Enoxaparin: Difference between revisions
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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 ( | **Renal impairment (creatinine clearance <30) | ||
***Use 50% of usual dose or use UFH instead | ***Use 50% of usual dose or use UFH instead | ||
*Hepatic Dosing: not established | |||
*Hepatic Dosing | |||
*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 | |||
*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]] | |||
== | ==References== | ||
<references/> | <references/> | ||
[[Category: | [[Category:Pharmacology]] | ||
[[Category:Heme/Onc]] | [[Category:Heme/Onc]] | ||
Latest revision as of 17:58, 28 November 2019
General
- Type: Low molecular weight heparin
- Dosage Forms: subcutaneous
- Common Trade Names: Lovenox
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
- Check Anti-Xa level every week EXACTLY 4 hours after 3rd dose of lovenox
- 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
- Renal impairment (creatinine clearance <30)
- 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