Enoxaparin
General
- Type: Low molecular weight heparin
- Dosage Forms: subcutaneous
- Common Trade Names: Lovenox
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 Anti-Xa level every week EXACTLY 4 hours after 3rd dose of lovenox
- prophylactic goal: 0.2-0.6
- therapeutic goal: 0.6-1.2
- Check Anti-Xa level every week EXACTLY 4 hours after 3rd dose of lovenox
- 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
- Renal impairment (creatinine clearance <30)
- 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
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Non-ST-elevation myocardial infarction | 1mg/kg BID | Antithrombotic; preferred over UFH unless CABG within 24hr | SC | Adult |
| Pulmonary embolism | 1 mg/kg SC q12h | Anticoagulation (1st line, LMWH) | SC | Adult |
| ST-segment elevation myocardial infarction | 30 mg IV bolus, then 1 mg/kg SC q12h (<75yo); 0.75 mg/kg SC q12h (≥75yo); 1 mg/kg SC daily (CrCl <30) | Anticoagulation (LMWH) | IV/SC | Adult |
| Unstable angina | 1mg/kg SC q12hr | Antithrombotic, alternative to UFH | SC | Adult |