Enoxaparin is a type of low molecular weight heparin and belongs to the group of medications known as anticoagulants or antithrombotic agents. These medications reduce the clotting ability of the blood and can reduce the risk of harmful blood clots forming in blood vessels.
Enoxaparin is used to prevent and treat deep vein thrombosis (DVT), which is a condition that leads to the formation of blood clots in the blood vessels in the leg. These blood clots sometimes travel to the lungs and block blood vessels there, resulting in a serious condition known as pulmonary embolism.
Enoxaparin may be used to prevent DVT in people who are bedridden due to serious illness (heart failure, severe chest infections, or respiratory failure), or after they have had certain types of surgery (such as hip or knee replacements; or abdominal, gynecological, urological, or colorectal surgery). It may be used to prevent clotting in the blood outside the body during hemodialysis. Enoxaparin is also used to treat DVT with or without pulmonary embolism.
Enoxaparin is also used in combination with ASA to treat people who have unstable angina and non-Q-wave heart attacks (a type of heart attack that does not involve the full thickness of the heart wall).
This medication is also used to treat a particular type of heart attack called ST-segment elevation myocardial infarction (STEMI) and for Percutaneous Coronary Intervention (PCI) to open up the coronary arteries after a heart attack.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.
Each multidose vial contains 300 mg of enoxaparin sodium in 3 mL of water for injection (concentration 10 mg/0.1 mL) and 1.5% (m/v) benzyl alcohol as a preservative.
30 mg/0.3 mL
Each syringe contains 30 mg of enoxaparin sodium in 0.3 mL of water for injection. The solution is preservative-free and intended for use as a single-dose injection.
40 mg/0.4 mL
Each syringe contains 40 mg of enoxaparin sodium in 0.4 mL of water for injection. The solution is preservative-free and intended for use as a single-dose injection.
60 mg/0.6 mL
Each syringe contains 60 mg of enoxaparin sodium in 0.6 mL of water for injection. The solution is preservative-free and intended for use as a single-dose injection.
80 mg/0.8 mL
Each syringe contains 80 mg of enoxaparin sodium in 0.8 mL of water for injection. The solution is preservative-free and intended for use as a single-dose injection.
100 mg/1 mL
Each syringe contains 100 mg of enoxaparin sodium in 1 mL of water for injection. The solution is preservative-free and intended for use as a single-dose injection.
The 60 mg/0.6 mL, 80 mg/0.8 mL, and the 100 mg/1 mL syringes are imprinted with a graduation scale of 1 mL with major increments of 0.1 mL and minor increments of 0.025 mL.
Each Lovenox® presentation has a solution pH of 5.5 to 7.5 with an approximate anti-factor Xa activity of 100 IU/1 mg of drug (with reference to the WHO First International Low Molecular Weight Heparin Reference Standard).
Enoxaparin is injected under the skin (subcutaneously, not intramuscularly).
The recommended dose varies according to the individual and the condition being treated.
For acute-ST-segment elevation heart attacks, you will receive a single dose of 30 mg of enoxaparin injected into a vein. Subsequent doses are injected subcutaneously every 12 hours, and are calculated as 1 mg per kilogram of body weight. This is usually continued for 8 days or until release from the hospital.
For the treatment of unstable angina or Non-Q-Wave heart attacks, the dose is calculated as 1 mg per kilogram of body weight, injected subcutaneously every 12 hours. To treat deep vein thrombosis (DVT), the recommended dose is 1.5 mg per kilogram of body weight, injected subcutaneously once daily or 1 mg per kilogram of body weight, injected subcutaneously every 12 hours.
If enoxaparin is being used to prevent blood clots when you are having knee or hip replacement surgery, the recommended dose is 30 mg injected subcutaneously every 12 hours, starting 12 to 24 hours after surgery. This is usually used for 7 to 14 days.
To prevent blood clots caused by abdominal, colorectal, gynecological, or urological surgery, the recommended dose is 40 mg injected subcutaneously 2 hours before surgery and continuing once daily for 7 to 10 days. If there is no risk of bleeding, but high risk of developing blood clots, this dose may be continued for up to 4 weeks.
