Enoxaparin Other names: Enoxaparin sodium

Therapeutic indications

Enoxaparin is indicated for:

Prophylaxis of venous thromboembolic disease in moderate and high risk surgical patients

Population group: only adults (18 years old or older)

Prophylaxis of venous thromboembolic disease in moderate and high risk surgical patients, in particular those undergoing orthopaedic or general surgery including cancer surgery.

For this indication, competent medicine agencies globally authorize below treatments (click for details):

2,000 IU (20 mg) or 4,000 IU (40 mg) once daily for patients at moderate or high risk of thromboembolism respectively

Prophylaxis of venous thromboembolic disease in medical patients with an acute illness

Population group: only adults (18 years old or older)

Prophylaxis of venous thromboembolic disease in medical patients with an acute illness (such as acute heart failure, respiratory insufficiency, severe infections or rheumatic diseases) and reduced mobility at increased risk of venous thromboembolism.

For this indication, competent medicine agencies globally authorize below treatments (click for details):

4,000 IU (40 mg) once daily for 6-14 days

Deep vein thrombosis (DVT), pulmonary embolism (PE)

Population group: only adults (18 years old or older)

Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), excluding PE likely to require thrombolytic therapy or surgery.

For this indication, competent medicine agencies globally authorize below treatments (click for details):

150 IU/kg (1.5 mg/kg) once daily or 100 IU/kg (1 mg/kg) twice daily

Prevention of thrombus formation in extra corporeal circulation during haemodialysis

Population group: only adults (18 years old or older)

Thrombosis and additionally Hemodialysis procedure

For this indication, competent medicine agencies globally authorize below treatments (click for details):

100 IU/kg (1 mg/kg) once

Unstable angina and Non ST-segment elevation myocardial infarction (NSTEMI)

Population group: only adults (18 - 65 years old)

Acute coronary syndrome:

Treatment of unstable angina and Non ST-segment elevation myocardial infarction (NSTEMI), in combination with oral acetylsalicylic acid.

For this indication, competent medicine agencies globally authorize below treatments (click for details):

100 IU/kg (1 mg/kg) in combination with antiplatelet therapy every 12 hours for 2-8 days

Acute coronary syndrome

Population group: only elderly (65 years old or older)

Acute coronary syndrome:

Treatment of unstable angina and Non ST-segment elevation myocardial infarction (NSTEMI), in combination with oral acetylsalicylic acid.
Treatment of acute ST-segment elevation myocardial infarction (STEMI) including patients to be managed medically or with subsequent percutaneous coronary intervention (PCI).

For this indication, competent medicine agencies globally authorize below treatments (click for details):

75 IU/kg (0.75 mg/kg) SC every 12 hours

Acute ST-segment elevation myocardial infarction (STEMI)

Population group: only adults (18 - 65 years old)

Treatment of acute ST-segment elevation myocardial infarction (STEMI) including patients to be managed medically or with subsequent percutaneous coronary intervention (PCI).

For this indication, competent medicine agencies globally authorize below treatments (click for details):

A single intravenous bolus of 3,000 IU (30 mg) plus a 100 IU/kg (1 mg/kg) SC dose followed by 100 IU/kg (1 mg/kg) administered SC every 12 hours

Deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients with active cancer

Population group: only adults (18 years old or older)

Extended treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) and prevention of its recurrence in patients with active cancer.

For this indication, competent medicine agencies globally authorize below treatments (click for details):

100 IU/kg (1 mg/kg) twice daily for 5-10 days and thereafter 150 IU/kg (1.5 mg/kg) once daily for up to 6 months

Contraindications

Enoxaparin is contraindicated in the following cases:

Active clinically significant bleeding and conditions with a high risk of haemorrhage

at least one of

Bleeding
At risk of hemorrhage
Gastrointestinal ulcer
Renal vascular disorder
Vascular graft aneurysm
Intracerebral vascular finding
Esophageal varices
Cerebral hemorrhage
Surgical procedure on eye proper

Hypersensitivity to enoxaparin or heparin

at least one of

Enoxaparin allergy
Heparin allergy

History of immune mediated heparin-induced thrombocytopenia within the past 100 days, heparin antibodies

at least one of

Heparin-induced thrombocytopenia
Heparin antibody

Spinal anaesthesia, epidural anaesthesia, loco-regional anaesthesia

at least one of

Spinal block
Epidural anesthesia
Regional anesthesia

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