From the Guidelines
Lovenox (enoxaparin) is typically administered subcutaneously at a dose of 1 mg/kg every 12 hours for the treatment of acute coronary syndromes, as recommended by the 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes 1.
Administration Frequency
The frequency of Lovenox administration depends on the specific condition being treated and the patient's renal function.
- For patients with normal renal function, the recommended dose is 1 mg/kg every 12 hours.
- For patients with impaired renal function (CrCl <30 mL per minute), the dose should be reduced to 1 mg/kg once daily, as stated in the 2014 AHA/ACC guideline 1.
Dosing Considerations
Dosing may be adjusted based on kidney function, body weight, and bleeding risk.
- The medication is given as a subcutaneous injection, usually in the abdomen.
- Patients should rotate injection sites and avoid the 2-inch area around the navel to minimize bruising.
Clinical Evidence
The ESSENCE trial demonstrated that enoxaparin therapy significantly reduced the rates of recurrent ischemic events and invasive diagnostic and therapeutic procedures in patients with unstable angina or non-Q-wave myocardial infarction 1.
Renal Function Consideration
It is essential to calculate the creatinine clearance (CrCl) in patients considered for enoxaparin therapy, especially in older patients, as impaired renal function is a common finding in this population 1.
- The 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction also recommends adjusting the dose of enoxaparin based on renal function, with a reduced dose of 1 mg/kg every 24 hours for patients with CrCl <30 mL/min 1.
From the Research
Administration Frequency of Lovenox (Enoxaparin)
- The administration frequency of Lovenox (enoxaparin) varies depending on the patient's condition and the specific treatment regimen.
- According to the studies, enoxaparin can be administered once daily (o.d.) or twice daily (b.i.d.) in doses ranging from 20-60 mg o.d. and 0.75-1.5 mg/kg b.i.d. 2.
- In some cases, enoxaparin is administered at a fixed dose of 40 mg once daily, as seen in the prevention of venous thromboembolism after acute ischemic stroke 3.
- Other studies have used doses of 1.5 mg/kg subcutaneously once daily for the treatment of deep-vein thrombosis 4, 5.
- The frequency of administration can also depend on the specific indication, such as prevention of deep vein thrombosis in elective cancer surgery, where enoxaparin is administered 40 mg once daily 6.
Specific Administration Frequencies
- Once daily: 40 mg subcutaneously once daily for prevention of venous thromboembolism after acute ischemic stroke 3, 1.5 mg/kg subcutaneously once daily for treatment of deep-vein thrombosis 4, 5.
- Twice daily: 0.75-1.5 mg/kg subcutaneously twice daily for treatment of venous and arterial thromboembolism 2.