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Enoxaparin

PCaution when used during pregnancy - Caution when used during pregnancy

LCaution when used during lactation - Caution when used during lactation

Molecule Info

Indication & Dosage

Subcutaneous

Prophylaxis of venous thromboembolism during surgical procedures

  Adult: Low to moderate risk: 20 mg once daily with the 1st dose 2 hr pre-operatively.  High risk: 40 mg once daily with the 1st dose 12 hr pre-operatively.  Alternatively, 30 mg bid starting within 12-24 hr after the operation.  After hip replacement surgery, continue treatment at 40 mg once daily for a further 3 wk.  For immobilised patients, treatment should continue at 40 mg daily for at least 6 days or until patient becomes fully ambulant, up to a max of 14 days.

CrCl

Dosage Recommendation

<30

Reduce dose.  Max: 1 mg/kg/day.

Subcutaneous

Deep vein thrombosis

  Adult: 1 mg /kg every 12 hr for 5 days and until Oral   anticoagulation is established.

CrCl

Dosage Recommendation

<30

Reduce dose.  Max: 1 mg/kg/day.

Subcutaneous

Prophylaxis of clotting in the extracorporeal circulation during haemodialysis

  Adult: 1 mg/kg into the arterial line of the circuit at the beginning of the dialysis session.  Give a further dose of 0. 5-1 mg/kg if required.  Reduce dose in patients at high risk of haemorrhage.

CrCl

Dosage Recommendation

<30

Reduce dose.  Max: 1 mg/kg/day.

Subcutaneous

Unstable angina

  Adult: 1 mg/kg every 12 hr for 2-8 days with low-dose aspirin.

CrCl

Dosage Recommendation

<30

Reduce dose.  Max: 1 mg/kg/day.

Special Populations: Reduce dose in patients at high risk of haemorrhage.

Administration

May be taken with or without food.  May be taken w/ meals to minimise GI upset.

Contraindications

Hypersensitivity, acute bacterial endocarditis; major bleeding disorder, haemorrhagic stroke, drug-induced thrombocytopenia.

Special Precautions

Renal or hepatic impairment, history of GI ulceration, uncontrolled hypertension, spinal or epidural anaesthesia; lactation and pregnancy; elderly.  Periodic blood counts, platelet count and stool occult blood test recommended.

Adverse Drug Reactions

Thrombocytopenia, mild bleeding, inj site irritation, pain and ecchymoses, hypersensitivity and erythema. Potentially Fatal: Haemorrhagic complications.

Drug Interactions

Potentially Fatal: Risk of haemorrhage increased with Oral   anticoagulants, platelet aggregation inhibitors, NSAIDs including aspirin.

Lab Interference

Elevation of transaminases may interfere with interpretation of LFT results and diagnosis of MI, liver disease and pulmonary emboli.

Pregnancy Category

A

B √

C

D

X

 

Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect that was not confirmed in controlled studies in women in the 1sttrimester.

Storage

Subcutaneous: Store at 25°C.

Mechanism of Action

Enoxaparin is a low molecular weight heparin with anticoagulant properties.  It acts by enhancing the inhibition rate of activated clotting factors including thrombin and factor Xa through its action on antithrombin III.  Absorption: Rapidly and almost completely absorbed after SC inj with a bioavailability of about 100%.   Metabolism: Metabolised hepatically.   Excretion: Elimination half-life: 4-5 hr.  Excreted in urine as unchanged drug and metabolites.

mph Class

Anticoagulants, Antiplatelets & Fibrinolytics

ATC Classification

B01AB05 - enoxaparin; Belongs to the class of heparin group.  Used in the treatment of thrombosis.

