Precautions and warnings

Enoxaparin injection should not be given into the muscle. Use enoxaparin carefully in people who have a higher risk of bleeding. This includes patients with blood clotting problems, a history of stomach ulcers, recent stroke, uncontrolled high blood pressure, diabetic eye disease, recent brain or eye surgery, and those who are underweight. Platelet counts should be checked before starting enoxaparin and monitored regularly while on treatment.

Drug Interactions

There is a higher risk of bleeding when this is used with blood thinners, drugs that prevent platelets from clumping (such as dipyridamole, aspirin, NSAIDs, and sulfinpyrazone), or vitamin E.

Contraindications

Do not use this medicine if you are extremely sensitive or allergic to Enoxaparin, heparin, or other similar blood thinners. It should also not be used if you have serious blood clotting problems, such as a history of low platelet counts, active stomach ulcers, bleeding injuries, or a recent brain bleed from a stroke. Although it doesn’t happen often, some people may have skin or whole-body allergic reactions.

Mode of actions

Enoxaparin is a type of blood thinner known as a low molecular weight heparin. It works by helping antithrombin III, a natural protein in the body, to block certain clotting factors, including thrombin and factor Xa. This helps to prevent blood clots from forming.

Dosage & Administration

Adult: SC Prophylaxis of venous thromboembolism during surgery Low-moderate risk: 20 mg once daily, start 2 hr before start of procedure. High risk: 40 mg once daily, start 12 hr before start of procedure.

Child: 2 mth 500 mcg/kg (50 u/kg) 12 hrly.

For hip replacement surgery: 40 mg once daily for a further 3 wk. For immobilised patients: 40 mg once daily for at least 6 days or until patient is ambulant, up to a max of 14 days.

Deep vein thrombosis 1 mg/kg 12 hrly for 5 days and until oral anticoagulation is established.

Prevention of clotting in extracorporeal circulation during haemodialysis 1 mg/kg into the arterial line of the circuit at the start of the dialysis session. Give a further dose of 0.5-1 mg/kg if needed.

Unstable angina 1 mg/kg 12 hrly for 2-8 days w/ low dose aspirin.

Parenteral
Acute ST-elevation myocardial infarction
Adult: Initially, 30 mg (3000 u) via IV w/ 1 mg/kg (100 u/kg) via SC given at the same time. Dose should be followed by 1 mg/kg (100 u/kg) via SC 12 hrly for 8 days or until hospital discharge. The 1st 2 SC doses should not exceed 100 mg (10,000 u) each.
Patients who undergo PCI: An additional 300 mcg/kg (30 u/kg) via IV given at the time of the procedure if the last SC dose was given >8 hr ago.

Elderly: >75 yr SC: 750 mcg/kg (75 u/kg) 12 hrly, w/ max 75 mg (7500 u) for each of the 1st 2 doses.

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect even sometimes unable to demonstrate the risk on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required.

Discuss with your doctors and tell them feedback about this medicine.

There is no specific information about whether this medicine is passed on to the baby through breast milk. Discuss with your doctor before breastfeeding.

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