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Enoxaparin Sodium (Clexane-Lovenox)

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Anaesthetics and Critical Care

Obstetrics Gynaecology

Trauma and Orthopaedics

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Urology

Version Jan 2023

About : Always check the BNF link here

Low molecular weight Heparin indirect thrombin inhibitors

Action

Binds to antithrombin and enhances inactivation of factor Xa
More predictable effect than UFH

Indication/Dose

Name	Starting Dose	Frequency	Route
Enoxaparin (VTE prophylaxis)	40 mg 20 mg with renal impairment 40 mg BD if >100 kg	OD	SC
Enoxaparin (DVT/PE)	1.5 mg/kg	SC	PO whist starting warfarin
Enoxaparin (STEMI)	30 mg IV then 1 mg/kg SC BD for <8 days (<75 years) OR Enoxaparin 0.75 mg/kg SC BD (max 75 mg/dose) (>75 years).		PO
Enoxaparin (USA/NSTEMI)	1 mg/kg	BD	PO for 2-8 days

Interactions

See Low Molecular weight Heparin

Cautions

See LMWH, Reduce dose in renal failure

Monitoring

anti-Factor Xa activity (not routinely needed)

Contraindications

Endocarditis, trauma, epidural, lumbar puncture, bleeding disorder
Peptic ulcer; recent cerebral haemorrhage; recent surgery to the eye
Recent CNS surgery, severe HTN, low platelets
History of Heparin-induced thrombocytopenia, bleeding
Severe renal failure

Side effects

Bleeding, low platelets (HITT), high K and osteoporosis long term
HITT occurs at day 5-10 with thrombosis and a drop in platelets.
Consider dose reduction in elderly and severe renal impairment

References

Enoxaparin in BNF

PLEASE NOTE LEGAL ADVICE: The contents are under continuing development and improvements and may contain errors of omission or fact. The official launch will be at the end of 2018. Feedback vital and always welcome at drokane at gmail.com. This is not to be used for the assessment, diagnosis or management of patients. It should not be regarded as medical advice. It is only for educational purposes. Please adhere to your local protocols. If you are unwell please seek healthcare advice from your doctor. This does not replace senior or specialist advice. If you do not accept this then please do not use the website. If you need medical advice, please consult a doctor or other appropriate medical professional. If you are a medical professional and you need advice then speak to your senior or colleagues.

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