From the Research
For a 125 kg male requiring VTE prophylaxis with enoxaparin, the recommended dose is 40 mg subcutaneously once daily, as standard prophylactic dosing is typically maintained even for obese patients 1.
Key Considerations
- The injection should be administered at the same time each day, typically in the abdominal area, at least 2 inches away from the navel or any scars.
- Prior to initiating therapy, baseline complete blood count and renal function should be assessed, as dose adjustment may be needed in patients with severe renal impairment (creatinine clearance <30 mL/min) 2.
- Monitor for signs of bleeding during treatment, as the risk of bleeding is a concern in patients with higher body weight 3.
Mechanism of Action
- Enoxaparin works by enhancing antithrombin III activity and inhibiting factor Xa, thereby preventing the conversion of prothrombin to thrombin and reducing clot formation.
Dosing Considerations
- While some clinicians may consider dose adjustment for patients with higher body weight, the most recent and highest quality study suggests that standard prophylactic dosing is typically maintained even for obese patients 1.
- Weight-based dosing of enoxaparin for VTE prophylaxis in morbidly obese, medically-ill patients has been studied, and a dose of 0.5 mg/kg once daily has been suggested as a feasible option 4. However, this is not the most recent or highest quality study, and therefore, the standard prophylactic dose of 40 mg subcutaneously once daily is recommended.