Lovenox

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Generic Name: Lovenox Brand Name(s): Generics only. No brands available.

Uses

What is Lovenox® (enoxaparin) used for?

Lovenox® is an anticoagulant that helps prevent the formation of blood clots.

Lovenox® is used to treat or prevent a type of blood clot called deep vein thrombosis (DVT), which can lead to blood clots in the lungs (pulmonary embolism). A DVT can occur after certain types of surgery, or in people who are bed-ridden due to a prolonged illness.

Lovenox® is also used to prevent blood vessel complications in people with certain types of angina (chest pain) or heart attack.

Lovenox® may also be used for purposes not listed in this medication guide.

How should I take Lovenox® (enoxaparin)?

Lovenox® is usually given every day until your bleeding condition improves. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Lovenox® is injected under the skin or into a vein through an IV. You may be shown how to use injections at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

You should be sitting or lying down during the injection. Do not inject Lovenox® into a muscle.

Use a different place on your stomach each time you give an injection under the skin. Your care provider will show you the best places on your body to inject the medication. Do not inject into the same place two times in a row.

Prepare your dose in a syringe only when you are ready to give yourself an injection. Do not mix Lovenox® with other medications in the same IV. Do not use Lovenox® if it has changed colors or has particles in it. Call your pharmacist for new medication.

Use a disposable needle only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof “sharps” disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

Tell any doctor who treats you that you are using Lovenox®. If you need surgery or dental work, tell the surgeon or dentist ahead of time that you are using this medication.

While using Lovenox® your blood and your stool (bowel movement) may need to be tested often. Your nerve and muscle function may also need to be tested. Visit your doctor regularly.

How do I store Lovenox® (enoxaparin)?

Lovenox® is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Lovenox® in the bathroom or the freezer. There may be different brands of Lovenox® that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Lovenox® down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Lovenox® (enoxaparin)?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of Lovenox® or other medications.
  • You have any other illnesses, disorders, or medical conditions.

You should not use Lovenox® if you are allergic to enoxaparin, heparin, benzyl alcohol, or pork products, or if you have:

  • Active or uncontrolled bleeding
  • A low level of platelets in your blood after testing positive for a certain antibody while using Lovenox®.

Lovenox® may cause you to bleed more easily, especially if you have:

  • A bleeding disorder that is inherited or caused by disease
  • Hemorrhagic stroke
  • An infection of the lining of your heart (also called bacterial endocarditis)
  • Stomach or intestinal bleeding or ulcer
  • Recent brain, spine, or eye surgery

Lovenox® can cause a very serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural). This type of blood clot could cause long-term or permanent paralysis, and may be more likely to occur if:

  • You have a spinal cord injury.
  • You have a spinal catheter in place or if a catheter has been recently removed.
  • You have a history of spinal surgery or repeated spinal taps.
  • You have recently had a spinal tap or epidural anesthesia.
  • You are taking an NSAID (nonsteroidal anti-inflammatory drug)-ibuprofen (Advil, Motrin), naproxen (Aleve), diclofenac, indomethacin, meloxicam, and others.
  • You are using a blood thinner (warfarin, Coumadin) or other medicines to treat or prevent blood clots.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using Lovenox® during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Lovenox®. Lovenox® is pregnancy risk category B, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from Lovenox® (enoxaparin)?

Get emergency medical help if you have any of these signs of an allergic reaction to Lovenox®: hives; itching or burning skin; difficulty breathing; swelling of your face, lips, tongue, or throat.

Also seek emergency medical attention if you have symptoms of a spinal blood clot: back pain, numbness or muscle weakness in your lower body, or loss of bladder or bowel control.

Call your doctor at once if you have:

  • Unusual bleeding (nose, mouth, vagina, or rectum), bleeding from wounds or needle injections, any bleeding that will not stop
  • Easy bruising, purple or red pinpoint spots under your skin
  • Pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating
  • Black or bloody stools, coughing up blood or vomit that looks like coffee grounds
  • Sudden weakness, severe headache, confusion, or problems with speech, vision, or balance
  • Trouble breathing

Common side effects may include:

  • Nausea, diarrhea
  • Fever
  • Swelling in your hands or feet
  • Mild pain, irritation, redness, or swelling where the medicine was injected

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Lovenox® (enoxaparin)?

