From the Guidelines
Antepartum Dose of Lovenox (Enoxaparin) for History of Pulmonary Embolism (PE)
The antepartum dose of Lovenox (enoxaparin) for a history of pulmonary embolism (PE) is 40 mg once daily [ 1 ].
- This dose is recommended for pregnant women at increased risk, including those with a previous unprovoked VTE, such as PE [ 1 ].
- The use of low-molecular-weight heparin, such as enoxaparin, is preferred over warfarin for both prevention and treatment of VTE in pregnant patients [ 1 ].
- It is essential to note that the dose may need to be adjusted based on patient weight and renal function, and anticoagulation therapy should be continued throughout pregnancy and postpartum [ 1 ].
- For patients with a history of PE, antepartum prophylaxis is suggested, and the recommended dose of enoxaparin is 40 mg once daily [ 1 ].
- Postpartum prophylaxis for 6 weeks with prophylactic dose LMWH or warfarin with a goal INR of 2.0 to 3.0 is also recommended for pregnant women with previous VTE [ 1 ].
From the Research
Antepartum Dose of Lovenox (Enoxaparin) for History of Pulmonary Embolism (PE)
- The antepartum dose of Lovenox (enoxaparin) for a history of pulmonary embolism (PE) is not explicitly stated in the provided studies.
- However, according to the study 2, for pregnant women with a history of VTE, antepartum prophylactic low-molecular-weight heparin (LMWH) or unfractionated heparin (UFH) is recommended.
- The study 3 suggests that subcutaneous enoxaparin at a fixed dosage of 1.0 mg/kg twice daily or 1.5 mg/kg once daily is as effective as continuously infused unfractionated heparin in acute symptomatic venous thromboembolic disease.
- The study 4 investigated the efficacy and safety of extended enoxaparin monotherapy in symptomatic patients with acute pulmonary embolism (PE) and found that extended enoxaparin monotherapy is feasible and warrants further investigation in a large clinical trial.
- The study 5 tested enoxaparin monotherapy without oral anticoagulation to treat acute symptomatic pulmonary embolism and found that it is feasible and warrants further study in a large clinical trial.
- The study 6 compared once daily versus twice daily enoxaparin for acute pulmonary embolism in cancer patients and found that cancer patients receiving once daily enoxaparin may be at increased risk of recurrent PE and clinically overt bleeding.
Dosage Considerations
- The dosage of enoxaparin for pregnant women with a history of PE is not explicitly stated in the provided studies.
- However, based on the studies 3 and 4, a possible dosage could be 1.0 mg/kg twice daily or 1.5 mg/kg once daily, but this should be determined by a healthcare professional based on individual patient needs and medical history 2, 6, 4, 3, 5.