enoxaparin (Lovenox)
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Introduction
Tradename: Lovenox. (see low molecular weight heparin)
Dosage
- 1 mg/kg SC BID (full anticoagulation)
- QD-dosing if creatinine clearance < 30 mL/min[6][7]
- DVT prophylaxis:
- overlap with warfarin therapy, discontinue when INR is therapeutic for 2 consecutive days
- discontinue for 12 hours prior to surgery
Dosage adjustment in renal failure
Pharmacokinetics
- bioavailability is 90% following SC administration
- 1/2life is 4 hours
- duration of action is 12 hours
- elmination is prolonged with renal insufficiency
Adverse effects
- bruising, bleeding
- minor bleeding more common than with heparin in patients with severe renal insufficiency[7]
- see heparin, LMW heparin
- treat with protamine sulfate[3]
Mechanism of action
- inhibits coagulation factor Xa
More general terms
References
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ 3.0 3.1 Medical Knowledge Self Assessment Program (MKSAP) 11, 16. American College of Physicians, Philadelphia 1998, 2013
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Prescriber's Letter 7(12):72 2000
- ↑ 6.0 6.1 6.2 Prescriber's Letter 11(2):9 2004 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=200204&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 7.0 7.1 7.2 7.3 Journal Watch 24(10):78, 2004 Thorevska N, Amoateng-Adjepong Y, Sabahi R, Schiopescu I, Salloum A, Muralidharan V, Manthous CA. Anticoagulation in hospitalized patients with renal insufficiency: a comparison of bleeding rates with unfractionated heparin vs enoxaparin. Chest. 2004 Mar;125(3):856-63. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15006942
- ↑ Samama MM, Cohen AT, Darmon JY et al A comparison of enoxaparin with placebo for the prevention of venous thromboembolism in acutely ill medical patients. Prophylaxis in Medical Patients with Enoxaparin Study Group. N Engl J Med. 1999 Sep 9;341(11):793-800. PMID: https://www.ncbi.nlm.nih.gov/pubmed/10477777 Free Article
- ↑ 9.0 9.1 A Pocket Guide to the 2019 Beer's Criteria. American Geriatrics Society.