Overview: Enoxaparin is a blood thinner that you inject under your skin to treat or prevent blood clots or prevent problems after heart problems, such as a heart attack or severe chest pain. The most common side effects with enoxaparin are pain or blood clots at the injection site or bleeding or bruising more easily. Call your healthcare provider right away if you have severe bleeding or bleeding that is difficult to stop.
Uses
What is enoxaparin used for?
Enoxaparin is commonly used for the following conditions.
- Prevent a blood clot in the leg, also called a deep venous thrombosis (DVT), after certain hip, knee, or stomach surgeries or in someone who is not able get up and move around due to illness
- Treat a DVT or a blood clot in the lung, also called a pulmonary embolism (PE)
- Prevent problems after a heart attack or episode of unstable angina (chest pain)
- Treat a heart attack
Enoxaparin may also be used for other conditions as determined by your healthcare provider.
How does enoxaparin work (mechanism of action)?
Enoxaparin is a blood thinner, or anticoagulant. It works by blocking certain substances in the blood that form clots.
How is enoxaparin supplied (dosage forms)?
Brands and other names
- Lovenox
Dosage forms and strengths
- 30 mg/0.3 mL, 40 mg/0.4 mL single-dose prefilled syringe
- 60 mg/0.6 mL, 80 mg/0.8 mL, 100 mg/mL, 150 mg/mL, 120 mg/0.8 mL single-dose graduated prefilled syringe
- 300 mg/3 mL multiple-dose vial
How should I store enoxaparin?
Enoxaparin should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.
Side Effects
What are the most common side effects of enoxaparin?
The most common side effects of enoxaparin are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Bleeding (see below)
- Bruising
- Low levels of red blood cells (anemia)
- Low platelet levels (see below)
- Nausea and diarrhea
- Fluid retention (edema)
- Shortness of breath
- Confusion
- Pain at the injection-site
There may be other side effects of enoxaparin that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of enoxaparin?
While less common, the most serious side effects of enoxaparin are described below, along with what to do if they happen.
Spinal Blood Clots. Blood clots can form around the spinal cord if you are using enoxaparin and have a spinal tap or receive an epidural. These blood clots can cause long-term or permanent paralysis (unable to move). Your risk is higher if a thin tube (catheter) is placed in your spine, you are taking other medicines that may cause bleeding, including other blood thinners, you have a history of difficult or repeated spinal punctures, you have a history of problems with your spine, or had a recent surgery on your spine. Your healthcare provider will monitor you closely during the procedure. Tell your healthcare provider right away if you have back pain, tingling, numbness, muscle weakness (especially in your legs and feet), or loss of control of the bowels or bladder.
Bleeding. Enoxaparin can increase your risk of severe bleeding that can lead to death. Some patients with serious bleeding may need a blood transfusion or surgery. Call your healthcare provider right away if you have any of the following signs of severe bleeding while using enoxaparin.
- Pink, red, or brown urine (pee)
- Vomit with blood that looks like coffee grounds
- Red or black stools (looks like tar)
- Coughing up blood or blood clots
Low Platelet Levels. Enoxaparin can cause you to have a severely low number of platelets in your blood, also called thrombocytopenia. Platelets help to form blood clots. Having a low level of platelets may increase your risk of bleeding and can sometimes lead to death. Sometimes thrombocytopenia is an immune response, called heparin-induced thrombocytopenia (HIT). HIT actually increases clotting. Tell your healthcare provider right away if you have any of the following symptoms of low platelet levels.
- Easy bruising or bleeding
- Bleeding that does not stop
- Nosebleeds
Severe Allergic Reactions. Enoxaparin may cause allergic reactions, which can be serious. Stop using enoxaparin and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Warnings & Precautions
Who should not use enoxaparin?
Allergies to Ingredients. People who are allergic to any of the following should not use enoxaparin.
- Enoxaparin
- Lovenox
- Heparin
- Pork products
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific enoxaparin products they stock.
Bleeding problems. Do not use enoxaparin if you have uncontrolled bleeding.
Heparin-Induced Thrombocytopenia (HIT). Do not use enoxaparin if you recently (within the last 100 days) had HIT or if you have heparin antibodies in your blood.
What should I know about enoxaparin before using it?
Do not use enoxaparin unless it has been prescribed to you by a healthcare provider. Use it as prescribed.
Do not share enoxaparin with other people, even if they have the same condition as you. It may harm them.
Keep enoxaparin out of the reach of children.
This medicine is injected under the skin. Make sure that you or a caregiver understands how to properly prepare and use enoxaparin. Avoid using the same injection site each time you use enoxaparin by rotating where you inject it. Do not inject enoxaparin through your clothes, or into skin that is scarred or bruised. If you have any questions, talk to your pharmacist or other healthcare provider.
People who are 65 or older can be at greater risk for some side effects from enoxaparin. Talk to your healthcare provider about your risks if you are in this age group.
Enoxaparin is a blood thinner. It may take longer than usual to stop bleeding if you get injured. You also may notice that you bruise or bleed more easily while using enoxaparin. See the Side Effects section for more details.
Some forms of enoxaparin may have a preservative in it, called benzyl alcohol. Benzyl alcohol should not be used in babies or pregnant women because it may cause problems in the baby. If you have any concerns about this, talk with your pharmacist or healthcare provider.
Enoxaparin should be clear and seem colorless or a pale yellow color. Look at the enoxaparin liquid before you inject it. If it has any particles floating in it, is not clear, or the color has changed, do not inject it. Throw it away and use a new injection.
What should I tell my healthcare provider before using enoxaparin?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if enoxaparin is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Upcoming surgery or procedure at the dentist
- Have a mechanical heart valve
- Kidney problems
- Low body weight
- Obesity
- High blood pressure that is not well controlled
- An infection in your heart (endocarditis)
- Bleeding problems, including recent ulcers in your stomach, intestines or esophagus
- Heparin-induced thrombocytopenia (HIT)
- Stroke
- Recent brain, spine, or eye surgery
- Problems with your platelets or low platelet levels (thrombocytopenia)
- Eye problem, such as diabetic retinopathy
Pregnancy. Your healthcare provider will advise you if you should take enoxaparin while you are pregnant or trying to get pregnant. It is not known if or how enoxaparin could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.
Breastfeeding. It is not known if enoxaparin passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use enoxaparin while breastfeeding.
Interactions
Does enoxaparin interact with foods or drinks?
There are no known interactions between enoxaparin and foods or drinks.
It is unknown if drinking alcohol will affect enoxaparin, but both enoxaparin and alcohol can increase your risk of bleeding. It is best to limit the amount of alcohol you drink.
Does enoxaparin interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over the counter (OTC) medicines, vitamins/minerals, herbal products, or other supplements you are taking.
In particular, make sure that you discuss if you are using any of the following before using enoxaparin:
- A blood thinner, which is a medicine used to treat or prevent blood clots
- An antiplatelet medicine, such as clopidogrel (Plavix), ticagrelor (Brilinta), aspirin/dipyridamole, or cilostazol, which is a medicine used to prevent blood clots
- A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which is in many prescription and OTC products for pain, swelling, and fever
- A salicylate, such as diflunisal or salsalate, which is a medicine used for osteoarthritis or rheumatoid arthritis
- Aspirin, which is in many prescription and OTC products, including those for pain, swelling, and fever
This may not be a complete list of medicines that can interact with enoxaparin. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much enoxaparin?
If you or someone else has used too much enoxaparin, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of enoxaparin?
If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.
Are you currently using Enoxaparin (Lovenox)?
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