Clexane Drug Interactions

Clinical trials revealed no adverse effects that could be caused by drug interactions.
It is recommended that agents which affect haemostasis should be discontinued prior to enoxaparin therapy unless strictly indicated. These agents include medications eg, anticoagulants, thrombolytics, nonsteroidal anti-inflammatory agents (including ketorolac), preparations containing acetylsalicylic acid, systemic salicylates, ticlopidine, dextran 40, or systemic glucocorticoids. If the combination is indicated, Clexane should be used with careful clinical and laboratory monitoring of the haemostatic factors, when appropriate.
Spinal/Epidural Anaesthesia: As with other anticoagulants, there have been rare cases of intraspinal haematomas reported with the concurrent use of enoxaparin and spinal/epidural anaesthesia resulting in long-term or permanent paralysis. The risk of these rare events may be higher with the use of postoperative indwelling epidural catheters.
Monitoring of Platelet Count: The risk of antibody-mediated heparin-induced thrombocytopaenia also exists with low molecular weight heparins. Should thrombocytopaenia occur, it usually appears between the 5th and the 21st day following the beginning of enoxaparin treatment. Therefore, it is recommended that the platelet counts be measured before initiation of therapy with enoxaparin and then regularly thereafter during the treatment. In practice, if a confirmed significant decrease of the platelet count is observed (30-50% of the initial value), enoxaparin treatment must be immediately discontinued and the patient switched to another therapy.