Enoxaparin
Anticoagulant/Antiplatelet · Low molecular weight heparin (LMWH)
Indications
Prophylaxis of venous thromboembolism particularly associated with orthopaedic or general surgery and in bedridden patients. Treatment of venous thromboembolic disease presenting with deep vein thrombosis, pulmonary embolism or both. Treatment of unstable angina and non-Q wave MI. Prevention of thrombus formation in the extracorporeal circulation during haemodialysis. COVID-19.
Dosage
Adults: Prophylaxis low to moderate risk (general surgery): 20 mg by deep SC injection 2 hrs pre-op, then 20 mg once daily for 7-10 days or until risk. Prophylaxis high risk (orthopaedic surgery): 40 mg by deep SC injection 12 hrs pre-op, then 40 mg once daily for 7-10 days or until risk. Prophylaxis in acute illness: 40 mg by deep SC injection 12 hrs pre-op, then 40 mg once daily for minimum 6 days and continue until full ambulation; max 14 days. Alternate injection site between left and right anterolateral and left and right posterolateral abdominal wall. Treatment of venous thromboembolism: 1.5 mg/kg by SC inj daily for minimum 5 days or until adequate oral anticoagulants is established. Treatment of unstable angina: 1 mg/kg by SC inj every 12 hr for minimum 2 days or until clinical stabilisation, usually 2-8 days. Plus oral aspirin 100-325 mg once daily. Haemodialysis: 1 mg/kg into…
Administration
Should be administered by deep SC Injection to the left or right anterolateral and left or right posterolateral abdominal wall. To avoid loss of drug from the 30 mg and 40 mg syringes, do not expel the air bubble from the syringe prior to injection. In order to minimize bruising, do not rub injection site. Enoxaparin is available in 100 mg/ mL and 150 mg/ mL concentrations. Compatibility: Stable in NS. Stability: Store at 15°C-25°C (59°F-77°F). Do not freeze. Do not mix with other injections or infusions.
Adverse Effects
Headache, raised LFTs, thrombocytosis, thrombocytopenia, haemorrhage, skin and inj site reactions.
Risk Factor (Pregnancy/Lactation)
Pregnancy: No evidence of risk in humans. Lactation: Caution advised or effect undetermined. Contraindications: Acute bacterial endocarditis, major bleeding disorders, increased risk of haemorrhage, thrombocytopenia, active peptic ulcer, haemorrhagic CVA. Renal impairment ( CrCl <15 mL/min), except when used for prevention of extracorporeal thrombus formation. Precautions: Hepatic insufficiency, renal impairment, increased bleeding risk, hypertension, history of Gl ulceration. Spinal or epidural anaesthesia, spinal puncture, history of spinal surgery or spinal deformity, monitor platelet count. Risk of osteoporosis with long term use. Risk of hypoaldosteronism leading to hyperkalaemia, esp in patients with diabetes, chronic renal failure, pre- existing acidosis or taking K+ sparing drugs; monitor serum potassium. Elderly, very low or high body wt.
Interactions
Oral anticoagulants, heparin treatment, locoregional anaesthesia, antiplatelet agents, NSAIDs, aspirin, dextran, thrombolytics, glucocorticoids.
Advice to Patient
If this medication is to be self-administered, follow exact directions for administration and needle disposal. Do not rub the site after administration of injection. Contact prescriber if there is chest pain; persistent constipation; persistent erection; unusual bleeding or bruising (bleeding gums, nose bleed, blood in urine or stool); joint pain; back pain; redness, swelling, burning or pain at injection site. During treatment, use soft toothbrush, waxed dental floss, electric razor. Avoid scissors and sharp knives.
Pharmacokinetics
Onset of action: Peak effect: SC: Anti factor Xa and antithrombin (anti factor IIa): 3-5 hrs. Duration: 40 mg: Anti factor Xa activity: Approx. 12 hrs. Metabolism: Hepatic. Bioavailability: Adults: SC: Approx. 100%. Half-life elimination, plasma: Based on anti factor Xa activity: 4.5-7 hrs. Excretion: Urine.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.