Wednesday, 25 April 2012

Enoxaparin



Pronunciation: ee-nox-AP-a-rin
Generic Name: Enoxaparin
Brand Name: Lovenox

Tell your doctor you use Enoxaparin before you have any type of spinal puncture or epidural/spinal anesthesia. Patients who have these procedures while they use Enoxaparin are at risk for developing a blood clot on or near the spinal cord. This could result in long-term or permanent paralysis.


The risk is increased in patients who have an indwelling epidural catheter, traumatic or repeated epidural or spinal puncture, history of a deformed spine or spinal surgery, and in patients who use medicines that may affect blood clotting such as warfarin, aspirin, platelet inhibitors (eg, clopidogrel), and nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen, naproxen).


If you have a spinal puncture or epidural/spinal anesthesia while you use Enoxaparin, tell your doctor immediately if you notice any signs or symptoms of nerve problems, such as numbness or tingling, muscle weakness, or paralysis.





Enoxaparin is used for:

Preventing blood clots in patients who have certain illnesses or who will be having certain types of surgery. It is also used along with other medicine to treat blood clots. It is also used along with other medicine to prevent certain problems caused by heart attack or unstable angina (chest pain). It is also used to decrease the risk of recurring heart attack in certain patients. It may also be used for other conditions as determined by your doctor.


Enoxaparin is a low molecular weight heparin (LMWH). It works by blocking the formation of blood clots.


Do NOT use Enoxaparin if:


  • you are allergic to any ingredient in Enoxaparin

  • you are allergic to heparin, benzyl alcohol, or pork products

  • you have severe or uncontrolled high blood pressure, or active major bleeding

  • you are taking a salicylate (eg, aspirin) or an NSAID (eg, ibuprofen, naproxen)

  • you have a low platelet count and the presence of antiplatelet antibodies

Contact your doctor or health care provider right away if any of these apply to you.



Before using Enoxaparin:


Some medical conditions may interact with Enoxaparin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:


  • if you are pregnant, planning to become pregnant, or are breast-feeding

  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

  • if you have allergies to medicines, foods, or other substances

  • if you have a history of kidney problems, liver problems, stomach or intestinal problems (eg, ulcers), stroke, or vision problems caused by diabetes

  • if you have inflammation of the heart due to a bacterial infection; severe, uncontrolled high blood pressure; low body weight; or have a mechanical prosthetic heart valve

  • if you have a bleeding disorder, a history of brain bleeding or blood conditions, or von Willebrand disease

  • if you have recently had or are scheduled to have brain, spine, or eye surgery, an epidural catheter, or a spinal puncture

  • if you are taking medicines that affect platelets (eg, aspirin, clopidogrel, ticlopidine)

  • if you have a history of low platelet counts or bleeding problems after taking heparin

  • if you have recently given birth

Some MEDICINES MAY INTERACT with Enoxaparin. Tell your health care provider if you are taking any other medicines, especially any of the following:


  • Activated protein C, anticoagulants (eg, warfarin), dextran, dipyridamole, direct factor XA inhibitors (eg, rivaroxaban), direct thrombin inhibitors (eg, dabigatran), injectable cephalosporins (eg, cephazolin), injectable penicillins (eg, ampicillin), NSAIDs (eg, ibuprofen, ketorolac, naproxen), platelet inhibitors (eg, clopidogrel, ticlopidine), salicylates (eg, aspirin), sulfinpyrazone, or thrombolytics (eg, streptokinase) because the risk of side effects, such as bleeding, may be increased

  • Nitrates (eg, nitroglycerin) because they may decrease the effectiveness of Enoxaparin

This may not be a complete list of all interactions that may occur. Ask your health care provider if Enoxaparin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.


How to use Enoxaparin:


Use Enoxaparin as directed by your doctor. Check the label on the medicine for exact dosing instructions.


  • Enoxaparin is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using Enoxaparin at home, a health care provider will teach you how to use it. Be sure you understand how to use Enoxaparin. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.

  • Use the proper technique taught to you by your doctor. Inject deep under the skin, NOT into muscle.

  • Do not use Enoxaparin if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.

  • Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.

  • If you miss a dose of Enoxaparin, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Enoxaparin.



Important safety information:


  • Enoxaparin may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.

  • Tell your doctor or dentist that you take Enoxaparin before you receive any medical or dental care, emergency care, or surgery.

  • Before you begin taking any new prescription or nonprescription medicine, check the label to see if it has aspirin or ibuprofen in it. If it does or you are not sure, contact your doctor or pharmacist.

  • Some forms of Enoxaparin contain benzyl alcohol. Do not use medicine with benzyl alcohol in NEWBORNS or INFANTS. It may cause serious and sometimes fatal side effects. If you have questions, check with your doctor or pharmacist.

  • If you have ever had an allergic reaction to benzyl alcohol, ask your doctor or pharmacist if your medicine has benzyl alcohol in it.

  • Enoxaparin may affect certain lab tests, including liver enzyme. Be sure your doctor and lab personnel know you are using Enoxaparin.

  • Lab tests, including complete blood cell counts (eg, platelet counts) and tests for blood in the stool, may be performed while you use Enoxaparin. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

  • Use Enoxaparin with caution in the ELDERLY; they may be more sensitive to its effects, especially bleeding.

  • Enoxaparin should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.

  • PREGNANCY and BREAST-FEEDING: Enoxaparin may contain the preservative benzyl alcohol, which can cause harm to the fetus. If you become pregnant, use a formulation without this preservative. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Enoxaparin while you are pregnant. It is not known if Enoxaparin is found in breast milk. If you are or will be breast-feeding while you are using Enoxaparin, check with your doctor. Discuss any possible risks to your baby.


Possible side effects of Enoxaparin:


All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:



Diarrhea; mild pain, irritation, swelling, redness, bleeding, or bruising at the injection site; nausea.



Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody, black, or tarry stools; confusion; difficulty walking; fainting; fever; pale skin; pink or red urine; severe or persistent dizziness, tiredness, or weakness; swelling; tingling, numbness (especially in the legs and feet), and muscle weakness; unusual bleeding or bruising; vomit that looks like coffee grounds.



This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.


See also: Enoxaparin side effects (in more detail)


If OVERDOSE is suspected:


Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include bruising; excessive bleeding.


Proper storage of Enoxaparin:

Store Enoxaparin at room temperature, between 59 and 77 degrees F (15 and 25 degrees C). Store away from heat, moisture, and light. Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Keep Enoxaparin out of the reach of children and away from pets.


General information:


  • If you have any questions about Enoxaparin, please talk with your doctor, pharmacist, or other health care provider.

  • Enoxaparin is to be used only by the patient for whom it is prescribed. Do not share it with other people.

  • If your symptoms do not improve or if they become worse, check with your doctor.

  • Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Enoxaparin. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.



Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Enoxaparin resources


  • Enoxaparin Side Effects (in more detail)
  • Enoxaparin Use in Pregnancy & Breastfeeding
  • Enoxaparin Drug Interactions
  • Enoxaparin Support Group
  • 8 Reviews for Enoxaparin - Add your own review/rating


  • enoxaparin Subcutaneous, Injection Advanced Consumer (Micromedex) - Includes Dosage Information

  • Enoxaparin Sodium Monograph (AHFS DI)

  • Lovenox Prescribing Information (FDA)

  • Lovenox Consumer Overview



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