Enoxaparin

Generic name: enoxaparin [ ee-NOX-a-PAR-rin ]
Brand names: Lovenox, Lovenox HP, Clexane, Clexane Forte

Drug Class: Low Molecular Weight Heparin (LMWH).

Dosage Form: Injection solution; Prefilled syringe.

Route of Administration: Subcutaneous, Intravenous.

Dose: Available in various strengths, including 30 mg/0.3 mL, 40 mg/0.4 mL, 60 mg/0.6 mL, 80 mg/0.8 mL, and 100 mg/mL in prefilled syringes; 300 mg/3 mL in vials.

Mechanism of Action: Enoxaparin enhances the inhibition of Factor Xa and thrombin by accelerating the activity of antithrombin III. This inhibition is crucial for the blood coagulation pathway, reducing the ability of blood to clot and thus preventing the formation and growth of clots.

Drug Usage Cases: It’s used for the prevention and treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE). Enoxaparin is also used in patients undergoing abdominal surgery or hip or knee replacement surgery to prevent thrombotic complications and in acute coronary syndrome (ACS) management.

Drug Contraindications: Contraindicated in patients with active major bleeding, history of heparin-induced thrombocytopenia (HIT), hypersensitivity to enoxaparin or heparin, and in those with conditions that have a high risk of uncontrolled bleeding.

Side Effects: Common side effects include bleeding complications, anemia, thrombocytopenia, injection site reactions, and elevated liver enzymes. Serious side effects may include spinal or epidural hematomas, which can result in long-term or permanent paralysis.

Warnings: Care should be taken when using enoxaparin in patients with renal impairment, elderly patients, and those with a low body weight. The risk of spinal or epidural hematoma is increased in patients undergoing spinal puncture or epidural anesthesia.

Use During Pregnancy or Breastfeeding: Enoxaparin is considered safe for use during pregnancy as it does not cross the placenta. However, caution is advised due to the risk of bleeding. There is limited information on the use of enoxaparin during breastfeeding; a healthcare provider should be consulted to weigh the potential benefits and risks.