Method of administration: 1 mg (0.01 mL) of Enoxaparin corresponds approximately to 100 anti-Xa I.U. Enoxaparin should be injected by deep SUBCUTANEOUS ROUTE in prophylactic and curative treatment and by INTRAVENOUS ROUTE during haemodialysis. Do not inject intramuscularly.
Subcutaneous administration technique: The prefilled syringes are ready-to-use. The air bubble from the syringe should not be expelled before the injection. The subcutaneous injection should preferably be made when the patient is lying down. Enoxaparin is administered in the subcutaneous cellular tissue of the anterolateral or posterolateral abdominal wall, alternately on the left and the right side.
The injection itself consists in introducing the needle perpendicularly and not tangentially, throughout its entire length into a fold skin held between the thumb and index finger. The skin fold should be held throughout the injection.
Prophylaxis of venous thrombosis: In the case of a surgery with a moderate thrombogenic risk and when patients do not present high thrombo-embolism risk, the recommended dosage is 20 mg (0.2 mL) once daily by a single subcutaneous injection. In the case of a surgery with a high thrombogenic risk (hip and knee surgery) and/or patients with a high risk of thromboembolism, the dosage should be 40 mg (0.4 ml)-once daily by a single subcutaneous injection. In general surgery, the first injection should be given 2 hours before the surgical procedure. In orthopaedic surgery, the first injection is to be given 12 hours preoperatively. A higher prophylactic dosage may be envisaged when the risk of thrombo-embolism linked to the type of surgery and/or to the patient's history is increased.
Enoxaparin treatment is usually prescribed for an average period of 7 to 10 days. Longer treatment duration may be appropriate in certain cases and the treatment should be continued for as long as there is a risk of venous thrombo-embolism and until the patient is ambulatory.
Treatment of established deep vein thrombosis: A dose of 1 mg/kg should be given subcutaneously every 12 hours. The duration of the treatment should not exceed a period of 10 days.
Treatment of unstable angina and non-Q-wave myocardial infarction: A dose of 1 mg/kg should be given subcutaneously every 12 hours. The recommended treatment should be prescribed for a period of 2 to 8 days, until clinical stabilization of the patient. Enoxaparin should be administered concurrently with aspirin (100 to 325 mg daily per oral route).
Elderly: No dosage adjustment is necessary in preventive therapy. In curative therapy measurement of anti-Xa activity is recommended.
Children: Enoxaparin is not recommended for children.
Renal impairment: No dosage adjustment is necessary at prophylactic doses whereas dosage adjustment is necessary and the monitoring of anti-Xa activity is recommended at curative doses.
Patients under 40 kg and over 100 kg weight: Particular clinical surveillance is necessary in order to adjust dosage if necessary. In all cases, strictly follow the physician's prescription.