Enoxaparin Injection: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Enoxaparin Injection (enoxaparin sodium) is a low molecular weight heparin (LMWH) anticoagulant, or blood thinner, used to prevent and treat harmful blood clots. It is used after certain surgeries, in patients with restricted mobility, for deep vein thrombosis and pulmonary embolism, and in certain heart conditions. It works by blocking factor Xa, a substance needed for blood clotting.

What is Enoxaparin Injection

Enoxaparin is an anticoagulant medicine, also known as a blood thinner. It is a type of heparin that is used to prevent and treat harmful blood clots.

Enoxaparin Injection uses

• Prevention of deep vein thrombosis (DVT) after hip replacement, knee replacement, or abdominal surgery
• Prevention of DVT in medical patients with severely restricted mobility during acute illness
• Treatment of acute deep vein thrombosis with or without pulmonary embolism (used with warfarin)
• Prevention of complications from unstable angina and certain types of heart attack (non-Q-wave myocardial infarction), used with aspirin
• Treatment of acute ST-segment elevation heart attack (STEMI), managed medically or with a procedure to open blocked arteries (PCI)

Benefits of Enoxaparin Injection

• Helps reduce the risk of stroke or heart attack by preventing harmful blood clots
• Reduces the risk of blood clots forming after certain surgeries

How Enoxaparin Injection works

Enoxaparin works by blocking a substance in the blood called factor Xa, which is needed for blood to clot. This helps keep the blood flowing smoothly and lowers the activity of clotting proteins.

Enoxaparin Injection dosage

This medicine is injected under the skin (subcutaneously), usually once or twice a day, in the stomach area at least 2 inches away from the belly button. Do not inject into a muscle. Change the injection site each time between the left and right sides of the abdomen to lessen injury under the skin. To lessen bruising, do not rub the injection site after the injection.

Check the liquid before use; do not use if it is discolored, cloudy, or contains particles. Do not remove any air bubbles from the prefilled syringe before injecting, as this can cause loss of medicine. It may also be given as an injection into a vein by a healthcare professional.

Use this medicine regularly, at the same time each day, to get the most benefit. Patients may self-inject only after their doctor determines it is appropriate and provides proper training.

Available forms and strengths

• Injection (prefilled syringes)
• Tablet
• Gel

Side effects of Enoxaparin Injection

Common

• Mild irritation, pain, bruising, redness, and swelling at the injection site
• Tiredness
• Fever
• Stomach discomfort
• Nausea
• Rash
• Increase in liver enzymes
• Increase in blood platelet count
• Back pain
• Dizziness
• Fast heartbeat
• Diarrhoea

Serious

• Unusual pain, swelling, or discomfort
• Unusual or prolonged bleeding
• Unusual or easy bruising
• Dark urine
• Black stools
• Severe headache
• Confusion
• Vision changes
• Unusual dizziness
• Fainting
• Seizures
• Weakness
• Numbness
• Bleeding gums
• Increased menstrual flow
• Collection of blood under the skin
• Swollen ankles or feet
• Blood in urine
• Signs of a serious allergic reaction such as rash, itching or swelling of the face, tongue, or throat, severe dizziness, or trouble breathing

Warnings and precautions

• This medicine is generally not recommended during pregnancy and should be used only if clearly needed. Your doctor will weigh the benefits and risks before prescribing it.
• It is not known if this medicine passes into breast milk. Talk to your doctor before breastfeeding while using this medicine.
• This medicine may increase the risk of bleeding if you have kidney problems. Your doctor may need to adjust your dose or monitor you more closely.
• This medicine should be used with caution if you have liver problems, as it may increase liver enzyme levels and the risk of bleeding.
• Limit alcohol while using this medicine because it may increase the risk of stomach bleeding.
• People using this medicine may bleed near the spinal cord after certain spinal procedures such as epidural anesthesia or spinal puncture. This bleeding can cause long-lasting or permanent paralysis.
• The risk of spinal bleeding is higher if you have a deformed spine, have had previous spinal procedures or surgery, or are taking other drugs that increase bleeding risk, such as antiplatelet drugs, other blood thinners, or NSAIDs like ibuprofen.
• This medicine can cause serious bleeding, including major bleeding in the retroperitoneal area or brain, and some cases have been fatal.
• This medicine can cause a serious drop in platelet count called heparin-induced thrombocytopenia (HIT), which can lead to organ damage, limb problems, or death.
• This medicine cannot be swapped, unit for unit, with heparin or other low molecular weight heparins, since they are made differently and dosed differently.
• Pregnant women with mechanical prosthetic heart valves may be at higher risk of blood clots forming on the valve while using this medicine, which can lead to serious harm to the mother or baby.

Storage

• Store at room temperature away from light
• Store in the original carton or packaging until ready to use
• Discard the multiple dose vials 28 days after the first use
• Keep all medications away from children and pets
• Do not flush medications down the toilet or pour them into a drain unless instructed to do so
• Properly discard this product when it is expired or no longer needed

When to see a doctor

• Tell your doctor right away if you notice back pain, numbness, tingling, or weakness in your legs, or loss of control of your bowels or bladder, as these may be signs of bleeding near the spinal cord.
• Get medical help right away if you notice signs of a serious allergic reaction, such as rash, itching or swelling of the face, tongue, or throat, severe dizziness, or trouble breathing.
• Tell your doctor right away if you have any serious signs of bleeding, including unusual pain, swelling or discomfort, unusual or prolonged bleeding, easy bruising, dark urine, black stools, severe headache, confusion, vision changes, unusual dizziness, fainting, seizures, weakness, or numbness.
• If someone has taken too much of this medicine and has serious symptoms such as passing out or trouble breathing, seek emergency medical help immediately. Otherwise, call your local poison control center right away.

Alternatives

• Warfarin
• Lovenox
• Unfractionated heparin
• Fondaparinux