Heparin (LMWH - Enoxaparin)

Mechanism of action

Anticoagulant (low molecular weight heparin).

Potentiates action of antithrombin III on factor Xa, inhibiting clot formation.

Indications and dose

Side-effects

Bleeding

Heparin-induced thrombocytopenia

Skin reactions

Precautions

Avoid if creatinine clearance <15 ml/minute.

Consult literature if creatinine clearance 15-30 ml/minute.

Reversal agent

Protamine

Monitoring

Check anti-Xa levels 3-4 hours after administration after 3 doses.

Pharmacokinetics

Routes: Subcutaneous, Intravenous

Onset: 3-5 hours

Duration: 12 hours (40 mg dose)

Bioavailability: 100%

Metabolism: Plasma

Half-life of elimination: 4.5-7 hours

Excretion: Urine

Directions for administration

For subcutaneous injection use alternate sites.

Medicinal forms

Solution for injection

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References

https://litfl.com/low-molecular-weight-heparin/ 

https://bnf.nice.org.uk/drugs/enoxaparin-sodium/ 

https://www.uptodate.com/contents/enoxaparin-including-biosimilars-available-in-canada-drug-information?search=lmwh%20dosing&selectedTitle=1~145&usage_type=panel&display_rank=1&kp_tab=drug_general&source=panel_search_result#F165080