Difference between revisions of "Enoxaparin"

(Therapeutic anticoagulation)
 
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==Treatment==
+
==General==
*DOSE = 1mg/kg sq bid
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*Type: [[Low molecular weight heparin]]
*No need to monitor PTT and adjust dosages.
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*Dosage Forms: subcutaneous
 +
*Common Trade Names: Lovenox
  
==Uses/Benefits==
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==Adult Dosing==
# DVT/PE - equal efficacy
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===<u>Therapeutic</u> anticoagulation (e.g. treating [[DVT]]/[[PE]], [[unstable angina]])===
# Unstable Angina (better than heparin)
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*1mg/kg SC q12h
# Ischemic Stroke - (LMWH benefit at 6 months)
 
# Prevent prolonged hospitalization
 
# Rapid neutralization with protamine possible
 
#1:1 mg upto 50 for lovenox in last 8hours
 
# Renal insufficiency (creatinine >2), liver disease, pregnancy, or obesity
 
  
==Source ==
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{{Chemical prophylaxis of VTE}}
7/2/09 PANI
 
  
[[Category:Drugs]]
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==Pediatric Dosing==
 +
''Off-label''
 +
*DVT prophylaxis:
 +
**<2 months: 0.75 mg/kg SC q12hr 
 +
**≥2 months: 0.5 mg/kg SC q12h
 +
*Therapeutic anticoagulation:
 +
**<2 months: 1.5 mg/kg SC q12hr
 +
**≥2 months: 1 mg/kg SC q12hr
 +
 
 +
==Special Populations==
 +
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B
 +
*Lactation: Unknown risk
 +
*Renal Dosing
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**Renal impairment (creatinine clearance <30)
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***Use 50% of usual dose or use UFH instead
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*Hepatic Dosing: not established
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*Obesity
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**Weight-based dosing safe up to 190kg (no data available thereafter)
 +
 
 +
==Indications==
 +
*[[DVT]]
 +
*[[PE]]
 +
*[[NSTEMI]]
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*[[STEMI]]
 +
 
 +
==Contraindications==
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*Allergy to class/drug
 +
 
 +
==Adverse Reactions==
 +
*Bleeding
 +
*Pruritus
 +
*Local skin reaction
 +
 
 +
==Pharmacology==
 +
*Half-life: 4.5h
 +
*Metabolism: hepatic
 +
*Excretion: urine
 +
*Mechanism of Action: inhibits factor Xa by increasing inhibition rate of clotting proteases that are activated by antithrombin III
 +
 
 +
==See Also==
 +
*[[Heparin (Unfractionated)]]
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*[[Coagulopathy (Main)]]
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*[[Anticoagulant reversal for life-threatening bleeds]]
 +
 
 +
==References==
 +
<references/>
 +
 
 +
[[Category:Pharmacology]]
 
[[Category:Heme/Onc]]
 
[[Category:Heme/Onc]]

Latest revision as of 17:58, 28 November 2019

General

Adult Dosing

Therapeutic anticoagulation (e.g. treating DVT/PE, unstable angina)

  • 1mg/kg SC q12h

Chemical Prophylaxis of VTE

  • Lovenox 30mg SubQ q12 hrs (if Cr Clearance > 30)
    • Check Anti-Xa level every week EXACTLY 4 hours after 3rd dose of lovenox
      • prophylactic goal: 0.2-0.6
      • therapeutic goal: 0.6-1.2
  • Recheck AntiXa level after each 3rd dose if dose is changed until you are at goal
  • Recheck level every week (usually qMonday) for all patients
  • If renal dysfunction order heparin 5000 Units SubQ q8 hrs (search “SURG DVT/VTE prophylaxis” order set)

Pediatric Dosing

Off-label

  • DVT prophylaxis:
    • <2 months: 0.75 mg/kg SC q12hr
    • ≥2 months: 0.5 mg/kg SC q12h
  • Therapeutic anticoagulation:
    • <2 months: 1.5 mg/kg SC q12hr
    • ≥2 months: 1 mg/kg SC q12hr

Special Populations

  • Pregnancy Rating: B
  • Lactation: Unknown risk
  • Renal Dosing
    • Renal impairment (creatinine clearance <30)
      • Use 50% of usual dose or use UFH instead
  • Hepatic Dosing: not established
  • Obesity
    • Weight-based dosing safe up to 190kg (no data available thereafter)

Indications

Contraindications

  • Allergy to class/drug

Adverse Reactions

  • Bleeding
  • Pruritus
  • Local skin reaction

Pharmacology

  • Half-life: 4.5h
  • Metabolism: hepatic
  • Excretion: urine
  • Mechanism of Action: inhibits factor Xa by increasing inhibition rate of clotting proteases that are activated by antithrombin III

See Also

References