Enoxaparin (Lovenox)

Indications

Cardiac

Pulmonary

Other Indications for Anticoagulation

  • xxxx

Pharmacology

  • Low Molecular Weight Heparin

Administration

  • SQ (DVT Prophylaxis): 40 mg qday or xxx
  • SQ (Full Anticoagulation): xxx

Dose Adjustment

  • Hepatic: xxx
  • Renal: xxx

Effect on Anticoagulation Tests

  • Prothrombin Time (PT)/International Normalized Ratio (INR) (see Prothrombin Time, [[Prothrombin Time]]): no effect
    • Enoxaparin is an indirect thrombin inhibitor and should theoretically prolong the INR: however, most INR assay reagents contain heparin-binders which block the effect of heparin (or similar agents) at concentrations <1 unit/mL -> therefore, at heparin concentration of >1 unit/mL, the INR may be prolonged
  • Partial Thromboplastin Time (PTT) (see Partial Thromboplastin Time, [[Partial Thromboplastin Time]]): no effect-prolonged
  • Anti-Factor Xa (see Anti-Factor Xa, [[Anti-Factor Xa]]): prolonged

Management of Enoxaparin Therapy Prior to Surgery/Procedure

  • Recommendations (Chest Antithrombotic Therapy and Prevention of Thrombosis 2012 Guidelines) [MEDLINE]
    • Administer Last Dose of Enoxaparin 24 hrs Prior to Surgery/Procedure (Grade 2C Recommendation)

Post-Operative Resumption of Enoxaparin Following Surgery/Procedure with High Bleeding Risk

  • Recommendations (Chest Antithrombotic Therapy and Prevention of Thrombosis 2012 Guidelines) [MEDLINE]
    • Resume Enoxaparin 48-72 hrs Following Surgery/Procedure (Grade 2C Recommendation)

Adverse Effects

Hemorrhagic Adverse Effects

Other Adverse Effects

  • xxx

References

  • Executive summary: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb;141(2 Suppl):7S-47S. doi: 10.1378/chest.1412S3 [MEDLINE]