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Lovenox (enoxaparin sodium)

Indications

Lovenox is used for the following conditions:

• Prevention of Deep Vein Thrombosis (DVT): Helps prevent blood clots in patients undergoing surgeries such as hip or knee replacements, or in those with limited mobility due to illness.
• Treatment of Deep Vein Thrombosis (DVT): Treats existing blood clots in the legs.
• Prevention of Pulmonary Embolism (PE): Reduces the risk of blood clots traveling to the lungs.
• Treatment of Pulmonary Embolism (PE): Treats blood clots that have reached the lungs.
• Prevention of Ischemic Complications in Unstable Angina and Non-Q-Wave Myocardial Infarction: Helps prevent complications in patients with certain types of heart attacks.
• Acute ST-Segment Elevation Myocardial Infarction (STEMI): Used in combination with other treatments for certain types of heart attacks.

Dosage and Administration

• Follow your doctor’s instructions precisely for dosage.
• Administer the injection subcutaneously (under the skin), typically in the abdominal area.
• Rotate injection sites to avoid bruising and irritation.
• Use the syringe only once and then dispose of it properly.
• Do not inject into muscle tissue.
• Do not administer intravenously.
• Do not rub the injection site after administration.
• Do not use if the solution is cloudy or contains particles.

Mechanism of Action

Enoxaparin Sodium is a low molecular weight heparin (LMWH) that works by inhibiting the formation of blood clots. It enhances the activity of antithrombin III, which inhibits clotting factors IIa (thrombin) and Xa. This prevents the development and growth of clots within the blood vessels.

Contraindications

• Allergy to Enoxaparin or Heparin: Do not use if you have a known hypersensitivity to enoxaparin, heparin, or pork products.
• Active Major Bleeding: Avoid use in patients with active, uncontrolled bleeding.
• History of Heparin-Induced Thrombocytopenia (HIT): Do not use in patients with a history of this condition.
• Severe Kidney Disease: Not recommended for patients with severe renal impairment unless specifically directed by a healthcare provider.
• Recent Brain, Eye, or Spinal Surgery: Avoid use due to increased risk of bleeding.

Side Effects

Common Side Effects

• Mild bruising at the injection site
• Pain or irritation at the injection site
• Mild headache
• Nausea

Serious Side Effects

• Unusual bleeding or bruising
• Dark or bloody stools
• Blood in urine
• Severe headache
• Dizziness or fainting
• Shortness of breath
• Chest pain

Precautions

• Inform Your Doctor About All Medications: Ensure your doctor knows about all the medications you are taking to avoid drug interactions.
• Monitor for Signs of Bleeding: Watch for unusual bleeding or bruising and report to your doctor immediately.
• Regular Blood Tests: Regular monitoring of blood platelet levels and kidney function may be required.
• Avoid Activities that Increase Bleeding Risk: Be cautious with activities that might cause injury or bleeding.
• Pregnancy and Breastfeeding: Inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding.

Storage Instructions

• Store at room temperature, between 20°C to 25°C (68°F to 77°F).
• Protect from heat and direct sunlight.
• Do not freeze the medication.
• Keep out of reach of children and pets.
• Dispose of used syringes in a puncture-proof container.

References

https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020164s083lbl.pdf