Enoxaparin
Enoxaparin (Lovenox)
Enoxaparin
(ee- nox-ah- PAIR-in)
Pregnancy Category: B Lovenox (Rx)

Classification: Anticoagulant, low molecular weight heparin

See Also: See also Heparins, Low Molecular Weight.

Action/Kinetics: t 1/2, elimination: 4.5 hr after SC use. Elimination may be delayed in the elderly. Duration: 12 hr following a 40-mg dose. Excreted mainly through the urine.

Uses: Acute (in the hospital) and extended (at home for up to three weeks) prophylaxis of DVT, which may lead to pulmonary embolism, after hip or knee replacement surgery or abdominal surgery in those at risk for thromboembolic complications. With warfarin for inpatient treatment of DVT with and without pulmonary embolism; with warfarin for outpatient treatment of DVT without pulmonary embolism. With aspirin to prevent ischemic complications of unstable angina and non-Q-wave MI. Investigational: Systemic anticoagulation, secondary prophylaxis for thromboembolic recurrence.

Side Effects: Hematologic: Thrombocytopenia, thrombocythemia, hemorrhage hypochromic anemia, ecchymosis. At site of injection: Mild local irritation, pain, hematoma, erythema. GI: Nausea. CNS: Confusion. Miscellaneous: Fever, pain, edema, peripheral edema, spinal hematoma.

How Supplied: Injection: 30 mg/0.3 mL, 40 mg/0.4 mL, 60 mg/0.6 mL, 80 mg/0.8 mL, 100 mg/1 mL

Dosage
?SC only Prophylaxis of DVT in hip or knee replacement.
Adults: 30 mg b.i.d. with the initial dose given within 12-24 hr after surgery (providing hemostatsis has been established) for 7-10 days (usually).
Prophylaxis of DVT in abdominal surgery.
Adults: 40 mg once daily, with the initial dose given 2 hr prior to surgery. Give for 7-10 days, up to 12 days.
Treatment of DVT/pulmonary embolism for outpatients.
1 mg/kg SC q 12 hr.
Treatment of DVT/pulmonary embolsim for inpatients.
1 mg/kg SC q 12 hr or 1.5 mg/kg SC once daily at the same time each day.

Note: For both in- and outpatients, initiate warfarin within 72 hr of enoxaparin. Continue enoxaparin for a minimum of 5 days and until an INR of 2-3 is reached (average duration is 7 days; up to 17 days has been well tolerated). Unstable angina/Non-Q-wave MI.
1 mg/kg q 12 hr with PO aspirin (100-325 mg once/day). Usual duration for enoxaparin is 2-8 days.