From the Guidelines
Switching from Eliquis to Lovenox should be done under medical supervision, with Lovenox administered 12 hours after the last Eliquis dose, at a dose of approximately 1 mg/kg twice daily or 1.5 mg/kg once daily, based on the patient's weight and medical condition, as recommended by the most recent guidelines 1. When switching from Eliquis (apixaban) to Lovenox (enoxaparin), it is crucial to consider the differences in their mechanisms of action and the clinical context of the patient. Eliquis is an oral direct factor Xa inhibitor, while Lovenox is an injectable low molecular weight heparin. The switch is often necessary before surgical procedures, during pregnancy, or when oral medications cannot be taken.
- The dosing of Lovenox is typically based on the patient's weight, with a common regimen being 1 mg/kg subcutaneously every 12 hours or 1.5 mg/kg once daily 1.
- The patient should be instructed on proper injection technique, including rotating injection sites between the left and right anterolateral abdominal wall.
- Side effects to watch for include bruising at injection sites, unusual bleeding, or signs of allergic reaction.
- The healthcare provider will determine the exact dose and frequency based on the patient's specific condition, kidney function, and bleeding risk, as well as other individual medical needs.
- It is essential to follow the doctor's specific instructions, as they may customize this approach based on the patient's unique medical situation.
- The most recent guidelines from 2024 1 provide the basis for this recommendation, emphasizing the importance of medical supervision and proper dosing to maintain effective anticoagulation and minimize risks.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Switching from Eliquis to Lovenox
- There is no direct evidence on how to switch from Eliquis (apixaban) to Lovenox (enoxaparin) in the provided studies.
- However, the studies suggest that apixaban and enoxaparin are both effective in preventing venous thromboembolism (VTE) 2, 3, 4, 5, 6.
- A study comparing apixaban and enoxaparin for thromboprophylaxis after total hip and total knee arthroplasty found that apixaban had a better safety profile than enoxaparin 6.
- Another study found that apixaban decreased coagulation activity in patients with acute deep-vein thrombosis, similar to low-molecular-weight heparin followed by vitamin K antagonist (LMWH/VKA) 5.
- The studies suggest that apixaban is a safe and effective alternative to conventional treatment for VTE, but do not provide specific guidance on switching from apixaban to enoxaparin 2, 3, 4.
Considerations for Switching
- When considering switching from apixaban to enoxaparin, it is essential to take into account the individual patient's risk factors, medical history, and current treatment regimen.
- The decision to switch should be made in consultation with a healthcare professional, who can assess the patient's specific needs and provide guidance on the best course of treatment.
- It is crucial to monitor the patient's condition closely after switching to ensure that the new treatment is effective and safe 6.