From the Guidelines
Enoxaparin Classification
Enoxaparin is a form of low-molecular weight heparin 1, derived from unfractionated heparin.
- It has a distinct pharmacological profile, with greater activity against Factor Xa than thrombin 1.
- The 4:1 ratio of Factor Xa: thrombin activity in enoxaparin 1 contributes to its anticoagulant effects.
- Compared to unfractionated heparin, enoxaparin has reduced binding to plasma proteins, resulting in a more predictable anticoagulant effect 1.
- Enoxaparin's longer half-life and delayed clearance in renal dysfunction 1 are key considerations in its clinical use.
- As a low-molecular weight heparin, enoxaparin is often preferred over unfractionated heparin due to its more predictable pharmacokinetic profile and lower risk of major bleeding complications.
From the Research
Definition of Enoxaparin
- Enoxaparin is a low molecular weight heparin (LMWH) 2, 3, 4, 5
- It is used as an anticoagulant to prevent the formation of blood clots 3, 5
Comparison with Unfractionated Heparin (UFH)
- Enoxaparin has a higher ratio of anti-Xa to anti-IIa activity compared to UFH 4
- It has a more consistent release of tissue factor pathway inhibitor and weaker interactions with platelets compared to UFH 4
- Enoxaparin has a higher bioavailability and a longer plasma half-life compared to UFH 4
- It does not require laboratory monitoring and can be administered once daily, unlike UFH which requires routine monitoring of the activated partial thromboplastin time 2, 4
Clinical Use of Enoxaparin
- Enoxaparin is used in the treatment of acute coronary syndromes, including unstable angina and non-ST-elevation myocardial infarction 2, 5
- It is also used in the treatment of ST-elevation myocardial infarction, with or without percutaneous coronary intervention 3
- Enoxaparin has been shown to be effective in reducing cardiovascular events and mortality in patients with acute coronary syndromes 2, 3, 5