Enoxaparin

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Enoxaparin is an anticoagulant that helps prevent the formation of blood clots otherwise known as deep vein thrombosis that occur in the lungs (pulmonary embolism). Deep vein thrombosis may develop after certain types of surgery or chronic illnesses that cause people to become bedridden.

Enoxaparin can also be used to prevent vascular complications in people with certain types of angina (chest pain) or heart attacks. 

Severe blood clots around the spinal cord can occur if you are taking enoxaparin during a spinal tap or receiving spinal (epidural) anesthesia – particularly if you have a genetic spinal defect, a history of spinal surgery, or recurrent spinal injuries.

In addition, blood clots can also occur if you are taking other medicines such as blood thinners or NSAIDs (ibuprofen, Advil, Aleve, and others). This type of blood clot can cause long-term or permanent paralysis.

Seek immediate medical help if you have symptoms of a spinal cord blood clot such as back pain, numbness, muscle weakness in the lower body, or loss of bladder or bowel control.

Dosing Considerations for Enoxaparin

It is strongly advised to take enoxaparin based on the dosage recommended by your doctor or listed on the packaging. 

Condition: Deep vein thrombosis

  • Outpatient adults: 1 mg / kg subcutaneously every 12 hours.
  • Inpatient adults: 1 mg / kg subcutaneously every 12 hours or 1.5 mg / kg subcutaneously once daily at the same time daily.

Condition: Deep vein thrombosis – Prophylaxis

  • Adults: 40 mg subcutaneously once daily.

Condition: Myocardial Infarction

  • Adults with unstable angina and non-Q wave myocardial infarction: 1 mg / kg subcutaneously every 12 hours along with oral aspirin therapy (100 to 325 mg once daily).
  • Adults with acute myocardial infarction: 30 mg IV bolus once plus 1 mg / kg subcutaneously, once followed by 1 mg / kg subcutaneously every 12 hours (maximum 100 mg for the first two doses only, followed by 1 mg / kg for the remaining dose).

Condition: Angina Pectoris

  • Adults with unstable angina and non-Q wave myocardial infarction: 1 mg / kg subcutaneously every 12 hours along with oral aspirin therapy (100 to 325 mg once daily).

Condition: Acute Coronary Syndrome

  • Adults with unstable angina and non-Q wave myocardial infarction: 1 mg / kg subcutaneously every 12 hours along with oral aspirin therapy (100 to 325 mg once daily)

Guidelines for Enoxaparin

Follow the guidelines for using enoxaparin below or as recommended by your doctor:

  • Make sure you follow all instructions on the drug label and read the instruction sheets. Use the drug exactly as directed.
  • Enoxaparin is injected beneath the skin, or intravenously. Your healthcare provider may teach you how to take your own medicine properly.
  • Avoid using enoxaparin if you do not understand the instructions as listed on the drug label. Ask your doctor or pharmacist if you have questions.
  • Prepare injections only if you are ready to give them. Do not use if the drug has discoloration or has particles in it. Contact your pharmacist for new medicines.
  • You will need to sit or lie down during injection. Do not inject enoxaparin into the muscles.
  • Your healthcare provider will show you where to inject enoxaparin. Use a different location for each injection. Do not inject into the same place twice.
  • Perform medical tests frequently to help your doctor determine how long you should be on treatment with enoxaparin.
  • If you need surgery or dental work, tell your surgeon or dentist that you are currently taking enoxaparin.
  • Store enoxaparin at room temperature and keep it away from moisture and heat.
  • Each single-use syringe is for one-time use only. Dispose of it after one use even if there is still some medicine in it.
  • After opening the enoxaparin vial (bottled medicine), you must use the drug within 28 days, then discard the vial after 28 days.
  • Use the needle and syringe only once, then place them in a leak-proof container. Keep out of reach of children and pets.

Indications for Enoxaparin

Enoxaparin is indicated for:

  • Treatment for blood clots.
  • Blood thinners – make your blood less likely to clot..
  • Reduce heart attacks in patients experiencing unstable angina or mild heart attacks.

Warnings

Be sure to observe the following warnings for using enoxaparin:

  • Before using enoxaparin, inform your doctor or pharmacist if you are allergic to it or if you have any other allergies. This product may contain inactive ingredients which can cause allergic reactions or other problems.
  • Before using enoxaparin, inform your doctor or pharmacist about your medical history, especially if you have artificial heart valves, kidney disease, liver disease, bleeding or blood problems (such as a low platelet count), stroke, high blood pressure, eye problems, stomach problems, and so on.
  • Limit alcohol consumption while taking enoxaparin, as it can increase the risk of gastrointestinal bleeding.
  • Before undergoing surgery, inform your doctor or dentist about all the products you use, including prescription & nonprescription medicines and herbal products.
  • To lower risk of injury, be careful with sharp objects such as razors and nail clippers, and avoid activities such as contact sports.
  • Older adults may be more sensitive to the side effects of enoxaparin, especially bleeding.
  • Pregnant women should only use enoxaparin when needed. Discuss the risks and benefits with your doctor. Pregnant women with artificial heart valves require close monitoring.

Enoxaparin Drug Interactions

Inform your doctor if you are currently taking other medications, especially those used to treat or prevent blood clotting, such as:

  • Abciximab, anagrelide, cilostazol, clopidogrel, dipyridamole, eptifibatide, ticlopidine, or tyrosphilia.
  • Alteplase, reteplase, tenecteplase, or urokinase.
  • Apixaban, argatroban, bivalirudin, dabigatran, desirudin, fondaparinux, lepirudin, rivaroxaban, or tinzaparin.
  • Heparin.

Other medications can also affect enoxaparin, including prescription and over-the-counter medications, vitamins, and herbal products.

Side Effects of Enoxaparin

Seek emergency medical help if you have signs of an allergic reaction such as hives, itchy or burning skin, difficulty breathing, swelling of your face, lips, tongue, or throat. 

You also require medical care if you have symptoms of blood clots in the spine, back pain, numbness, muscle weakness in the lower body, or loss of bladder or bowel control.

Call your doctor right away if you experience:

  • Nosebleeds or bleeding gums.
  • Abnormal vaginal bleeding.
  • Blood in the urine or stool.
  • Coughing up blood or vomiting that looks like coffee grounds.
  • Easy bruising, as well as purple or red spots under the skin.
  • Unusual bleeding or bleeding that does not stop.
  • Low red blood cells (anemia). Symptoms include pale skin, unusual fatigue, feeling dizzy or short of breath, cold hands and feet.
  • Signs of brain bleed (brain hemorrhage) such as sudden weakness (especially on one side of the body), sudden severe headache, speech disorders, or vision impairment.

Common side effects of enoxaparin include:

  • Nausea.
  • Diarrhea.
  • Anemia.
  • Confusion.
  • Pain, bruising, redness, or irritation at the injection site.

Contact your doctor or pharmacist through Smarter Health to find out more about the recommended dosage of enoxaparin. Smarter Health allows you to access health services whenever you need them.

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