From the Guidelines
Enoxaparin is indicated for the prevention and treatment of various thromboembolic disorders, including deep vein thrombosis (DVT), pulmonary embolism, unstable angina, and non-ST-elevation myocardial infarction (NSTEMI), as well as for the prevention of DVT in patients undergoing high-risk surgeries or with restricted mobility 1.
Key Indications
- Prevention of DVT in patients undergoing orthopedic, abdominal, or other high-risk surgeries
- Prevention of DVT in medically ill patients with restricted mobility
- Treatment of acute DVT with or without pulmonary embolism
- Treatment of unstable angina and NSTEMI
Dosage and Administration
- Typical prophylactic dose: 40mg subcutaneously once daily
- Treatment doses: weight-based, usually 1mg/kg twice daily or 1.5mg/kg once daily
- Dosage adjustments necessary for patients with severe renal impairment (creatinine clearance <30 mL/min) and for elderly patients
Mechanism of Action
- Enoxaparin works by binding to antithrombin III, enhancing its inhibitory effect on coagulation factors Xa and IIa
- Offers advantages over unfractionated heparin, including more predictable pharmacokinetics, longer half-life, and lower risk of heparin-induced thrombocytopenia
Important Considerations
- Regular monitoring of platelet counts and signs of bleeding is important during treatment
- Enoxaparin may be considered as an alternative to unfractionated heparin in patients with STEMI undergoing PCI, but patients initially treated with enoxaparin should not be switched to UFH and vice versa to avoid increased risk of bleeding 1
From the Research
Indications for Enoxaparin
Enoxaparin is indicated for the prevention and treatment of various thromboembolic disorders. The following are some of the specific indications:
- Prevention of deep vein thrombosis (DVT) in medically ill patients at increased risk for thromboembolism 2
- Prevention of DVT and pulmonary embolism in patients undergoing major orthopedic surgery, such as hip and knee replacement surgery 3, 4
- Treatment of established DVT 4, 5
- Prevention of coagulation of extracorporeal circulation in patients undergoing haemodialysis 4
Patient Populations
Enoxaparin is effective in various patient populations, including:
- Medically ill patients at increased risk for thromboembolism 2
- Patients undergoing major orthopedic surgery, such as hip and knee replacement surgery 3, 4
- Patients with acute venous thrombosis 5
- Patients undergoing haemodialysis 4
Dosage and Administration
The dosage and administration of enoxaparin vary depending on the specific indication and patient population. For example: