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Enoxaparin Sodium (Clexane-Lovenox) 💊
📖 About
Always check the BNF link here.
- 💉 Low Molecular Weight Heparin (LMWH) – an indirect thrombin inhibitor.
- 🎯 Used for prophylaxis and treatment of VTE, ACS, and bridging therapy with warfarin.
⚡ Mechanism of Action
- 🔗 Binds to antithrombin → enhances inactivation of Factor Xa.
- 📊 Has a more predictable anticoagulant effect than UFH → less monitoring required.
🩺 Indications & Dosing (verify in BNF/datasheet)
| Indication | Details |
|---|---|
| 🛡️ VTE prophylaxis |
Enoxaparin
• 40 mg SC OD • 20 mg SC OD if renal impairment • 40 mg SC BD if >100 kg |
| 🩸 DVT / PE (treatment) |
Enoxaparin
• 1.5 mg/kg SC OD • Or 1 mg/kg SC BD (protocol dependent) • Continue while initiating warfarin |
| ❤️ STEMI |
Enoxaparin
• <75 yrs: 30 mg IV bolus, then 1 mg/kg SC BD (max 100 mg first 2 doses), up to 8 days • ≥75 yrs: 0.75 mg/kg SC BD (max 75 mg/dose) |
| 🇺🇸 NSTEMI / Unstable Angina |
Enoxaparin
• 1 mg/kg SC BD • Duration: 2–8 days |
⚠️ Interactions
- See LMWH general guidance (↑ bleeding risk with antiplatelets, anticoagulants, fibrinolytics).
⚠️ Cautions
- 📉 Reduce dose in renal failure (especially if CrCl <30 mL/min).
- 👴 Consider dose reduction in elderly patients.
- 🧪 Use with care if increased bleeding risk (recent surgery, trauma).
📊 Monitoring
- Routine monitoring not required.
- Anti-Factor Xa activity used in special cases (renal impairment, pregnancy, extremes of weight).
🚫 Contraindications
- Active bleeding disorders, peptic ulcer disease.
- Infective endocarditis.
- Recent cerebral haemorrhage, CNS/eye surgery, or major trauma.
- Epidural/spinal anaesthesia or lumbar puncture.
- Severe uncontrolled hypertension.
- History of HIT (Heparin-induced thrombocytopenia).
- Severe renal impairment.
💥 Side Effects
- 🩸 Bleeding (dose-related).
- ⬇️ Platelets (HIT/HITT) – usually day 5–10; presents with thrombosis + platelet fall.
- ⬆️ Hyperkalaemia.
- 🦴 Osteoporosis with long-term use.
📑 References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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