Enoxaparin

Details About Generic Salt ::  Enoxaparin 

Main Medicine Class:: Hematological System   Sub Medicine Class ::  Anti Coagulants

5B. ANTI-COAGULANTS in 5. HEMATOLOGICAL SYSTEM
ENOXAPARIN
LOW-MOLECULAR-WEIGHT HEPARIN | ANTICOAGULANT
PK: D: 4.3 L (Vd) M: Hepatic E: Urine

Indications & Dose: DEEP VEIN THROMBOSIS Adjuvant therapy IV Adult 0.3mg/kg single dose in patients undergoing PCI if balloon inflation occurs 8-12h after the last SC enoxaparin dose. However, no additional dosing is needed if balloon inflation occurs <8h after the last SC enoxaparin dose | Acute SC Adult Inpatient treatment (with/without pulmonary embolism): 1mg/kg/dose q12h or 1.5mg/kg/day 5-7 days, Outpatient treatment (without pulmonary embolism): 1mg/kg/dose BID 5-7 days. Note: Start warfarin on the first treatment day | DEEP VEIN THROMBOSIS/PULMONARY EMBOLISM Prophylactic therapy SC Adult Hip/knee replacement surgery: 30mg 12-24h after surgery (provided hemostasis has been established), repeated q12h 7-10 days until risk of DVT has diminished. Alternatively, hip-replacement patient may receive 40mg 12h before surgery & then OD for further 3 wk . General Surgery (including abdominal, gynecologic/ urologic surgery): Initially 40mg OD 2h before surgery and continued for 7-10 days, duration of therapy may be increased to 2-3 wk after hospital discharge in high-risk surgery patients including those undergoing major cancer surgery. Severely immobilised patients: 40mg/day 6-11 days | DVT IN STEMI IV Adult <75 yr: Initially 30mg single bolus plus 1mg/kg SC q12h (max 100mg for the first 2 doses only). The first SC dose should be administered with IV bolus. MD 1mg/kg BID SC after first 2 doses | SC Adult >75 yr: Initially 0.75mg/kg BID, max 75mg for the first 2 doses. MD 0.75mg/kg BID after first 2 doses. Note: No IV bolus is administered in this population | FOR PREVENTION OF CLOTTING DURING HEMODIALYSIS IA Adult 1mg/kg (100U/kg) given into the arterial line of the circuit at the beginning of the dialysis. If required another dose of 0.5-1mg/kg (50-100U/kg) may be given. Reduce dose in patients at high risk of hemorrhage | ISCHEMIC COMPLICATIONS Prophylactic therapy SC Adult 1mg/kg BID 2-8 day to reduce complications in patients with unstable angina receiving aspirin

Contra: Hypersensitivity, thrombocytopenia, hypersensitivity to pork products, active major bleeding, IM route of administration

Precautions: Severe hepatic/renal disease, retinopathy, uncontrolled HTN, hemorrhagic stroke, bacterial endocarditis, GI bleeding/other bleeding disorders, recent history of ulcer disease, history of congenital/acquired bleeding disorder, history of thrombocytopenia, recent CNS surgery, children, elderly

ADR: Serious: hemorrhage, thrombocytopenia, ALT & AST increased, hematuria, Others: Inj site hematoma, local reactions, anemia, fever, confusion, pain, erythema, bruising, nausea, diarrhea

DDI: Serious NSAIDs may increases the risk of bleeding

Monitor: Platelets, occult blood, anti-Xa levels, Secr

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