Lovenox (enoxaparin)
LOVENOX (enoxaparin) – a low molecular weight heparin commonly used in clinical settings where anticoagulation is needed. Low molecular weight heparins exert their clinical effect through the antithrombotic properties of heparins.
FDA approved uses: Lovenox is indicated for:
Available dosage forms: Injection: 100 mg/mL concentration – Prefilled syringes: 30 mg/0.3 mL, 40 mg/0.4 mL; Graduated prefilled syringes: 60 mg/0.6 mL, 80 mg/0.8 mL,100 mg/1 mL; Multiple-dose vial: 300 mg/3 mL. 150 mg/mL concentration – Graduated prefilled syringes: 120 mg/0.8 mL.
Usual dosage: The recommended dose of Lovenox varies by indication.
Contraindications: Active major bleeding; Thrombocytopenia with a positive in vitro test for anti-platelet antibody in the presence of enoxaparin sodium; Hypersensitivity to enoxaparin sodium; Hypersensitivity to heparin or pork products; Hypersensitivity to benzyl alcohol.
Special warnings: 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. Factors that can increase the risk of developing epidural or spinal hematomas in these patients include: Use of indwelling epidural catheters; Concomitant use of other drugs that affect hemostasis, such as non-steroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, other anticoagulants; A history of traumatic or repeated epidural or spinal puncture; A history of spinal deformity or spinal surgery. Monitor patients frequently for signs and symptoms of neurological impairment. If neurological compromise is noted, urgent treatment is necessary. Consider the benefits and risks before neuraxial intervention in patients anticoagulated or to be anticoagulated for thromboprophylaxis.
Adverse reactions (side effects) of these medications: The most common side effects of Lovenox include were bleeding, anemia, thrombocytopenia, elevation of serum aminotransferase, diarrhea, and nausea. Other adverse events reported include headache, abdominal pain. injection site reactions, infections, chest pain, toothache, depression, dizziness. upper respiratory infection bronchitis, nausea, arthralgia, urinary tract infections, alopecia, eye disorders, anemia, migraines and vasodilation.
Common drug interactions: Discontinue agents which may enhance hemorrhage risk prior to initiation of Lovenox or conduct close clinical and laboratory monitoring. These agents include medications such as: anticoagulants, platelet inhibitors including acetylsalicylic acid, salicylates, NSAIDs (including ketorolac tromethamine), dipyridamole, or sulfinpyrazone.
Special instructions for patients: Use this medication exactly as directed by physician. Read the full Patient Medication Guide prior to starting your first prescription, and with each refill. Obtain adequate instructions on self injection before attempting to administer to yourself. Watch for signs and symptoms of spinal or epidural hematoma, such as tingling, numbness (especially in the lower limbs) and muscular weakness and notify physician immediately if they occur. Report any unusual bleeding, bruising, or signs of thrombocytopenia (such as a rash of dark red spots under the skin) to physician.
Full prescribing information may be found at the manufacturer‘s official website Lovenox.com or at the U.S. Food and Drug Administration’s website at Lovenox Info at Drugs@FDA
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