What anticoagulants are derived from pork products?

Pork-Derived Anticoagulants

Unfractionated heparin (UFH) and low-molecular-weight heparins (LMWHs) are the primary anticoagulants derived from pork products, specifically from porcine intestinal mucosa. 1

Heparin Products from Porcine Sources

Unfractionated Heparin (UFH)

• UFH is derived from porcine intestinal mucosa and has been the standard anticoagulant for over 60 years 1, 2
• The FDA-approved heparin sodium injection explicitly states it is "derived from porcine intestinal mucosa" 1
• UFH consists of heterogeneous straight-chain anionic mucopolysaccharides (glycosaminoglycans) extracted from pig intestines 1

Low-Molecular-Weight Heparins (LMWHs)

• LMWHs are manufactured from unfractionated porcine heparin through chemical or enzymatic depolymerization 3, 2
• Common LMWHs include enoxaparin, dalteparin, and tinzaparin—all derived from porcine intestinal heparin 4
• These products maintain their porcine origin through the manufacturing process 5

Danaparoid Sodium

• Danaparoid is an extraction heparinoid derived from pig intestine, similar to several LMWHs 3
• It contains heparan sulfate, dermatan sulfate, and chondroitin sulfate extracted from porcine intestinal mucosa 3
• Danaparoid is used primarily as an alternative anticoagulant in heparin-induced thrombocytopenia (HIT) 3

Important Clinical Considerations

Religious and Cultural Implications

• Patients with religious or cultural restrictions against pork products (such as Jewish or Muslim patients) should be informed that standard heparin and LMWH preparations are pork-derived 1
• Alternative anticoagulants that are not pork-derived include:
  • Fondaparinux (synthetic pentasaccharide) 3
  • Argatroban (synthetic direct thrombin inhibitor) 3
  • Direct oral anticoagulants (DOACs) 3
  • Bivalirudin (synthetic direct thrombin inhibitor) 3

Bovine-Derived Alternatives

• Heparin can also be sourced from bovine (cattle) intestinal mucosa, though this is less common 6, 7
• Bovine heparin differs structurally and functionally from porcine heparin, with approximately half the anticoagulant potency (∼100 IU/mg vs ∼180 IU/mg) 7
• Bovine and porcine heparins are considered different drugs and should not be used interchangeably without appropriate dosing adjustments 6
• The use of bovine heparin as interchangeable with porcine heparin has caused bleeding incidents in some countries 7

Supply Chain Context

• Porcine intestinal mucosa remains the almost exclusive source for commercial heparin production globally 8
• The 2008 heparin contamination crisis highlighted the vulnerability of relying on a single animal source 8
• Research continues into alternative sources, including bovine mucosa and non-animal synthetic methods 8