enoxaparin sodium


Mega Lifesciences


Concise Prescribing Info
Enoxaparin Na
Inpatient treatment of acute DVT w/ or w/o pulmonary embolism; outpatient treatment of acute DVT w/o pulmonary embolism. Acute ST-segment elevation MI managed medically or w/ subsequent percutaneous coronary intervention. Prophylaxis of DVT in abdominal, hip, & knee replacement surgery, or in patients w/ severely restricted mobility during acute illness; ischemic complications of unstable angina & non-Q-wave MI.
Dosage/Direction for Use
SC DVT 1 mg/kg SC inj 12 hrly for ≤10 days. Unstable angina & non-Q-wave MI 1 mg/kg SC inj 12 hrly for 2-8 days, until patient is clinically stable. To be administered concurrently w/ aspirin 100-325 mg PO. Prophylaxis of venous thrombosis: In moderate thrombogenic risk surgery (hip & knee) & w/o presence of high thromboembolism risk 20 mg SC inj once daily. Duration of treatment: 7-10 days. In high thrombogenic risk surgery (hip & knee) &/or w/ presence of high thromboembolism risk 40 mg SC inj once daily. Duration of treatment: 7-10 days. General surgery Give 1st inj 2 hr before procedure. Duration of treatment: 7-10 days. Orthopaedic surgery Give 1st inj 12 hr pre-op. Duration of treatment: 7- 10 days.
Hypersensitivity to enoxaparin Na, heparin or pork products. Active major bleeding; thrombocytopenia associated w/ positive in vitro test for anti-platelet Ab in the presence of enoxaparin Na.
Special Precautions
Not for IM inj. Epidural or spinal hematomas resulting in long-term or permanent paralysis in associated use w/ spinal/epidural anesth or spinal puncture; or at higher risk w/ use of post-op indwelling epidural catheters, additional drugs affecting hemostasis (eg, NSAIDs), w/ traumatic or repeated epidural or spinal puncture, history of spinal surgery or deformity. Patients w/ increased risk of hemorrhage, eg, bacterial endocarditis, congenital or acquired bleeding disorders, active ulcerative & angiodysplastic GI disease, hemorrhagic stroke, post-brain, spinal or ophth surgery, or concomitant treatment w/ platelet inhibitors. Potentially fatal, major hemorrhages including retroperitoneal & intracranial bleeding. Bleeding at any site may occur; search for bleeding site if fall in hematocrit or BP occurs. Minimize risk of bleeding in percutaneous coronary revascularization procedures by adhering to recommended dosing intervals; achieve hemostasis at puncture site; immediately remove sheath if closure device is used; or remove sheath 6 hr after last inj if manual compression is used. Give next scheduled doses not sooner than 6-8 hr after sheath removal if treatment should be continued. Observe signs of bleeding & hematoma formation at the site of procedure. Patients w/ bleeding diathesis, uncontrolled arterial HTN, history of recent GI ulceration, diabetic retinopathy, renal dysfunction & hemorrhage. Use w/ extreme caution in patients w/ history of heparin-induced thrombocytopenia. Thrombocytopenia may occur. Do not use interchangeably w/ heparin or other LMWH. Recommend complete blood counts including platelet count & stool occult blood tests during treatment. May use antifactor Xa levels to monitor patients w/ significant renal impairment or during therapy if abnormal coagulation parameters or bleeding occur. Renal impairment; recommend dosage adjustment in severe renal impairment (CrCl <30 mL/min). Development of hyperkalemia is associated w/ patients w/ renal failure. Hepatic impairment. Do not use during pregnancy & lactation. Pregnant women w/ mechanical prosthetic heart valves. Elderly who may show delayed enoxaparin elimination; monitor elderly w/ low body wt; consider those predisposed to decreased renal function. Adjust dosage in preventive therapy & measure anti-Xa activity in curative therapy for the elderly. Not recommended in childn. Low wt patients (ie, <45 kg in women & <57 kg in men).
Adverse Reactions
Hemorrhage, bluish marks at inj site, localized or general allergic reactions, thrombocytopenia, osteoporosis, increased blood enzyme levels. Neuraxial hematomas resulting to neurological injuries including long-term or permanent paralysis in concurrent use w/ spinal/epidural anesth or spinal puncture.
Drug Interactions
Risk of hemorrhage may be enhanced by anticoagulants, platelet inhibitors including acetylsalicylic acid, salicylates, NSAIDs (including ketorolac tromethamine), dipyridamole, sulfinpyrazone; discontinue prior to enoxaparin therapy initiation, or conduct close clinical & lab monitoring if co-administration is essential.
MIMS Class
Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)
ATC Classification
B01AB05 - enoxaparin ; Belongs to the class of heparin group. Used in the treatment of thrombosis.
Clonox soln for inj 40 mg/0.4 mL
Clonox soln for inj 60 mg/0.6 mL
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