Difference between revisions of "Enoxaparin"

(Therapeutic anticoagulation)
 
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#Redirect[[Low Molecular Weight Heparin (Lovenox)]]
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==General==
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*Type: [[Low molecular weight heparin]]
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*Dosage Forms: subcutaneous
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*Common Trade Names: Lovenox
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==Adult Dosing==
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===<u>Therapeutic</u> anticoagulation (e.g. treating [[DVT]]/[[PE]], [[unstable angina]])===
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*1mg/kg SC q12h
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{{Chemical prophylaxis of VTE}}
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==Pediatric Dosing==
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''Off-label''
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*DVT prophylaxis:
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**<2 months: 0.75 mg/kg SC q12hr 
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**≥2 months: 0.5 mg/kg SC q12h
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*Therapeutic anticoagulation:
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**<2 months: 1.5 mg/kg SC q12hr
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**≥2 months: 1 mg/kg SC q12hr
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==Special Populations==
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*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B
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*Lactation: Unknown risk
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*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)
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==Indications==
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*[[DVT]]
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*[[PE]]
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*[[NSTEMI]]
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*[[STEMI]]
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==Contraindications==
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*Allergy to class/drug
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==Adverse Reactions==
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*Bleeding
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*Pruritus
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*Local skin reaction
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==Pharmacology==
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*Half-life: 4.5h
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*Metabolism: hepatic
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*Excretion: urine
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*Mechanism of Action: inhibits factor Xa by increasing inhibition rate of clotting proteases that are activated by antithrombin III
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==See Also==
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*[[Heparin (Unfractionated)]]
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*[[Coagulopathy (Main)]]
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*[[Anticoagulant reversal for life-threatening bleeds]]
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==References==
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<references/>
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[[Category:Pharmacology]]
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[[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