Clexane

Enoxaparin Na

Deep vein thrombosis w/ or w/o pulmonary embolism; unstable angina & non-Q wave MI, administered concurrently w/ aspirin; acute ST-segment elevation MI including patients w/ subsequent percutaneous coronary intervention. Prophylaxis of venous thrombo-embolic diseases, in particular those which may be associated w/ orthopedic or general surgery; venous thrombo-embolism in medical patients bedridden due to acute illnesses including cardiac insufficiency, resp failure, severe infections, rheumatic diseases; prevention of thrombus formation in extracorporeal circulation during hemodialysis.

Prophylaxis of venous thrombosis in surgical patient Patient w/ moderate risk of thromboembolism 20 or 40 mg SC once daily. Give 1st inj 2 hr before surgical procedure. Patient w/ high risk of thromboembolism 40 mg SC once daily, initiated 12 hr pre-op or 30 mg bid, initiated 12-24 hr after surgery. Ave duration: 7-10 days. May continue therapy as long as there is venous thrombo-embolism risk & until patient is ambulatory eg, 40 mg once daily for 3 wk in orthopedic surgery. Prophylaxis of venous thrombo-embolism in medical patient 40 mg SC once daily for a min of 6 days & continued until return to full ambulation. Max: 14 days. DVT w/ or w/o pulmonary embolism 1.5 mg/kg SC once daily or 1 mg/kg SC bid. Patient w/ complicated thrombo-embolic disorders 1 mg/kg SC bid. Ave duration: 10 days. Initiate oral anticoagulant therapy when appropriate & continue treatment until therapeutic anticoagulant effect has been achieved (INR 2-3). Prevention of extracorporeal thrombus during hemodialysis 1 mg/kg introduced into the arterial line of the circuit prior to hemodialysis, sufficient for a 4-hr session. Additional dose of 0.5-1 mg/kg may be given if fibrin rings are found eg, after longer sessions. Patient w/ high risk of hemorrhage Reduced dose to 0.5 mg/kg for double vascular access or 0.75 mg/kg for single vascular access. Unstable angina & non-Q-wave MI 1 mg/kg SC every 12 hr w/ aspirin PO (100-325 mg once daily) for min of 2 days & continued until clinical stabilization (usual duration: 2-8 days). Acute ST-segment elevation MI 30 mg single IV bolus + 1 mg/kg SC followed by 1 mg/kg SC every 12 hr. Max: 100 mg for 1st 2 doses only, followed by 1 mg/kg SC for the remaining doses. Give 15 min before & 30 min after start of fibrinolytic therapy when administered in conjunction w/ a fibrin/non-fibrin specific thrombolytic. Recommended duration: 8 days or until hospital discharge, whichever comes first. Elderly ≥75 yr Initially 0.75 mg/kg SC every 12 hr (max: 75 mg for 1st 2 doses only, followed by 0.75 mg/kg SC for the remaining doses). Patient managed w/ percutaneous coronary intervention Last enoxaparin Na SC administration given <8 hr before balloon inflation: no additional dosing needed. Last SC administration given >8 hr before balloon inflation: Administer 0.3 mg/kg IV bolus of enoxaparin Na. Severe renal impairment 1 mg/kg SC once daily. Acute STEMI in patient ≥75 yr 1 mg/kg SC once daily w/o initial bolus. Max: 100 mg for 1st SC dose. Acute STEMI in patient <75 yr 30 mg single IV bolus + 1 mg/kg SC, followed by 1 mg/kg SC once daily. Max: 100 mg for 1st SC dose. Prophylaxis 20 mg SC once daily.

Hypersensitivity to enoxaparin Na, heparin or its derivatives including other LMWH. History of immune mediated heparin induced thrombocytopenia (HIT) w/in the past 100 days or in the presence of circulating antibodies. Active major bleeding & conditions w/ a high risk of uncontrolled hemorrhage including hemorrhagic stroke.

Concurrent use of spinal/epidural anaesth, patients w/ a history of spinal surgery or spinal deformity; history of heparin-induced thrombocytopenia w/ or w/o thrombosis. Hemorrhage; impaired hemostasis; history of peptic ulcer; recent ischemic stroke; uncontrolled severe arterial HTN; diabetic retinopathy; recent neuro- or ophth surgery. Patients w/ mechanical prosthetic heart valves. Monitor platelet counts before & during treatment; discontinue use & switch to another therapy w/ significant decrease of platelets (30-50% of initial values). Do not administer by IM route. Renal impairment. Pregnancy & lactation; pregnant women w/ mechanical prosthetic heart valves. Elderly; low-wt women (<45 kg) & low-wt men (<57 kg); obese patients.

Haemorrhage; thrombocytosis. Thrombocytopenia. Increase hepatic enzyme. Allergic reaction; urticaria, pruritus, erythema; inj site haematoma, inj site pain, other inj site reaction.

Discontinue use w/ agents that affect hemostasis eg, systemic salicylates, acetylsalicylic acid & NSAIDs including ketorolac, dextran 40, ticlopidine & clopidogrel, systemic glucocorticoids, thrombolytics & anticoagulants, other antiplatelet agents including glycoprotein IIb/IIIa antagonists. If co-administration is essential, use w/ careful clinical & laboratory monitoring when appropriate.

Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)

B01AB05 - enoxaparin ; Belongs to the class of heparin group. Used in the treatment of thrombosis.

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