a) No; therapeutic interchange of LMWH products is not advisable

Correct.

Therapeutic interchange is the substitution of one agent of different chemical make-up with another agent. This is often done for supposed cost savings. However, a therapeutic interchange program must have its outcomes measured to determine if the interchange proved to be safe, therapeutically effective, and cost effective. This has not been clearly demonstrated with the LMWH's. Because each LMWH is unique and has its own unique dosing, you can not assume that you can simply use one product over the other.(8)

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