How to use Neoparin in an obese person with thrombosis?

It is believed that in obese patients, the dose of small-molecule heparin should be converted to TBW (Total Body Weight) if we are talking about therapeutic (non-prophylactic) doses. To monitor efficacy and safety in patients with a BMI above 35 kg/m2, it is suggested to determine anti-Xa activity 4 hours after the last injection. The amount of Neoparin that the patient should take depends on the reason why the preparation was ordered. If you are asking about the treatment of blood clots (deep vein thrombosis, pulmonary embolism), the usual dose is 150 U.m (1.5 mg) for every kilogram of body weight once a day, or 100 U.m (1 mg) for every kilogram of body weight twice a day. In patients who are complicated (including obesity), a regimen should be used that takes into account the administration of the drug every 12 hours. And so, in one of the studies on the use of econsaparin in patients with obesity, where the average body weight was 147 kilograms (so similar to the described case), patients in one of the groups received a full dose of 150 mg of the drug every 12 hours. INR (International Normalized Ratio) is a laboratory blood coagulation index used to assess the effectiveness of treatment with oral anticoagulants, rather than small-molecule heparin administered subcutaneously such as Neoparin. In healthy, non-drug users, the INR should be between 0.8 and 1.2. In patients taking tablets with acenocoumarol or warfarin, the INR should be approximately between 2-3. This means that the bleeding time is prolonged, but at the same time the risk of serious bleeding does not go beyond the safe range. Regarding the dosage of the drug and the control of the coagulation system during therapy, it is best to contact the doctor who made the diagnosis and recommended Neoparin. I enclose additional information: https://www.gdziepolek.pl/artykuly/przewodnik-po-lekach-przeciwzakrzepowych