural anesthesia, you should ensure there is sufficient time interval between administration of arimidex for men and the introduction or removal of the spinal / epidural catheter or needle.
Careful observation of the patient for signs and symptoms of neurological impairment. Upon detection of disturbances in the neurological status of the patient requires urgent appropriate therapy.
Salicylates, non-steroidal anti-inflammatory and platelet aggregation inhibitors in the prevention or treatment of venous thromboembolism and the prevention of blood clotting in the extracorporeal circulation system during hemodialysis is not recommended joint appointment with drugs such as acetylsalicylic acid and other salicylates, nonsteroidal anti-inflammatory drugs arimidex for menand platelet aggregation inhibitors, since it may increase the risk of bleeding.