Lovenox® may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Products that may interact with this drug are:

  • Abciximab, anagrelide, cilostazol, clopidogrel, dipyridamole, eptifibatide, ticlopidine, tirofiban
  • Alteplase, reteplase, tenecteplase, urokinase
  • Apixaban, argatroban, bivalirudin, dabigatran, desirudin, fondaparinux, lepirudin, rivaroxaban, tinzaparin
  • Heparin

Does food or alcohol interact with Lovenox® (enoxaparin)?

Lovenox® may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Lovenox® (enoxaparin)?

Lovenox® may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Health conditions that may interact with this drug are:

  • Kidney or liver disease
  • Uncontrolled high blood pressure
  • Eye problems caused by diabetes
  • Recent stomach ulcer
  • If you have ever had low blood platelets after receiving heparin

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using Lovenox® (enoxaparin).

What is the dose of Lovenox® (enoxaparin) for an adult?

Abdominal Surgery:

In patients undergoing abdominal surgery who are at risk for thromboembolic complications, the recommended dose is 40 mg once a day administered by SC injection with the initial dose given 2 hours prior to surgery.

The usual duration of administration is 7 to 10 days; up to 12 days administration has been administered in clinical trials.

Hip or Knee Replacement Surgery:

In patients undergoing hip or knee replacement surgery, the recommended dose is 30 mg every 12 hours administered by SC injection. Provided that hemostasis has been established, the initial dose should be given 12 to 24 hours after surgery.

For hip replacement surgery, a dose of 40 mg once a day SC, given initially 12 (±3) hours prior to surgery, may be considered. Following the initial phase of thromboprophylaxis in hip replacement surgery patients, it is recommended that continued prophylaxis with Lovenox® 40 mg once a day be administered by SC injection for 3 weeks. The usual duration of administration is 7 to 10 days; up to 14 days administration has been administered in clinical trials.

Medical Patients During Acute Illness:

In medical patients at risk for thromboembolic complications due to severely restricted mobility during acute illness, the recommended dose is 40 mg once a day administered by SC injection. The usual duration of administration is 6 to 11 days; up to 14 days of Lovenox® has been administered in the controlled clinical trial.

Treatment of Deep Vein Thrombosis with or without Pulmonary Embolism:

In outpatient treatment, patients with acute deep vein thrombosis without pulmonary embolism who can be treated at home, the recommended dose is 1 mg/kg every 12 hours administered SC.

In inpatient (hospital) treatment, patients with acute deep vein thrombosis with pulmonary embolism or patients with acute deep vein thrombosis without pulmonary embolism (who are not candidates for outpatient treatment), the recommended dose is 1 mg/kg every 12 hours administered SC or 1.5 mg/kg once a day administered SC at the same time every day.

In both outpatient and inpatient (hospital) treatments, warfarin sodium therapy should be initiated when appropriate (usually within 72 hours of Lovenox). Lovenox® should be continued for a minimum of 5 days and until a therapeutic oral anticoagulant effect has been achieved (International Normalization Ratio 2.0 to 3.0). The average duration of administration is 7 days; up to 17 days administration has been administered in controlled clinical trials.

Unstable Angina and Non-Q-Wave Myocardial Infarction:

In patients with unstable angina or non-Q-wave myocardial infarction, the recommended dose is 1 mg/kg administered SC every 12 hours in conjunction with oral aspirin therapy (100 to 325 mg once daily).

Treatment should be prescribed for a minimum of 2 days and continued until clinical stabilization.

The usual duration of treatment is 2 to 8 days; up to 12.5 days has been administered in clinical trials.

Treatment of Acute ST-Segment Elevation Myocardial Infarction:

In patients with acute ST-segment elevation myocardial infarction, the recommended dose is a single IV bolus of 30 mg plus a 1 mg/kg SC dose followed by 1 mg/kg administered SC every 12 hours (maximum 100 mg for the first two doses only, followed by 1 mg/kg dosing for the remaining doses).

Dosage adjustments are recommended in patients ≥75 years of age. All patients should receive aspirin as soon as they are identified as having STEMI and maintained with 75 to 325 mg once daily unless contraindicated.

What is the dose of Lovenox® (enoxaparin) for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Lovenox® (enoxaparin) available?

Lovenox® is available in the following dosage forms and strengths:

  • Injection: enoxaparin sodium 30mg in 0.3Ml

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Lovenox®, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: July 26, 2017 | Last Modified: August 4, 2017

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