Enoxaparin: What is it and what is it for?

What is enoxaparin?

Enoxaparin is anantithrombotic anticoagulant, from the group of low molecular weight heparins. Its mechanism of action is to prevent the formation of clots, by acting on certain steps of coagulation pathways (series of molecular phenomena that culminate inthe formation of a blood clot to occlude a wound).

What is enoxaparin for?

• Enoxaparin is a low molecular weight heparin, which differentiates it from unfractionated heparin. Enoxaparinpotentiates the action of antithrombin III and prevents the activation of factor Xa.
• It is used to treat:
  • Prevention of clot formation, in venous thromboembolic disease and arterial thromboembolism. (1)
  • Prevention of clot formation in patients with an extracorporeal circulation circuit.
  • Prevention of blood clots, in patients before and after surgery.
  • Treatment inmyocardial infarctionwith ST-segment elevation, as well as unstable angina.

Dosage and routes of administration of enoxaparin

The advantage of enoxaparin sodium is that itallows subcutaneous administration, so it provides new routes of administration and new dosage possibilities, among which we have:

• 60 mg/0.6 ml solution for injection: As prophylactic treatment of venous thromboembolic disease inpatients with chronic venous insufficiency, the dose of enoxaparin is 20 mg/24 h for 7 to 10 days.
• 40 mg/0.04 mL solution for injection: In patients with acute myocardial infarction , a single bolus dose of 30 mg/kg is administered intravenously plus 1 mg/kg subcutaneously.

What products contain enoxaparin?

Some of the medicines that contain enoxaparin are:

• Enoxaparin Rovi®
• Clexane®
• Inixa®

Enoxaparin Rovi®

• Enoxaparin rovi® is the trade name for enoxaparin sodium.
• The anticoagulant capacity of enoxaparin proves to be superior to that of unfractionated heparin , especially for treating ST-segment elevation acute myocardial infarctions (clinical criteria used to determine their severity). (two) 
• It comes in 40 mg/0.4 ml Injectable Solutions , with subcutaneous and intravenous routes of administration.

Clexane®

• This medicine inhibits the intrinsic and extrinsic coagulation pathways, preventing the formation of blood clotsin surgical patients, with venous insufficiency or in occlusive arterial diseases. It is used both preventively and as a treatment.
• It comes in 60 mg/0.6 ml Injectable Solutions , with subcutaneous and intravenous routes of administration.
• For more information about this drug see What is clexane and what is it for?

Inixa®

• Treatment with inhixa® (sodium enoxaparin) is used in diseases or clinical conditions that imply a High risk of clot formation , such as surgeries or venous insufficiency, unstable angina and myocardial infarction.
• It comes in 40 mg/0.4 ml Injectable Solutions , with subcutaneous and intravenous routes of administration.

Enoxaparin Side Effects

Anticoagulants such as enoxaparin share similarities in terms of their Adverse effects, what differentiates them is the incidence of each one. In the case of enoxaparin, these are the following:

• Pain at the injection site.
• Hypersensitivity reactions, such as itching and redness.
• Epigastric pain, nausea, vomiting and diarrhea.
• Risk of bleeding and hemorrhagic anemia . (3)
• Thrombocytopenia (low platelet count).
• Hyperkalemia (high levels of potassium in the blood).

Important: If any of the aforementioned effects occur, it is recommended to discontinue the use of the medication and consult with the treating physician.

Enoxaparin Contraindications and Warnings

Anticoagulants such as enoxaparin must be used carefully and not all patient groups are suitable for these drugs. Here are the most frequent contraindications:

• Avoid the use of this medicine in case of hypersensitivity to its components.
• Avoid concomitant use of other antiplatelet drugs, such as acetylsalicylic acid or dipyridamole.
• In case of pregnancy, it should only be used under medical supervision.

Avoid if you have:

• Hypersensitivity to enoxaparin sodium.
• Active bleeding. 
• Thrombocytopenia (low platelet level). 
• Septic endocarditis (infection of the heart tissue).

Warnings

• Use with great care in patients at risk of bleeding (for example, uncontrolled hypertensive patients or patients who have recently undergone Central Nervous Systemsurgery).
• Every child receiving enoxaparin must be constantly monitored.
• Enoxaparin can cause hyperkalemia, so patients with risk factors (severe renal dysfunction) should also be closely monitored. (4)