Drug Delivery Research Laboratory, Department of Pharmaceutical Sciences, Dr. H. S. Gour Vishwavidyalaya, Sagar, M.P. 470003, India.
Med Res Rev. 2012 Mar;32(2):388-409. doi: 10.1002/med.20217. Epub 2011 Feb 1.
Unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) are first choices of clinicians among available anticoagulants. Currently, these agents are administered either parenterally or subcutaneously, which reduces patient compliance and acceptability. Oral heparin may serve as an alternative to both parenteral heparin as well as presently available oral anticoagulants such as warfarin. This review focuses mainly upon recent perspectives in the development of heparin as an oral anticoagulant. The possibility of its success with special emphasis to nanotechnological approaches has been elaborated. Important strategies such as the use of penetration enhancers, the development of lipid conjugates of heparin, and the incorporation of heparin in polymeric matrix systems have been discussed. Additionally, introductory information on biological activities, physiochemical aspects, and pharmacokinetic and pharmacodynamic parameters of heparin is summarized. A brief comparison of UFH and LMWH is also included for reader's benefit. Informative discussion on clinical trials with the successes and limitations of oral heparin formulations is also presented. Overall, the present review provides complete insight to the research that has been carried out for the development of heparin as oral anticoagulant.
未分级肝素(UFH)和低分子量肝素(LMWH)是临床医生在可用抗凝剂中首选的药物。目前,这些药物要么通过静脉内给药,要么通过皮下给药,这降低了患者的依从性和可接受性。口服肝素可以替代静脉内肝素以及目前可用的口服抗凝剂,如华法林。本综述主要关注肝素作为口服抗凝剂的最新研究进展。阐述了其成功的可能性,特别强调了纳米技术方法。讨论了一些重要的策略,如使用渗透增强剂、肝素的脂质缀合物的开发以及将肝素纳入聚合物基质系统。此外,还总结了肝素的生物学活性、物理化学方面以及药代动力学和药效动力学参数的简介信息。还包括对 UFH 和 LMWH 的简要比较,以方便读者阅读。还介绍了有关口服肝素制剂临床试验的有益讨论,包括成功和局限性。总的来说,本综述提供了对肝素作为口服抗凝剂开发所进行的研究的全面了解。