Enoxaparin

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General

Adult Dosing

Therapeutic anticoagulation

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)

DVT prophylaxis

  • 40mg SC daily

30mg SubQ q12 hrs (if Cr Clearance > 30)

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