 

Search Google: Enoxaparin

Brand/Product Info


Total Products : 16                
Brand Name Manufacturer/Marketer Composition Dosage Form Pack Size & Price
CARDINEX Drug International Ltd Enoxaparin sodium 40mg, 60mg & 80mg (100 IU/mg) Injection 40mg: 326.00, 60mg: 476.00 & 80mg: 526.00 MRP
CLEVEN 20 Beximco Pharmaceuticals Ltd Enoxaperin sodium 20mg/0.2ml Injection 1's: 200.00 MRP
CLEVEN 40 Beximco Pharmaceuticals Ltd Enoxaperin sodium 40mg/0.4ml Injection 1s: 350.00 MRP
CLEVEN 60 Beximco Pharmaceuticals Ltd Enoxaperin sodium 60mg/0.6ml Injection 1's: 500.00 MRP
CLEVEN 80 Beximco Pharmaceuticals Ltd Enoxaperin sodium 80mg/0.8ml Injection 1's: 550.00 MRP
CLEXANE Sanofi Enoxaparin sodium 20mg, 40mg, 60mg & 80mg (100 IU/mg) Pre-filled Syringe 20mg/0.2ml: 425.06 Tk, 40mg/0.4ml: 743.06, 60mg/0.6ml:1049.52 & 80mg/0.8ml: 1343.38 MRP
CLOTINEX 40 Square Pharmaceuticals Ltd. Enoxaparin Sodium 4000 Anti-Xa IU Pre-filled Syringe Injection 1x1's: 451.36 MRP
CLOTINEX 60 Square Pharmaceuticals Ltd. Enoxaparin Sodium 6000 Anti-Xa IU Pre-filled Syringe Injection 1x1's: 576.73 MRP
CLOTINEX 80 Square Pharmaceuticals Ltd. Enoxaparin Sodium 8000 Anti-Xa IU Pre-filled Syringe Injection 1x1's: 651.95 MRP
ENOPARIN Popular Pharmaceuticals Ltd. Enoxaparin sodium 40mg & 60mg & 80mg (100 IU/mg) Pre-filled Syringe 40mg: 326.23, 60mg: 476.79 & 80mg: 526.98 MRP
EPARIN Beacon Pharmaceuticals Limited Enoxaparin sodium 60mg (6000 IU) Pre-filled Syringe 60mg/0.6ml (6000 IU): 473.00 MRP
INTRAVAS Aristopharma Ltd. Enoxaparin sodium 40mg, 60mg & 80mg (100 IU/mg) Pre-filled Syringe 40mg: 325.00, 60mg: 476.00, 80mg: 525.00 MRP
Parinox 20 Incepta Pharmaceuticals Limited 2000 anti-Xa IU is equivalent to 20mg/0.2ml Enoxaparin Sodium BP Pre-filled syringe 1x1's:MRP 175 Tk
Parinox 40 Incepta Pharmaceuticals Limited 4000 anti-Xa IU is equivalent to 40mg/0.4ml Enoxaparin Sodium BP Pre-filled syringe 1x1's:MRP 350 Tk
Parinox 60 Incepta Pharmaceuticals Limited 6000 anti-Xa IU is equivalent to 60mg/0.6ml Enoxaparin Sodium BP Pre-filled syringe 1x1's:MRP 500 Tk
Parinox 80 Incepta Pharmaceuticals Limited 8000 anti-Xa IU is equivalent to 80mg/0.8ml Enoxaparin Sodium BP Pre-filled syringe 1x1's:MRP 525 Tk

Gen. MedInfo

 

IMPORTANT WARNING:

 

If you have epidural or spinal anesthesia or a spinal puncture while taking a 'blood thinner' such as enoxaparin, you are at risk for having a blood clot form in or around your spine that could cause you to become paralyzed.  Tell your doctor if you are taking other anticoagulants such as warfarin, anagrelide, aspirin or nonsteroidal anti-inflammatory drugs, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, sulfinpyrazone, ticlopidine, and tirofiban.

 

If you experience any of the following symptoms, consult your doctor immediately: numbness, tingling, leg weakness or paralysis, and loss of control over your bladder or bowels.

 

Talk to your doctor about the risk of taking enoxaparin.  Keep all appointments with your doctor.

 

Why is this medication prescribed?

 

Enoxaparin is used to prevent blood clots in the leg in patients who are on bedrest or who are having hip replacement, knee replacement, or stomach surgery.  It is used in combination with aspirin to prevent complications from angina and heart attacks.  It is also used in combination with warfarin to treat blood clots in the leg.  Enoxaparin is in a class of medications called low molecular weight heparins.  It works by stopping the formation of substances that cause clots.

