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Enoxaparin

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Enoxaparin, Lovenox

  • See Also
  1. Low Molecular Weight Heparin (LMWH)
  2. Heparin
  3. Heparin Induced Thrombocytopenia
  4. Anticoagulation
  • Indications
  1. Venous Thromboembolism (DVT, PE) prophylaxis and treatment
  2. Acute Coronary Syndrome
  • Mechanism
  1. See Low Molecular Weight Heparin (LMWH)
  • Dosing
  • Prophylactic Dose
  1. Creatinine Clearance (CrCl) >30 ml/min AND Weight 40-150 kg
    1. Enoxaparin (Lovenox) 40 mg SQ daily for medical inpatients or abdominal surgery
    2. Enoxaparin (Lovenox) 30 mg SQ every 12 hours if s/p knee or hip replacement
  2. Creatinine Clearance (CrCl) >30 ml/min AND Weight >150 kg (or BMI 40 of higher)
    1. Enoxaparin (Lovenox) 40 mg SQ twice daily
  3. Creatinine Clearance (CrCl) 15-30 ml/min (or weight <40 kg)
    1. Enoxaparin (Lovenox) 30 mg SQ daily
  4. Creatinine Clearance (CrCl) <15 ml/min
    1. Enoxaparin (Lovenox) is contraindicated
    2. Use unfractionated heaprin 5000 units SQ every 8-12 hours
  • Dosing
  • Therapeutic Dose
  1. Creatinine Clearance (CrCl) >30 ml/min
    1. Enoxaparin (Lovenox) 1 mg/kg SQ every 12 hours OR
    2. Enoxaparin (Lovenox) 1.5 mg/kg SQ every 24 hours for inpatients with acute VTE (DVT, PE)
  2. Creatinine Clearance (CrCl) 15-30 ml/min (or weight <40 kg)
    1. Unfractionated Heparin is preferred
    2. As an alternative, Enoxaparin (Lovenox) 1 mg/kg SQ once daily for up to 7 days
  3. Creatinine Clearance (CrCl) <15 ml/min
    1. Enoxaparin (Lovenox) is contraindicated
    2. Use Unfractionated Heparin 5000 units SQ every 8-12 hours
  • Safety
  1. Use in pregnancy when benefit outweighs the risk
  2. Considered safe in Lactation
  • Efficacy
  1. See Low Molecular Weight Heparin (LMWH)
  • Resources
  1. Enoxaparin (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=61df24ff-c141-4353-9f2c-1af7af24f6b2
  • References
  1. Dummer (2009) Perioperative Guidelines
  2. Douketis (2008) Chest 133(6 Suppl):299S-339S [PubMed]