II. Indications
- Venous Thromboembolism (DVT, PE) prophylaxis and treatment
- Acute Coronary Syndrome
III. Mechanism
IV. Dosing: VTE Prophylaxis Dose
-
Creatinine Clearance (CrCl) >30 ml/min
- Normal Dosing (BMI 18.5 to 40 kg/m2 or weight <100 kg)
- Enoxaparin (Lovenox) 40 mg SQ daily for medical inpatients or abdominal surgery
- Enoxaparin (Lovenox) 30 mg SQ every 12 hours if s/p knee or hip replacement
- Morbid Obesity (BMI >40 kg/m2 or weight >100 kg)
- BMI 40 to 49 kg/m2: Enoxaparin 40 mg SQ twice daily
- BMI >=50 kg/m2: Enoxaparin 60 mg SQ twice daily
- Low Body Weight (BMI <18.5 kg/m2 or weight <50 kg)
- Enoxaparin 30-40 mg SQ once daily
- Normal Dosing (BMI 18.5 to 40 kg/m2 or weight <100 kg)
-
Creatinine Clearance (CrCl) 15-30 ml/min (or weight <40 kg)
- Enoxaparin (Lovenox) 30 mg SQ daily
-
Creatinine Clearance (CrCl) <15 ml/min
- Enoxaparin (Lovenox) is contraindicated
- Use Unfractionated Heparin 5000 units SQ every 8-12 hours
V. Dosing: Therapeutic Dose
-
Creatinine Clearance (CrCl) >30 ml/min
- Normal Dosing (BMI <40 kg/m2 or weight <100 kg)
- Enoxaparin (Lovenox) 1 mg/kg SQ every 12 hours OR
- Enoxaparin 1.5 mg/kg SQ every 24 hours for inpatients with acute VTE (DVT, PE)
- Morbid Obesity (BMI >40 kg/m2 or weight >100 kg)
- Enoxaparin (Lovenox) 0.75 to 0.85 mg/kg SQ every 12 hours
- Normal Dosing (BMI <40 kg/m2 or weight <100 kg)
-
Creatinine Clearance (CrCl) 15-30 ml/min (or weight <40 kg)
- Unfractionated Heparin is preferred
- As an alternative, Enoxaparin (Lovenox) 1 mg/kg SQ once daily for up to 7 days
-
Creatinine Clearance (CrCl) <15 ml/min
- Enoxaparin (Lovenox) is contraindicated
- Use Unfractionated Heparin 5000 units SQ every 8-12 hours
VI. Safety
- Use in pregnancy when benefit outweighs the risk
- Considered safe in Lactation
- Factor Xa levels are not accurate for monitoring LMWH SQ Injection thereapeutic range
VII. Efficacy
VIII. Resources
IX. References
- Dummer (2009) Perioperative Guidelines
- Douketis (2008) Chest 133(6 Suppl):299S-339S [PubMed]
- (2025) Presc Lett 32(2): 11
Images: Related links to external sites (from Bing)
Related Studies
| 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 |
Ontology: Enoxaparin (C0206460)
| Definition (NCI_NCI-GLOSS) | A drug used to prevent blood clots. It belongs to the family of drugs called anticoagulants. |
| Definition (NCI) | A low molecular weight, synthetic heparin. As an anticoagulant/antithrombotic agent, enoxaprin's mechanism of action is similar to that of heparin, although it exhibits a higher ratio of anti-Factor Xa to anti-Factor IIa activity. This agent also has anti-inflammatory properties, inhibiting monocyte adhesion to tumor necrosis factor alpha- or lipopolysaccharide-activated endothelial cells. Compared to unfractionated heparins, the use of enoxaparin is associated with lower incidences of osteoporosis and heparin-induced thrombocytopenia. (NCI04) |
| Definition (MSH) | Low-molecular-weight fragment of heparin, having a 4-enopyranosuronate sodium structure at the non-reducing end of the chain. It is prepared by depolymerization of the benzylic ester of porcine mucosal heparin. Therapeutically, it is used as an antithrombotic agent. (From Merck Index, 11th ed) |
| Definition (PDQ) | A low molecular weight, synthetic heparin. As an anticoagulant/antithrombotic agent, enoxaprin's mechanism of action is similar to that of heparin, although it exhibits a higher ratio of anti-Factor Xa to anti-Factor IIa activity. This agent also has anti-inflammatory properties, inhibiting monocyte adhesion to tumor necrosis factor alpha- or lipopolysaccharide-activated endothelial cells. Compared to unfractionated heparins, the use of enoxaparin is associated with lower incidences of osteoporosis and heparin-induced thrombocytopenia. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=37880&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=37880&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1452" NCI Thesaurus) |
| Concepts | Pharmacologic Substance (T121) , Carbohydrate (T118) |
| MSH | D017984 |
| SnomedCT | 108984007, 372562003 |
| English | Enoxaparin, Enoxaparine, enoxaparin (medication), Enoxaparin [Chemical/Ingredient], enoxaparine, ENOXAPARIN, enoxaparin, Enoxaparin (product), Enoxaparin (substance) |
| Swedish | Enoxaparin |
| Czech | enoxaparin |
| Finnish | Enoksapariini |
| Italian | Enoxaparine, Enoxaparina |
| Russian | ENOKSAPARIN, ЭНОКСАПАРИН |
| Japanese | エノキサパリン |
| Polish | Enoksaparyna |
| Croatian | Enoksaparin |
| Spanish | enoxaparina (producto), enoxaparina (sustancia), enoxaparina, Enoxaparina |
| French | Énoxaparine |
| German | Enoxaparin |
| Portuguese | Enoxaparina |
Ontology: Lovenox (C0728963)
| Definition (CHV) | brand name of enoxaparin |
| Definition (CHV) | brand name of enoxaparin |
| Concepts | Pharmacologic Substance (T121) , Carbohydrate (T118) |
| MSH | D017984 |
| English | Lovenox [brand name], Lovenox |
