From the Research
Clexane (enoxaparin) can affect INR (International Normalized Ratio) values, as evidenced by a significant increase in post-operative INR levels in patients receiving enoxaparin for post-operative VTE prophylaxis. This is in contrast to the traditional understanding that low molecular weight heparins like enoxaparin do not impact INR values. The study published in the Journal of Surgical Oncology in 2018 1 found that patients who received enoxaparin had higher mean post-operative INR levels compared to the control group, suggesting a potential effect of enoxaparin on INR.
Mechanism of Action
Clexane works by inhibiting factor Xa and thrombin in the coagulation cascade, which is different from medications like warfarin that directly affect the vitamin K-dependent clotting factors measured by the INR test.
Clinical Implications
For patients taking Clexane, it is essential to monitor for signs of bleeding or bruising, even if INR measurements are not directly affected. If monitoring of Clexane's activity is needed, an anti-Xa assay would be used instead of INR monitoring.
Key Points
- Clexane can increase post-operative INR levels
- Clexane works by inhibiting factor Xa and thrombin
- INR monitoring is not typically used to guide Clexane dosing
- Anti-Xa assay is used to monitor Clexane activity if needed
- Patients taking Clexane should be monitored for signs of bleeding or bruising, regardless of INR measurements.