II. Dosing: Prophylactic Dose

  1. Creatinine Clearance (CrCl) >30 ml/min AND Weight 40-150 kg
    1. Enoxaparin (Lovenox) 40 mg SQ daily
  2. Creatinine Clearance (CrCl) >30 ml/min AND Weight >150 kg (or BMI 40 of higher)
    1. Enoxaparin (Lovenox) 40 mg SQ twice daily
  3. Creatinine Clearance (CrCl) 15-30 ml/min (or weight <40 kg)
    1. Enoxaparin (Lovenox) 30 mg SQ daily
  4. Creatinine Clearance (CrCl) <15 ml/min
    1. Enoxaparin (Lovenox) is contraindicated
    2. Use unfractionated heaprin 5000 units SQ every 8-12 hours

III. Dosing: Therapeutic Dose

  1. Creatinine Clearance (CrCl) >30 ml/min
    1. Enoxaparin (Lovenox) 1 mg/kg SQ every 12 hours
  2. Creatinine Clearance (CrCl) 15-30 ml/min (or weight <40 kg)
    1. Unfractionated Heparin is preferred
    2. As an alternative, Enoxaparin (Lovenox) 1 mg/kg SQ once daily for up to 7 days
  3. Creatinine Clearance (CrCl) <15 ml/min
    1. Enoxaparin (Lovenox) is contraindicated
    2. Use unfractionated heaprin 5000 units SQ every 8-12 hours

IV. References

  1. Dummer (2009) Perioperative Guidelines
  2. Douketis (2008) Chest 133(6 Suppl):299S-339S [PubMed]

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Cost: Medications

enoxaparin (on 8/17/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
ENOXAPARIN 100 MG/ML SYRINGE Generic $15.61 per ml
ENOXAPARIN 120 MG/0.8 ML SYR Generic $23.65 per ml
ENOXAPARIN 150 MG/ML SYRINGE Generic $27.93 per ml
ENOXAPARIN 30 MG/0.3 ML SYR Generic $19.19 per ml
ENOXAPARIN 40 MG/0.4 ML SYR Generic $17.47 per ml
ENOXAPARIN 60 MG/0.6 ML SYR Generic $16.52 per ml
ENOXAPARIN 80 MG/0.8 ML SYR Generic $15.34 per ml

Ontology: Enoxaparin (C0206460)

Definition (NCI_NCI-GLOSS) A drug used to prevent blood clots. It belongs to the family of drugs called anticoagulants.
Definition (NCI) A low molecular weight, synthetic heparin. As an anticoagulant/antithrombotic agent, enoxaprin's mechanism of action is similar to that of heparin, although it exhibits a higher ratio of anti-Factor Xa to anti-Factor IIa activity. This agent also has anti-inflammatory properties, inhibiting monocyte adhesion to tumor necrosis factor alpha- or lipopolysaccharide-activated endothelial cells. Compared to unfractionated heparins, the use of enoxaparin is associated with lower incidences of osteoporosis and heparin-induced thrombocytopenia. (NCI04)
Definition (MSH) Low-molecular-weight fragment of heparin, having a 4-enopyranosuronate sodium structure at the non-reducing end of the chain. It is prepared by depolymerization of the benzylic ester of porcine mucosal heparin. Therapeutically, it is used as an antithrombotic agent. (From Merck Index, 11th ed)
Definition (PDQ) A low molecular weight, synthetic heparin. As an anticoagulant/antithrombotic agent, enoxaprin's mechanism of action is similar to that of heparin, although it exhibits a higher ratio of anti-Factor Xa to anti-Factor IIa activity. This agent also has anti-inflammatory properties, inhibiting monocyte adhesion to tumor necrosis factor alpha- or lipopolysaccharide-activated endothelial cells. Compared to unfractionated heparins, the use of enoxaparin is associated with lower incidences of osteoporosis and heparin-induced thrombocytopenia. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=37880&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=37880&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1452" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Carbohydrate (T118)
MSH D017984
SnomedCT 108984007, 372562003
English Enoxaparin, Enoxaparine, enoxaparin (medication), Enoxaparin [Chemical/Ingredient], enoxaparine, ENOXAPARIN, enoxaparin, Enoxaparin (product), Enoxaparin (substance)
Swedish Enoxaparin
Czech enoxaparin
Finnish Enoksapariini
Italian Enoxaparine, Enoxaparina
Russian ENOKSAPARIN, ЭНОКСАПАРИН
Japanese エノキサパリン
Polish Enoksaparyna
Croatian Enoksaparin
Spanish enoxaparina (producto), enoxaparina (sustancia), enoxaparina, Enoxaparina
French Énoxaparine
German Enoxaparin
Portuguese Enoxaparina

Ontology: Lovenox (C0728963)

Definition (CHV) brand name of enoxaparin
Definition (CHV) brand name of enoxaparin
Concepts Pharmacologic Substance (T121) , Carbohydrate (T118)
MSH D017984
English Lovenox [brand name], Lovenox