II. Dosing: Prophylactic Dose

  1. Creatinine Clearance (CrCl) >30 ml/min AND Weight 40-150 kg
    1. Enoxaparin (Lovenox) 40 mg SQ daily
  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

III. Dosing: Therapeutic Dose

  1. Creatinine Clearance (CrCl) >30 ml/min
    1. Enoxaparin (Lovenox) 1 mg/kg SQ every 12 hours
  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 heaprin 5000 units SQ every 8-12 hours

IV. References

  1. Dummer (2009) Perioperative Guidelines
  2. Douketis (2008) Chest 133(6 Suppl):299S-339S [PubMed]

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Cost: Medications

enoxaparin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
ENOXAPARIN 100 MG/ML SYRINGE Generic $10.14 per ml
ENOXAPARIN 120 MG/0.8 ML SYR Generic $17.75 per ml
ENOXAPARIN 150 MG/ML SYRINGE Generic $16.75 per ml
ENOXAPARIN 30 MG/0.3 ML SYR Generic $12.43 per ml
ENOXAPARIN 300 MG/3 ML VIAL Generic $13.43 per ml
ENOXAPARIN 40 MG/0.4 ML SYR Generic $12.12 per ml
ENOXAPARIN 60 MG/0.6 ML SYR Generic $10.70 per ml
ENOXAPARIN 80 MG/0.8 ML SYR Generic $10.14 per ml