Indications/Uses
Listed in Dosage.
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Dosage/Direction for Use
Adult: SC Prophylaxis of venous thromboembolism during surgical procedures Low to moderate risk: 20 mg once daily for 7-10 days or until the risk of thromboembolism has diminished w/ the 1st dose approx 2 hr pre-op. High risk: 40 mg once daily w/ the 1st dose approx 12 hr pre-op. Alternatively, 30 mg bid starting w/in 12-24 hr post-op. Continue treatment at 40 mg once daily for a further 3 wk after hip replacement surgery. Immobilised patients: 40 mg once daily for at least 6 days, continue treatment until patient becomes fully ambulant, up to max 14 days. Deep vein thrombosis 1 mg/kg 12 hrly or 1.5 mg/kg once daily for at least 5 days and until oral anticoagulants is established. Prophylaxis of clotting in the extracorporeal circulation during haemodialysis 1 mg/kg into the arterial line of the circuit at the start of dialysis session. Give a further 0.5-1 mg/kg dose if required. Unstable angina 1 mg/kg 12 hrly, continue treatment for 2-8 days. IV/SC Acute ST-elevation myocardial infarction Initial: 30 mg via IV w/ 1 mg/kg via SC given at the same time. Give a further 1 mg/kg via SC 12 hrly for 8 days or until hospital discharge. The first 2 SC doses should not exceed 100 mg each. Patients who undergo PCI: An additional 300 mcg/kg via IV given at the time of the procedure if the last SC dose was given >8 hr ago.
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Contraindications
Hypersensitivity to enoxaparin, heparin. Patients w/ active major bleeding, acute bacterial endocarditis, recent haemorrhagic stroke, active gastric or duodenal ulceration, thrombocytopenia associated w/ positive in vitro test for platelet antibodies.
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Special Precautions
Patients w/ low body weight (women: <45 kg; men: <57 kg), bleeding diathesis, diabetic retinopathy, history of recent GI ulceration, history of heparin-induced thrombocytopenia, uncontrolled arterial HTN, or haemorrhage. Hepatic and renal impairment. Elderly, pregnancy and lactation. Monitoring Parameters Monitor patients for signs and symptoms of neurological impairment during treatment or immediately following diagnostic lumbar puncture, spinal or epidural anaesth. Periodic monitoring of CBC (e.g. platelet counts, stool occult blood tests). Monitor vascular access sites for signs of bleeding or haematoma during treatment.
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Adverse Reactions
Haemorrhage (including at the inj site), peripheral or unspecified oedema, anaemia, haematuria, ecchymosis, fever, confusion, nausea, diarrhoea, dyspnoea, inj site pain.
Potentially Fatal: Major haemorrhagic complications (e.g. retroperitoneal and intracranial bleeding). |
Drug Interactions
Increased risk of bleeding w/ anticoagulants, platelet aggregation inhibitors (e.g. dipyridamole, salicylates, NSAIDs, sulfinpyrazone). May increase bleeding w/ vit E.
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ATC Classification
B01AB05 - enoxaparin ; Belongs to the class of heparin group. Used in the treatment of thrombosis.
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