To prevent blood clots caused by other medical conditions, such as when you have an illness and have limited ability to move about, the recommended dose is 40 mg injected subcutaneously, once daily. The use of enoxaparin in these situations is usually short-term (6 to 11 days).
Steps to use the medication:
To prevent clot formation during hemodialysis, the dose varies depending on your circumstances and the medication will be given by injection into the tubing that carries your blood to the dialysis machine.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using this medication without consulting your doctor.
It is important to use this medication exactly as prescribed by your doctor. If you miss an injection, take it as soon as possible and continue with your regular schedule. If it is almost time for your next injection, skip the missed dose and continue with your regular dosing schedule. Do not inject a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from heat, and keep it out of the reach of children. If you are using the multiple dose vial, do not store it for more than 28 days after the first use.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Do not use enoxaparin if you:
People who need repeated doses of enoxaparin should not receive anesthetics that are injected into the spine or epidural space.
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Stop taking the medication and seek immediate medical attention if any of the following occur:
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Bleeding: The most serious risk associated with enoxaparin is bleeding in any tissue or organ. It is extremely important to have regular blood tests (as prescribed by your doctor) to ensure that the correct level of blood thinning is occurring. People with an increased risk of bleeding (such as seniors) should be closely monitored by their doctors while taking this medication. If you notice any signs of bleeding, such as frequent nosebleeds, unexplained bruising, or black and tarry stools, notify your doctor as soon as possible.
Body weight: The safety and efficacy of enoxaparin for people of high weight (e.g., over 120 kg) and low weight (e.g., under 45 kg) have not been fully established. If you have a high or low weight, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Kidney problems: Decreased kidney function or kidney disease can cause this medication to build up in the body, causing increased side effects. If you have kidney problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver problems: If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Medical conditions: If you have malignant disease; a history of thrombophilia and known deficiency in antithrombin III, protein C or protein S, or APC resistance; are bedridden due to infections with septic shock; severe COPD complicated by right heart failure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Osteoporosis: Prolonged use of this medication (i.e., longer than 3 months) has been associated with the development of osteoporosis. If you have osteoporosis or are at risk for developing osteoporosis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Platelets: Platelets are blood cells that cause blood to clot. While you are taking enoxaparin, your doctor will also be monitoring your platelet count. If your platelet level drops very suddenly, you may have to stop this medication and switch to another type of medication. Make sure to tell your doctor if you have had any problems with low platelets or platelet defects in the past.
Prosthetic heart valves: There have been reports of people with prosthetic heart valves who developed clots in their valves when treated with low molecular weight heparin medications, like enoxaparin. Your doctor will need to monitor you closely while you are taking enoxaparin.
Spinal/epidural hematomas (a collection of blood, usually clotted): There have been cases of spinal bleeding and blood clots when enoxaparin is used along with spinal or epidural anesthesia. These spinal blood clots may lead to long-term or permanent paralysis. The risk is greater with higher treatment doses of enoxaparin than with DVT prevention doses and if people are taking other medications that affect blood clotting (e.g., nonsteroidal anti-inflammatory drugs [NSAIDs] such as naproxen or ibuprofen). If you notice a sudden inability to move your body or sudden back pain or tenderness, get medical help immediately.
People who need repeated doses of enoxaparin should not receive anesthetics that are injected into the spine or epidural space.
Stomach or intestinal ulcers: If you have stomach or intestinal ulcers, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
If you do use enoxaparin while you are pregnant, your doctor will need to closely monitor you because of an increased risk of bleeding. Pregnant women should not use enoxaparin from multidose vials that contain benzyl alcohol as a preservative. Benzyl alcohol crosses the placenta and can cause a potentially fatal gasping syndrome in premature or newborn babies. Pregnant women who have artificial heart valves will also need to be closely monitored by their doctors if they use this medication because of a higher risk of developing clots in their heart valves.
Breast-feeding: It is not known if enoxaparin passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children.
Seniors: Seniors may be at an increased risk of bleeding while using enoxaparin. Your doctor may adjust your dose, especially if you weigh less than 45 kg or have decreased kidney function.
There may be an interaction between enoxaparin and any of the following:
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
All material copyright MediResource Inc. 1996 – 2020. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Lovenox