Difference between revisions of "Enoxaparin"

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(Therapeutic anticoagulation)
 
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==General==
 
==General==
 
*Type: [[Low molecular weight heparin]]
 
*Type: [[Low molecular weight heparin]]
*Dosage Forms:
+
*Dosage Forms: subcutaneous
 
*Common Trade Names: Lovenox
 
*Common Trade Names: Lovenox
  
 
==Adult Dosing==
 
==Adult Dosing==
 +
===<u>Therapeutic</u> anticoagulation (e.g. treating [[DVT]]/[[PE]], [[unstable angina]])===
 +
*1mg/kg SC q12h
 +
 +
{{Chemical prophylaxis of VTE}}
  
 
==Pediatric Dosing==
 
==Pediatric Dosing==
 +
''Off-label''
 +
*DVT prophylaxis:
 +
**<2 months: 0.75 mg/kg SC q12hr 
 +
**≥2 months: 0.5 mg/kg SC q12h
 +
*Therapeutic anticoagulation:
 +
**<2 months: 1.5 mg/kg SC q12hr
 +
**≥2 months: 1 mg/kg SC q12hr
  
 
==Special Populations==
 
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]:
+
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B
*Lactation:
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*Lactation: Unknown risk
 
*Renal Dosing
 
*Renal Dosing
**Renal impairment (Cr clearance <30)
+
**Renal impairment (creatinine clearance <30)
 
***Use 50% of usual dose or use UFH instead
 
***Use 50% of usual dose or use UFH instead
**Adult
+
*Hepatic Dosing: not established
**Pediatric
 
*Hepatic Dosing
 
**Adult
 
**Pediatric
 
 
*Obesity
 
*Obesity
 
**Weight-based dosing safe up to 190kg (no data available thereafter)
 
**Weight-based dosing safe up to 190kg (no data available thereafter)
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==Pharmacology==
 
==Pharmacology==
*Half-life:  
+
*Half-life: 4.5h
*Metabolism:  
+
*Metabolism: hepatic
*Excretion:  
+
*Excretion: urine
*Mechanism of Action:
+
*Mechanism of Action: inhibits factor Xa by increasing inhibition rate of clotting proteases that are activated by antithrombin III
  
 
==See Also==
 
==See Also==
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*[[Anticoagulant reversal for life-threatening bleeds]]
 
*[[Anticoagulant reversal for life-threatening bleeds]]
  
==Sources==
+
==References==
 
<references/>
 
<references/>
  
 
[[Category:Pharmacology]]
 
[[Category:Pharmacology]]
 
[[Category:Heme/Onc]]
 
[[Category:Heme/Onc]]

Latest revision as of 17:58, 28 November 2019

General

Adult Dosing

Therapeutic anticoagulation (e.g. treating DVT/PE, unstable angina)

  • 1mg/kg SC q12h

Chemical Prophylaxis of VTE

  • Lovenox 30mg SubQ q12 hrs (if Cr Clearance > 30)
    • Check AntiXa level every week EXACTLY 4 hours after 3rd dose of lovenox
      • prophylactic goal: 0.2-0.6
      • therapeutic goal: 0.6-1.2
  • Recheck AntiXa level after each 3rd dose if dose is changed until you are at goal
  • Recheck level every week (usually qMonday) for all patients
  • If renal dysfunction order heparin 5000 Units SubQ q8 hrs (search “SURG DVT/VTE prophylaxis” order set)

Pediatric Dosing

Off-label

  • DVT prophylaxis:
    • <2 months: 0.75 mg/kg SC q12hr
    • ≥2 months: 0.5 mg/kg SC q12h
  • Therapeutic anticoagulation:
    • <2 months: 1.5 mg/kg SC q12hr
    • ≥2 months: 1 mg/kg SC q12hr

Special Populations

  • Pregnancy Rating: B
  • Lactation: Unknown risk
  • Renal Dosing
    • Renal impairment (creatinine clearance <30)
      • Use 50% of usual dose or use UFH instead
  • Hepatic Dosing: not established
  • Obesity
    • Weight-based dosing safe up to 190kg (no data available thereafter)

Indications

Contraindications

  • Allergy to class/drug

Adverse Reactions

  • Bleeding
  • Pruritus
  • Local skin reaction

Pharmacology

  • Half-life: 4.5h
  • Metabolism: hepatic
  • Excretion: urine
  • Mechanism of Action: inhibits factor Xa by increasing inhibition rate of clotting proteases that are activated by antithrombin III

See Also

References