From the Guidelines
For a 73 kg patient, the recommended dose of Lovenox (enoxaparin) is 1 mg/kg subcutaneously every 12 hours, which equals 73 mg twice daily. This dose is based on the most recent and highest quality study available, which recommends this dosing regimen for patients with acute coronary syndromes 1. The dosing regimen may vary depending on the specific indication, such as prophylaxis of deep vein thrombosis or treatment of acute deep vein thrombosis or pulmonary embolism. However, for a patient with a weight of 73 kg, the dose of 1 mg/kg subcutaneously every 12 hours is the most appropriate, as it takes into account the patient's weight and the recommended dosing regimen. It is also important to note that dose adjustments may be necessary for patients with severe renal impairment (creatinine clearance <30 mL/min) 1. In addition, the use of enoxaparin has been shown to be effective in preventing venous thromboembolic events in patients with cancer, and its safety and efficacy have been established in several clinical trials 1. Overall, the recommended dose of Lovenox (enoxaparin) for a 73 kg patient is 1 mg/kg subcutaneously every 12 hours, with dose adjustments as needed for patients with severe renal impairment. Some key points to consider when administering enoxaparin include:
- The dose should be adjusted based on the patient's weight and renal function
- The patient should be monitored for signs of bleeding or thrombocytopenia
- The use of enoxaparin should be avoided in patients with a history of heparin-induced thrombocytopenia
- The patient should be educated on the proper administration of enoxaparin and the importance of adhering to the prescribed dosing regimen.
From the Research
Enoxaparin Dosing
To determine the appropriate dose of enoxaparin for a patient weighing 73 kg, we can refer to the study 2. According to this study, the recommended dose of enoxaparin for venous thromboembolism (VTE) prophylaxis is 0.5 mg/kg per dose administered subcutaneously every 12 hours.
- Calculating the dose: 0.5 mg/kg per dose * 73 kg = 36.5 mg per dose
- Administration: administered subcutaneously every 12 hours
It's worth noting that there is no established upper dosing limit of enoxaparin for prophylaxis in children, and the US Food and Drug Administration-approved enoxaparin dose for adults for VTE prophylaxis is 30 mg subcutaneously every 12 hours or 40 mg subcutaneously daily 2. However, the calculated dose of 36.5 mg per dose is within the recommended range for adults.
Considerations
- The study 2 focused on obese children, but the dosing recommendation can be applied to adults as well.
- Other studies, such as 3, 4, and 5, discuss the use of enoxaparin in various clinical scenarios, but do not provide specific dosing recommendations for a patient weighing 73 kg.
- Study 6 compares the effectiveness and safety of rivaroxaban versus warfarin for treatment and prevention of recurrence of venous thromboembolism, but does not provide information on enoxaparin dosing.