Enoxaparin
Enoxaparin is an anticoagulant that helps prevent the formation of blood clots. Enoxaparin is used to treat or prevent a type of blood clot called deep vein thrombosis(DVT), which can lead to blood clots in the lungs (pulmonary embolism). A DVT can occur after certain types of surgery, or in people who are bed-ridden due to a prolonged illness. Enoxaparin is also used to prevent blood vessel complications in people with certain types of angina (chest pain) or heart attack.
Mechanism of effect
Enoxaparin is a low molecular weight heparin which has antithrombotic properties
Pharmacodynamic
Enoxaparin is a well known and commonly used anticoagulant which has antithrombotic properties. Enoxaparin inhibits reactions that lead to the clotting of blood and the formation of fibrin clots both in vitro and in vivo.
Pharmacokinetics
Mean absolute bioavailability of enoxaparin, after 1.5 mg/kg given subcutaneously, based on anti-Factor Xa activity is approximately 100% in healthy volunteers Volume of distribution: 4.3 L. Enoxaparin sodium is primarily metabolized in the liver by desulfation and/or depolymerization Renal clearance of active fragments represents about 10% of the administered dose and total renal excretion of active and non-active fragments 40% of the dose
Drug indications
Angina Pectoris , Myocardial Infarction , acute coronary syndrome (ACS) , Prophylaxis of Deep Vein Thrombosis , Acute Deep Vein ThrombosisDosage
Usual Adult Dose for Deep Vein Thrombosis - Prophylaxis 40 mg subcutaneously once a day. The usual duration of administration is 6 to 11 days; up to 14 days administration has been well tolerated in clinical trials. In morbidly obese patients (BMI of 40 kg/m2 or greater), increasing the prophylactic dose by 30% may be appropriate.
Drug contraindications
Renal dysfunction , hypersensitivity to drug or its components. , Active liver disease , Uncontrolled hypertension , active pathological bleeding , ThrombocytopeniaSide effects
nausea , Hematuria , allergic reaction , Diarrhea , Dyspnea , thrombocytopenia , anemia , chronic heart failure , edema , Peripheral edema , confusion , Hyperkalemia , hemorrhage , pneumonia , atrial fibrillationInteractions
Dipyridamole , Protamine sulfat , Tanacetum parthenium , Feverfew , Sawpalmatto , Sawpalmatto complex , Citalopram , Medroxyprogesterone , Naproxen , Vitamin E , Curcuma , sulfinpyrazone , Vancomycin , Dabigatran , Apixaban , Desirudin , Argatroban , Quinine , Tirofiban , Ginkgo biloba , Anagrelide , fenoprofen , Dalteparin , Glucagon , Chitosan , Tinzaparin , Tositumomab , Ibritumomab tiuxetan , Antithrombin III , Estropipate , Cefpodoxime , Cefditoren pivoxil , Cefdinir , Cefoxitin , Cefotetan , Butabarbital , icosapent , Human Prothrombin , Betrixaban , Ramucirumab , Edoxaban , Bromfenac , Cordyceps , Netonal , Oxaprozin , Urokinase , Triphasic , Ipilimumab , bazedoxifene/conjugated estrogens , Dasatinib , cangrelor , defibrotide , Factor X , OmadacyclineAlerts
1-Epidural or spinal hematomas may occur in patients who are anticoagulated with low molecular weight heparins (LMWH) or heparinoids and are receiving neuraxial anesthesia or undergoing spinal puncture. These hematomas may result in long-term or permanent paralysis. Consider these risks when scheduling patients for spinal procedures. Factors that can increase the risk of developing epidural or spinal hematomas in these patients include: • Use of indwelling epidural catheters • Concomitant use of other drugs that affect hemostasis, such as non-steroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, other anticoagulants • A history of traumatic or repeated epidural or spinal punctures • A history of spinal deformity or spinal surgery • Optimal timing between the administration of Enoxaparin Sodium Injection and neuraxial procedures is not known 2-Monitor patients frequently for signs and symptoms of neurological impairment. If neurological compromise is noted, urgent treatment is necessary. 3-Consider the benefits and risks before neuraxial intervention in patients anticoagulated or to be anticoagulated for thromboprophylaxis.
Points of recommendation
1-Patients should also be informed: it may take them longer than usual to stop bleeding 2-they should report any unusual bleeding, bruising, or signs of thrombocytopenia (such as a rash of dark red spots under the skin) to their physician 3-to tell their physicians and dentists they are taking Enoxaparin Sodium Injection and/or any other product known to affect bleeding before any surgery is scheduled and before any new drug is taken
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