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Prophylaxis of Deep Vein Thrombosis Especially in Surgical Patients: By SC injection, moderate risk, 20 mg (2000 units) approximately 2 hrs before surgery then 20 mg (2000 units) every 24 hrs for 7–10 days.
High Risk (eg, Orthopaedic Surgery): 40 mg (4000 units) 12 hrs before surgery then 40 mg (4000 units) every 24 hrs for 7–10 days.
Prophylaxis of Deep Vein Thrombosis in Medical Patients: By SC injection, 40 mg (4000 units) every 24 hrs for at least 6 days and continued until patient ambulant (Max: 14 days).
Treatment of Deep Vein Thrombosis or Pulmonary Embolism: By SC injection, 1.5 mg/kg (150 units/kg) every 24 hrs, usually for at least 5 days (and until adequate oral anticoagulation established).
Treatment of Acute ST-Segment Elevation Myocardial Infarction: Adults <75 years: By IV injection, 30 mg (3000 units) followed by SC injection, 1 mg/kg (100 units/kg), then by SC injection, 1 mg/kg every 12 hrs for up to 8 days. Max dose: 100 mg (10,000 units) for first 2 SC doses only.
Elderly >75 years: By SC injection only, 750 mcg/kg (75 units/kg) every 12 hrs. Max dose: 75 mg (7500 units) for first 2 doses only.
Patients Undergoing Percutaneous Coronary Intervention: Additional dose, by IV injection, 300 mcg/kg (30 units/kg) at time of procedure if last SC dose given more than 8 hrs previously.
Note: When administered in conjunction with a thrombolytic, enoxaparin should be given between 15 min before and 30 min after the start of thrombolytic therapy.
Unstable Angina and Non-ST-Segment-Elevation Myocardial Infarction: By SC injection, 1 mg/kg (100 units/kg) every 12 hrs usually for 2–8 days (minimum 2 days).
Prevention of Clotting in Extracorporeal Circuits: Recommended Dose: 1 mg/kg. For patients with a high risk of haemorrhage the dose should be reduced to 0.5 mg/kg for double vascular access or 0.75 mg/kg for singular vascular access. During haemodialysis, enoxaparin should be introduced into the arterial line of the circuit at the beginning of the dialysis session. The effect of this dose is usually sufficient for a 4-hr session however, if fibrin rings are found eg, after a longer than normal session, a further dose of 0.5 to 1 mg/kg may be given.
Treatment of Venous Thromboembolism in Pregnancy: by SC injection, early pregnancy body-weight under 50 kg, 40 mg (4000 units) twice daily; body-weight 50–70 kg, 60 mg (6000 units) twice daily; body-weight 70–90 kg, 80 mg (8000 units) twice daily; body-weight over 90 kg, 100 mg (10 000 units) twice daily.
Administration: Intravas pre-filled disposable syringe is ready for immediate use. Intravas contains no antimicrobial agent and should be used only once and then discarded. Intravas should be injected by deep SC route in prophylactic and curative treatment and by IV route during hemodialysis. Do not administer by the IM route. The air bubble from the syringe should not be expelled before the injection. The SC injection should preferably be made when the patient is lying down. Intravas is administered alternatively between the left and right anterolateral or posterolateral abdominal wall. The whole length of the needle should be introduced vertically into a skin fold gently held between the thumb and forefinger. The skin fold should not be released until the injection is complete.