 

How should this medicine be used?

 

Enoxaparin comes as an injection in a syringe to be injected just under the skin but not into your muscle.  It is usually given twice a day.  You will probably begin using the drug while you are in the hospital and then use it for a total of 10–14 days.  Follow the directions on your prescription label carefully, and ask your Doctor to explain any part you do not understand.  Use enoxaparin exactly as directed.  Do not inject more or less of it or inject it more often than prescribed by your doctor.

 

Continue to use enoxaparin even if you feel well.  Do not stop taking enoxaparin without talking to your doctor.

 

Your healthcare provider will teach you how to give yourself the shot or arrangements will be made for someone else to give you the shot.  Enoxaparin is usually injected in the stomach area.  You must use a different area of the stomach each time you give the shot.  If you have questions about where to give the shot, ask your healthcare provider.  Each syringe has enough drug in it for one shot.  Do not use the syringe and needle more than one time.  Your doctor, Doctor, or health care provider will tell you how to throw away used needles and syringes to avoid accidental injury.  Keep syringes and needles out of reach of children.

 

To inject enoxaparin, follow these instructions:

 

  1. Wash your hands and the area of skin where you will give the shot.
  2. Look at the syringe to be sure the drug is clear and colorless or pale yellow.
  3. Take the cap off the needle.  Do not push any air or drug out of the syringe before giving the shot unless your healthcare provider tells you to.
  4. Lie down and pinch a fold of skin between your fingers and thumb.  Push the entire needle into the skin and then press down on the syringe plunger to inject the drug.  Hold onto the skin the entire time you give the shot.  Do not rub the site after you give the shot.

 

 

 

Other uses for this medicine

 

This medication may be prescribed for other uses; ask your Doctor for more information.

 

What special precautions should I follow?

 

Before taking enoxaparin,

 

  • tell your Doctor if you are allergic to enoxaparin, heparin, any other drugs, or pork products.
  • tell your Doctor what prescription and nonprescription medications you are taking, especially those listed in the IMPORTANT WARNING section and vitamins.
  • tell your doctor if you have an artificial heart valve and if you have or have ever had kidney disease, an infection in your heart, a stroke, a bleeding disorder, ulcers, or a low platelet count.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding.  If you become pregnant while taking enoxaparin, consult your doctor.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking enoxaparin.

 

What should I do if I forget a dose?

 

Inject the missed dose as soon as you remember it.  However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule.  Do not inject a double dose to make up for a missed one.

 

What side effects can this medication cause?

 

Enoxaparin may cause side effects.  Tell your doctor if any of these symptoms are severe or do not go away:

 

  • upset stomach
  • fever
  • irritation or burning at site of injection
  • unusual bleeding or bruising
  • black or bloody stools
  • blood in urine
  • swollen ankles and/or feet

 

If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, consult your doctor immediately:

 

If you experience a serious side effect, you or your doctor may send a report to the Office of Directorate General, Drugs Administration.

 

What storage conditions are needed for this medicine?

 

Keep this medication out of reach of children.  Store the syringes at room temperature and away from excess heat and moisture.  Do not use the syringe if it leaks or if the fluid is dark or contains particles.  Throw away any medication that is outdated or no longer needed.  Talk to your Doctor about the proper disposal of your medication.

 

In case of emergency/overdose

 

In case of overdose, consult your Doctor.  If the victim has collapsed or is not breathing, consult local medical emergency services.

 

What other information should I know?

 

Keep all appointments with your doctor and the laboratory.  Your doctor will order certain lab tests to monitor your enoxaparin therapy.

 

Enoxaparin prevents blood from clotting so it may take longer than usual for you to stop bleeding if you are cut or injured.  Avoid activities that have a high risk of causing injury.  Consult your doctor if bleeding is unusual.

 

Do not let anyone else use your medication.   

 

It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements.  You should bring this list with you each time you visit a doctor or if you are admitted to a hospital.  It is also important information to carry with you in case of emergencies.

 

 

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