Enoxaparin: Difference between revisions

(Text replacement - "Category:Drugs" to "Category:Pharmacology")
 
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==General==
==General==
*Type: [[Low molecular weight heparin]]
*Type: [[Low molecular weight heparin]]
*Dosage Forms:
*Dosage Forms: subcutaneous
*Common Trade Names: Lovenox
*Common Trade Names: Lovenox


==Adult Dosing==
==Adult Dosing==
===<u>Therapeutic</u> anticoagulation (e.g. treating [[DVT]]/[[PE]], [[unstable angina]])===
*1mg/kg SC q12h
{{Chemical prophylaxis of VTE}}


==Pediatric Dosing==
==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==
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]:
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B
*Lactation:
*Lactation: Unknown risk
*Renal Dosing
*Renal Dosing
**Renal impairment (Cr clearance <30)
**Renal impairment (creatinine clearance <30)
***Use 50% of usual dose or use UFH instead
***Use 50% of usual dose or use UFH instead
**Adult
*Hepatic Dosing: not established
**Pediatric
*Hepatic Dosing
**Adult
**Pediatric
*Obesity
*Obesity
**Weight-based dosing safe up to 190kg (no data available thereafter)
**Weight-based dosing safe up to 190kg (no data available thereafter)
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==Adverse Reactions==
==Adverse Reactions==
#Bleeding
*Bleeding
##Less common than with UFH
*Pruritus
##Treatment
*Local skin reaction
###Protamine
####Does not completely reverse LMWHs
####Carries significant anaphylaxis risk (0.2%); only use for major bleeding
####Dosing
#####For Enoxaparin: 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
#Pruritus
#Local skin reaction


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


==See Also==
==See Also==
*[[Heparin (Unfractionated)]]
*[[Heparin (Unfractionated)]]
*[[Coagulopathy (Main)]]
*[[Coagulopathy (Main)]]
*[[Anticoagulant reversal for life-threatening bleeds]]


==Sources==
==References==
<references/>
<references/>


[[Category:Pharmacology]]
[[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