Enoxaparin

Enoxaparin sodium is a low molecular weight heparin (LMWH) indicated for: Prophylaxis of deep vein thrombosis (DVT) in abdominal surgery, hip replacement surgery, knee replacement surgery, or medical patients with severely restricted mobility during acute illness. Inpatient treatment of acute DVT with or without pulmonary embolism. Outpatient treatment of acute DVT without pulmonary embolism. Prophylaxis of ischemic complications of unstable angina and non–Q-wave myocardial infarction (MI). Treatment of acute ST-segment elevation myocardial infarction (STEMI) managed medically or with subsequent percutaneous coronary intervention (PCI)

Enoxaparin is a low molecular weight heparin which has antithrombotic properties.

See full prescribing information for dosing and administration information. Pretreatment Evaluation Evaluate all patients for a bleeding disorder before starting enoxaparin sodium treatment, unless treatment is urgently needed.

Enoxaparin sodium is contraindicated in patients with: Active major bleeding History of immune-mediated heparin-induced thrombocytopenia (HIT) within the past 100 days or in the presence of circulating antibodies Known hypersensitivity to enoxaparin sodium (e.g., pruritus, urticaria, anaphylactic/anaphylactoid reactions) Known hypersensitivity to heparin or pork products Known hypersensitivity to benzyl alcohol (which is in only the multiple-dose formulation of enoxaparin sodium) Active major bleeding. History of heparin-induced thrombocytopenia (HIT) within the past 100 days or in the presence of circulating antibodies. Hypersensitivity to enoxaparin sodium.

Boxed warning (spinal/epidural hematomas): Epidural or spinal hematomas may occur in patients who are anticoagulated with low molecular weight heparins (LMWH) or heparinoids and are receiving neuraxial anesthesia or undergoing spinal puncture. These hematomas may result in long-term or permanent paralysis. Consider these risks when scheduling patients for spinal procedures. Increased Risk of Hemorrhage: Monitor for signs of bleeding. Risk of Heparin-Induced Thrombocytopenia with or without Thrombosis. Thrombocytopenia: Monitor platelet count closely. Interchangeability with other heparins: Do not exchange with heparin or other LMWHs. Increased Risk of Thrombosis in Pregnant Women with Mechanical Prosthetic Heart Valves: Women and their fetuses may be at increased risk. Monitor more frequently and adjust dosage as needed.

The following serious adverse reactions are also discussed in other sections of the labeling: Spinal/epidural hematomas Increased Risk of Hemorrhage Thrombocytopenia Most common adverse reactions (>1%) were bleeding, anemia, thrombocytopenia, elevation of serum aminotransferase, diarrhea, nausea, ecchymosis, fever, edema, peripheral edema, dyspnea, confusion, and injection site pain.

Whenever possible, agents which may enhance the risk of hemorrhage should be discontinued prior to initiation of enoxaparin sodium therapy. These agents include medications such as: anticoagulants, platelet inhibitors including acetylsalicylic acid, salicylates, NSAIDs (including ketorolac tromethamine), dipyridamole, or sulfinpyrazone. If coadministration is essential, conduct close clinical and laboratory monitoring. Discontinue agents which may enhance hemorrhage risk prior to initiation of enoxaparin sodium or conduct close clinical and laboratory monitoring.

Store at 25°C (77°F), excursions permitted to 15°C–30°C (59°F–86°F). Store in the original carton or packaging until ready to use. Do not store the multiple-dose vials for more than 28 days after the first use.