Precautions and warnings

Kidney or liver problems, history of stomach ulcers, uncontrolled high blood pressure, or having a spinal or epidural anesthetic can make this medicine riskier. It should not be used during pregnancy or breastfeeding, and extra caution is needed in elderly people. Regular blood tests (including blood cell and platelet counts) and stool tests for hidden blood are recommended.

Drug Interactions

There is a higher risk of bleeding if you take this medicine with blood thinners or drugs that prevent platelets from clumping together, such as dipyridamole, aspirin, NSAIDs, or sulfinpyrazone. Taking it with vitamin E may also increase the chance of bleeding.

Contraindications

Allergy to the medication, active bacterial infection of the heart lining, severe bleeding problems, recent bleeding in the brain, or low platelet count caused by medication.

Mode of actions

Enoxaparin is a type of blood thinner called low molecular weight heparin. It helps prevent blood clots by boosting the activity of antithrombin III, a natural protein in the body. This action slows down clotting by blocking certain clotting factors, mainly thrombin and factor Xa.

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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