Enoxaparin, Lovenox
Description: Anticoagulant, Low Molecular Weight Heparin
“Alert: Black Box Warning
Spinal/Epidural Hematoma
Epidural or spinal hematomas may occur in patients who are anticoagulated with LMWHs or heparinoids and are receiving neuraxial anesthesia or undergoing spinal puncture. These hematomas may result in long-term or permanent paralysis. Consider these risks when scheduling patients for spinal procedures. Monitor patients frequently for signs and symptoms of neurological impairment. If neurological compromise is noted, urgent treatment is necessary. Consider the benefits and risks before neuraxial intervention in patients anticoagulated or to be anticoagulated for thromboprophylaxis.”
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Enoxaparin, Lovenox is low molecular weight heparin that acts as an anticoagulant by increasing the inhibition rate of clotting proteases by antithrombin III impairing normal hemostasis and inhibition of factor Xa. Low molecular weight heparins have a small effect on the activated partial thromboplastin time and strongly inhibit factor Xa. Enoxaparin, Lovenox has a higher ratio of anti-factor Xa to anti-factor IIa activity than unfractionated heparin.
Indications For Use
Acute Coronary Syndrome, Deep Vein Thrombosis, Venous Thromboembolism
Precautions
Before starting Enoxaparin, Lovenox makes sure your physician is aware of any allergies or medications you currently take. The anticoagulant activity of Enoxaparin, Lovenox can increase the risk of bleeding which is higher in patients with bacterial endocarditis; congenital or acquired bleeding disorders; active ulcerative or angiodysplastic GI diseases; severe uncontrolled hypertension; hemorrhagic stroke; or use shortly after brain, spinal, or ophthalmic surgery; in patients treated concomitantly with platelet inhibitors; recent GI bleeding or ulceration; renal dysfunction and hemorrhage; thrombocytopenia or platelet defects or history of heparin-induced thrombocytopenia; severe liver disease; hypertensive or diabetic retinopathy; or in patients undergoing invasive procedures. Enoxaparin, Lovenox has been known to cause thrombocytopenia with cases of HIT and heparin-induced thrombocytopenia with thrombosis (HITTS), some complicated by organ infarction, limb ischemia, or death.
Usual Dosing
Subcutaneous: Dose injected is dependant upon body mass index and condition used.
Pharmacist Tips On Using
How to Use:
Administer a deep subcutaneous injection by alternating between the left or right anterolateral and left or right posterolateral abdominal wall. Do not mix with other infusions or injections. In order to minimize bruising, do not rub the injection site. To avoid loss of drug from the 30 mg and 40 mg prefilled syringes, do not expel the air bubble from the syringe prior to injection.
Side Effects
Anemia, hemorrhage, peripheral edema, confusion, nausea, major hemorrhage, bleeding and/or pain at the injection site, hematuria, fever.
Note this is not a complete list of side effects for Enoxaparin, Lovenox only common one.
Frequently Asked Questions
Why would my doctor give this to me if it can cause me to have a potentially fatal bleed, is it safe?
Your physician has found that given your medical conditions the reduction of risk of a major clot resulting in heart attack or stroke far outweighs the increased risk of a bleed. Every medication does have risks however the training of your medical team has established that the benefits outweigh said risks based on their many years of experience, schooling, training, and available clinical data.