Enoxaparin

Indications
 Subcutaneous
Prophylaxis of venous thromboembolism during surgical procedures
Adult: Low to moderate risk: 20 mg (2000 units) once daily with the 1st dose 2 hr pre-operatively. High risk: 40 mg (4000 units) once daily with the 1st dose 12 hr pre-operatively. Alternatively, 30 mg (3000 units) bid starting within 12-24 hr after the operation. After hip replacement surgery, continue treatment at 40 mg once daily for a further 3 wk. For immobilised patients, treatment should continue at 40 mg daily for at least 6 days or until patient becomes fully ambulant, up to a max of 14 days.
CrCl (ml/min)Dosage Recommendation
<30Reduce dose. Max: 1 mg/kg/day.

Subcutaneous
Deep vein thrombosis
Adult: 1 mg (100 units)/kg every 12 hr for 5 days and until oral anticoagulation is established.
CrCl (ml/min)Dosage Recommendation
<30Reduce dose. Max: 1 mg/kg/day.

Subcutaneous
Prophylaxis of clotting in the extracorporeal circulation during haemodialysis
Adult: 1 mg/kg (100 units/kg) into the arterial line of the circuit at the beginning of the dialysis session. Give a further dose of 0.5-1 mg/kg (50-100 units/kg) if required. Reduce dose in patients at high risk of haemorrhage.
CrCl (ml/min)Dosage Recommendation
<30Reduce dose. Max: 1 mg/kg/day.

Subcutaneous
Unstable angina
Adult: 1 mg/kg (100 units/kg) every 12 hr for 2-8 days with low-dose aspirin.
CrCl (ml/min)Dosage Recommendation
<30Reduce dose. Max: 1 mg/kg/day.


Special Populations: Reduce dose in patients at high risk of haemorrhage.
Contraindications
 Hypersensitivity, acute bacterial endocarditis; major bleeding disorder, haemorrhagic stroke, drug-induced thrombocytopenia.
Warnings / Precautions
 Renal or hepatic impairment, history of GI ulceration, uncontrolled hypertension, spinal or epidural anaesthesia; lactation and pregnancy; elderly. Periodic blood counts, platelet count and stool occult blood test recommended.
Adverse Reactions
 Thrombocytopenia, mild bleeding, inj site irritation, pain and ecchymoses, hypersensitivity and erythema.
Potentially Fatal: Haemorrhagic complications.
Drug Interactions
 Potentially Fatal: Risk of haemorrhage increased with oral anticoagulants, platelet aggregation inhibitors, NSAIDs including aspirin.
See Below for More enoxaparin Drug Interactions
Lab Interactions
 Elevation of transaminases may interfere with interpretation of LFT results and diagnosis of MI, liver disease and pulmonary emboli.
Mechanism of Actions
 Enoxaparin is a low molecular weight heparin with anticoagulant properties. It acts by enhancing the inhibition rate of activated clotting factors including thrombin and factor Xa through its action on antithrombin III.
Absorption: Rapidly and almost completely absorbed after SC inj with a bioavailability of about 100%.
Metabolism: Metabolised hepatically.
Excretion: Elimination half-life: 4-5 hr. Excreted in urine as unchanged drug and metabolites.
Storage Conditions
 Subcutaneous: Store at 25°C.
ATC Classification
 B01AB05 - enoxaparin ; Belongs to the class of heparin group. Used in the treatment of thrombosis.
Storage
 Subcutaneous: Store at 25°C.
Available As
  • Enoxaparin 20 mg
  • Enoxaparin 40 mg
  • Enoxaparin 60 mg
  • Enoxaparin 80 mg

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