View source for Low molecular weight heparin

==Background==
#Similar mechanism of action as heparin but with predictable effect
#Advantages over unfractionated heparin:
##More reliable level of anticoagulation
##No need for monitoring w/ PTT
##Decreased incidence of HIT
##Can give as oupt
#Disadvantages compared to unfractionated heparin:
##Renally excreted; may accumulate in pts w/ renal impairment leading to bleeding
##Longer half-life

==Dosing==
#Renal impairment (Cr clearance <30)
##Use 50% of usual dose or use UFH instead
#Obesity
##Weight-based dosing safe up to 190kg (no data available thereafter)

==Treatment==
#See:
##[[DVT]]
##[[PE]]
##[[NSTEMI]]
##[[STEMI]]

==Reversal==
#Protamine
##Does not completely reverse LMWHs
##Carries significant anaphylaxis risk (0.2%); only use for major bleeding
##Dosing
###For Enoxaparin: give protamine 1mg IV for every 1mg of enoxaparin given in previous 8h
####If 8–12h since last enoxaparin dose give 0.5mg IV for every 1mg of enoxaparin given

==See Also==
*[[Heparin (Unfractionated)]]

==Source ==
Tintinalli

[[Category:Drugs]]
[[Category:Heme/Onc]]