Classifications: anticoagulant; low molecular weight heparin; Therapeutic:antithrombotic; low molecular weight heparin
Pregnancy Category: B
30 mg/0.3 mL, 40 mg/0.4 mL, 60 mg/0.6 mL, 80 mg/0.8 mL, 100 mg/1 mL injection
Low molecular weight heparin with antithrombotic properties. Does not affect PT. Does affect thrombin time (TT) and activated
thromboplastin time (aPTT) up to 1.8 times the control value. Antithrombotic properties are due to its antifactor Xa and antithrombin
(antifactor IIa) in the coagulation activities.
An effective anticoagulation agent, it is used for prophylactic treatment as an antithrombotic agent following certain types
Prevention of deep vein thrombosis (DVT) after hip, knee, or abdominal surgery, treatment of DVT and pulmonary embolism, management
of acute ST elevation myocardial infarction (STEMI), non-Q wave MI.
Patients with active major bleeding, GI bleeding, hemophilia, heparin hypersensitivity, heparin-induced thrombocytopenia (HIT),
thrombocytopenia associated with an antiplatelet antibody in the presence of enoxaparin, bleeding disorders, idiopathic thrombocytopenia
purpura (ITP), hypersensitivity to enoxaparin; porcine protein hypersensitivity, neonates, infants and children.
Uncontrolled arterial hypertension, recent history of GI disease, conditions or surgery with increased risk of bleeding, hepatic
disease, hypertension, coagulopathy, thrombocytopenia, dental disease, diabetic retinopathy, dialysis, diverticulitis, inflammatory
bowel disease, peptic ulcer disease, older adults, endocarditis, renal disease, renal impairment, stroke, surgery, pregnancy
(category B), lactation.
Route & Dosage
|Prevention of DVT after Hip or Knee Surgery
Adult: SC 30 mg b.i.d. for 1014 d starting 1224 h post-surgery
Prevention of DVT after Abdominal Surgery
Adult: SC 40 mg q.d. starting 2 h before surgery and continuing for 710 d (max: 12 d)
Treatment of DVT and Pulmonary Embolus
Adult: SC 1 mg/kg q12h or 1.5 mg/kg/d; monitor anti-Xa activity to determine appropriate dose
Non-Q Wave MI
Adult: SC 1 mg/kg q12h for 28 d, give concurrently with aspirin 100325 mg/d
Adult: SC 30 mg bolus plus 1 mg/kg, then 1 mg/kg q12h
Clcr <30 mL/min: 30 mg or 1 mg/kg q24h
- Use a TB syringe or prefilled syringe to ensure accurate dosage.
- Do not expel the air bubble from the 30 or 40 mg prefilled syringe before injection.
- Place patient in a supine position for injection of the drug.
- Alternate injections between left and right anterolateral and posterolateral abdominal wall.
- Hold the skin fold between the thumb and forefinger and insert the whole length of the needle into the skin fold. Hold skin
fold throughout the injection. Do not rub site post injection.
- Store at 15°30° C (59°86° F).
Adverse Effects (≥1%)Body as a Whole:
Allergic reactions (rash, urticaria), fever, angioedema,
arthralgia, pain and inflammation at injection site, peripheral edema, fever. Digestive:
Abnormal liver function tests. Hematologic: Hemorrhage , thrombocytopenia
, ecchymoses, anemia. Respiratory:
can increase risk of hemorrhage. Herbal: Garlic, ginger, ginkgo, feverfew, horse chestnut
may increase risk of bleeding.
91% absorbed from SC injection site. Peak:
3 h. Duration:
4.6 h. Distribution:
Appears to accumulate in liver, kidneys, and spleen. Does not cross placenta. Elimination:
Primarily in urine. Half-Life:
Assessment & Drug Effects
- Lab tests: Baseline coagulation studies; periodic CBC, platelet count, urine and stool for occult blood.
- Monitor platelet count closely. Withhold drug and notify physician if platelet count less than 100,000/mm3.
- Monitor closely patients with renal insufficiency and older adults who are at higher risk for thrombocytopenia.
- Monitor for and report immediately any sign or symptom of unexplained bleeding.
Patient & Family Education
- Report to physician promptly signs of unexplained bleeding such as: pink, red, or dark brown urine; red or dark brown vomitus;
bleeding gums or bloody sputum; dark, tarry stools.
- Do not take any OTC drugs without first consulting physician.