ENOXAPARIN SODIUM

Product Description

Enoxaparin sodiumis ananticoagulant medication (blood thinner).It is used to treat and preventdeep vein thrombosis(DVT) andpulmonary embolism(PE) including duringpregnancy and following certain types of surgery.It is also used in those withacute coronary syndrome(ACS) andheart attacks. It is given byinjection just under the skinorinto a vein. It is also used duringhemodialysis. Common side effects include bleeding, fever, andswelling of the legs. Bleeding may be serious especially in those who are undergoing aspinal tap. Use duringpregnancy appears to be safe for the baby.Enoxaparin is in thelow molecular weight heparinfamily of medications. Enoxaparin sodium was first made in 1981 and approved for medical use in 1993. It is on theWorld Health Organization’s List of Essential Medicines. Enoxaparin is sold under several brand names and is available as ageneric medication. Enoxaparin is made fromheparin.In 2017, it was the 299th most commonly prescribed medication in the United States, with more than one million prescriptions.

Medical uses:

• Treatment of unstableangina(UA) and non-Q-wavemyocardial infarction(NQMI), administered concurrently withaspirin
• DVT prophylaxis in knee replacement surgery
• DVT prophylaxis in hip replacement surgery
• DVT prophylaxis in abdominal surgery
• Treatment of DVT with or without pulmonary embolism
• Treatment of DVT inpatient, withST-segment elevation myocardial infarction(STEMI)

Monitoring

Enoxaparin sodium has predictable absorption, bioavailability, and distribution therefore monitoring is not typically done. However, there are instances where monitoring may be beneficial for special populations, for example individuals with kidney insufficiency or those that are obese. In this case, anti-Xa units can be measured and dosing adjusted accordingly.

Reversal agent

Protamine sulfateis less effective at reversing enoxaparin compared toheparin, with a maximum neutralization of approximately 60% of the anti-factor Xa effect.

Pregnancy

• Enoxaparin sodium is a FDA pregnancy category B drug which means enoxaparin is not expected to cause harm to an unborn baby when used during pregnancy. This statement is based on reproductive studies involving pregnant rats and rabbits. No birth defects or toxic effects to an unborn fetus due to enoxaparin were observed during these animals studies. However a human’s response to enoxaparin might be different than that of a small animal, therefore enoxaparin should be used during pregnancy only if there is a definite need.
• Enoxaparin does not cross the placenta therefore it is unlikely an unborn baby would be exposed to it.
• Some fetal deaths have been reported by women who used enoxaparin during pregnancy, but it is unclear if enoxaparin caused these deaths.
• Pregnant woman on enoxaparin should be monitored on a regular basis for bleeding and/or “excessive anticoagulation” especially when the delivery date is approaching. The risk of hemorrhage is higher during delivery if the person is still using enoxaparin and this could endanger the life of the baby and/or the mother.
• The multiple-dose vials of the brand name enoxaparin (Lovenox) contain 15mgbenzyl alcoholper 1 mL as a preservative. Premature infants who have been given large amounts of benzyl alcohol (99405mg/kg/day) have experienced “gasping syndrome”.
• Although enoxaparin is used to prevent blood clots it is necessary to remember that pregnancy alone can raise a woman’s risk of clotting. (Source: Wikipedia)

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