enoxaparin, Lovenox

1. Take the Blood Disorders Quiz

Pharmacy Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

View Full Profile

Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

View Full Profile

GENERIC NAME: enoxaparin

BRAND NAME: Lovenox

DRUG CLASS AND MECHANISM: Enoxaparin is a low molecular weight heparin (LMWH) that is used to prevent blood clots. It is produced by chemically breaking heparin into smaller-sized molecules. Unlike heparin, the effect of enoxaparin does not need to be monitored with blood tests. Like heparin, enoxaparin prevents blood clots from forming by blocking the action of two of the 12 clot-promoting proteins in blood (factors X and II) whose action is necessary for blood to clot. Enoxaparin is used to treat or prevent blood clots and their complications (deep vein thrombosis or DVT and pulmonary embolism or PE). Deep vein thrombosis is the formation of blood clots in veins deep in a muscle, most often in the legs deep vein thrombosis may lead to pulmonary embolism, a condition in which a piece of the clot (the embolus) breaks loose and travels through the veins to the lung. In the lung the clot blocks an artery and prevents the part of the lung that is supplied by the artery from working normally. If the artery that is blocked is a large artery, the embolus can cause sudden death. Thrombosis and embolism are responsible for 300,000 to 600,000 hospitalizations each year, and pulmonary embolism causes as many as 200,000 deaths each year in the U.S. Patients undergoing hip replacement and other major surgery are at increased risk of deep vein thrombosis and pulmonary embolism. The FDA approved enoxaparin in 1993.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Enoxaparin is available in pre-filled syringes containing 30, 40, 60, 80, 100, 120, and 150 mg. Multiple dose vial: 300 mg STORAGE: All enoxaparin products should be stored at room temperature, between 15 and 30 C (59-86 F).

PRESCRIBED FOR: Enoxaparin is used for preventing deep vein thrombosis after abdominal, hip replacement, or knee replacement surgeries, and in patients with reduced mobility due to illness. It is used both in and out of the hospital for treating deep vein thrombosis and pulmonary embolism. Enoxaparin also is used for preventing a second heart attack and related complications after a heart attack and for preventing blood clots in arterial stents.

DOSING: Enoxaparin is administered by injection under the skin (subcutaneous) or intravenously.

• Preventing deep vein thrombosis after abdominal surgery: 40 mg subcutaneous injection once daily.
• Preventing deep vein thrombosis after knee replacement: 30 mg subcutaneous injection every 12 hours.
• Preventing deep vein thrombosis after hip replacement: 30 mg every 12 hours or 40 mg once daily by subcutaneous injection.
• Preventing deep vein thrombosis in ill patients with limited mobility: 40 mg subcutaneous injection once daily.
• Treatment of deep vein thrombosis or pulmonary embolism: 1 mg/kg every 12 hours or 1.5 mg/kg once daily by subcutaneous injection.
• Outpatient treatment of deep vein thrombosis: 1 mg/kg subcutaneous injection every 12 hours.
• Treatment of severe heart attacks (ST elevation myocardial infarction or STEMI): For patients under the age of 75, 30 mg intravenously plus 1 mg/kg subcutaneously followed by 1 mg/kg every 12 hours (maximum of 100 mg for each of the first two subcutaneous doses only). For patients over age 75, 0.75 mg/kg subcutaneously every 12 hours (maximum of 75 mg for each of the first two subcutaneous doses only). All patients should receive aspirin. Doses should be reduced in patients with impaired kidney function.
• Treatment of chest pain (unstable angina) or mild heart attack (non-Q-wave myocardial infarction): 1 mg/kg subcutaneously every 12 hours with aspirin.
• For coronary artery stent procedures (percutaneous coronary intervention or PCI): Patients should receive 0.3 mg/kg during stent placement if the last dose of enoxaparin was administered more than 8 hours before the procedure.

DRUG INTERACTIONS: Medications that increase the risk of bleeding will add to the effects of enoxaparin and further increase the risk of bleeding that is associated with enoxaparin. Such medications include aspirin, clopidogrel (Plavix), warfarin (Coumadin), other anticoagulants, and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin; Advil), naproxen (Naprosyn), diclofenac (Voltaren), and others.

Report Problems to the Food and Drug Administration You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088. Need help identifying pills and medications? Use the pill identifier tool on RxList.