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enoxaparin

Pronunciation: ee nox AP a rin

Brand: Lovenox

What is the most important information I should know about enoxaparin?

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You should not use this medication if you are allergic to enoxaparin, heparin, benzyl alcohol, or pork products, or if you have active bleeding, or a low level of platelets in your blood after testing positive for a certain antibody while using enoxaparin.

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Tell any doctor who treats you that you are using enoxaparin. If you need anesthesia for a medical procedure or surgery, you may need to stop using the medicine for a short time.

Enoxaparin may cause you to bleed more easily, especially if you have: a bleeding disorder, hemorrhagic stroke, an infection in the lining of your heart, stomach or intestinal bleeding or ulcer, or if you have had recent brain, spine, or eye surgery.

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Enoxaparin can cause a very serious blood clot around your brain or spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural), especially if you have a genetic spinal defect, a history of spinal surgery or repeated spinal taps, or if you are using other medications to treat or prevent blood clots. Symptoms of this type of blood clot include numbness, tingling, muscle weakness, or loss of movement.

Blood clots around the brain or spinal cord may occur during a spinal tap or epidural if you use enoxaparin with other drugs that can affect blood clotting, including aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) such as Advil or Motrin, and any other medications to treat or prevent blood clots.

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Many other drugs (including some over-the-counter medicines) can increase your risk of bleeding or life-threatening blood clots, and it is very important to tell your doctor about all medicines you have recently used.

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Tell your caregivers at once if you have signs of bleeding such as black or bloody stools, coughing up blood, confusion, feeling like you might pass out, or any bleeding that will not stop.

What is enoxaparin?

Enoxaparin is an anticoagulant that helps prevent the formation of blood clots.

Enoxaparin is used to treat or prevent a type of blood clot called deep vein thrombosis (DVT), which can lead to blood clots in the lungs (pulmonary embolism). A DVT can occur after certain types of surgery, or in people who are bed-ridden due to a prolonged illness.

Enoxaparin is also used to prevent blood vessel complications in people with certain types of angina (chest pain) or heart attack.

Enoxaparin may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using enoxaparin?

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You should not use this medication if you are allergic to enoxaparin, heparin, benzyl alcohol, or pork products, or if you have:

  • active or uncontrolled bleeding; or
  • a low level of platelets in your blood after testing positive for a certain antibody while using enoxaparin.

Enoxaparin may cause you to bleed more easily, especially if you have:

  • a bleeding disorder that is inherited or caused by disease;
  • hemorrhagic stroke;
  • an infection of the lining of your heart (also called bacterial endocarditis);
  • stomach or intestinal bleeding or ulcer; or
  • recent brain, spine, or eye surgery.
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Enoxaparin can cause a very serious blood clot around your brain or spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural). This type of blood clot could cause long-term paralysis, and may be more likely to occur if you have:

  • a genetic spinal defect;
  • a history of spinal surgery or repeated spinal taps; or
  • if you are using other medications to treat or prevent blood clots.

To make sure you can safely use enoxaparin, tell your doctor if you have other medical conditions, especially:

  • kidney or liver disease;
  • uncontrolled high blood pressure;
  • eye problems caused by diabetes;
  • recent stomach ulcer; or
  • if you have ever had low blood platelets after receiving heparin.
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FDA pregnancy category B. Enoxaparin is not expected to harm an unborn baby. However, some forms of this medication contain a preservative that may be harmful to a newborn. Tell your doctor if you are pregnant or plan to become pregnant during treatment. If you use this medication during pregnancy, make sure your doctor knows if you have a mechanical heart valve.

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It is not known whether enoxaparin passes into breast milk or if it could harm a nursing baby. Do not receive this medication without telling your doctor if you are breast-feeding a baby.

How should I use enoxaparin?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Enoxaparin is usually given every day until your bleeding condition improves. Follow the directions on your prescription label.

Enoxaparin is injected under the skin or into a vein through an IV. You may be shown how to use injections at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

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You should be sitting or lying down during the injection. Do not inject enoxaparin into a muscle.

Use a different place on your stomach each time you give an injection under the skin. Your care provider will show you the best places on your body to inject the medication. Do not inject into the same place two times in a row.

Prepare your dose in a syringe only when you are ready to give yourself an injection. Do not mix enoxaparin with other medications in the same IV. Do not use the medication if it has changed colors or has particles in it. Call your doctor for a new prescription.

Use a disposable needle only once. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

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Tell any doctor who treats you that you are using enoxaparin. If you need surgery or dental work, tell the surgeon or dentist ahead of time that you are using this medication.

To be sure this medication is not causing harmful effects, your blood and your stool (bowel movement) may need to be tested often. Your nerve and muscle function may also need to be tested. Visit your doctor regularly.

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Store enoxaparin vials (bottles) at room temperature away from moisture and heat. Once you have used a vial for the first time, the medicine will keep at room temperature for up to 28 days. Throw away the vial after 28 days have passed since you first used the vial, even if there is still medicine left in it.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

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Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose may cause excessive bleeding.

What should I avoid while using enoxaparin?

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Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

What are the possible side effects of enoxaparin?

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Get emergency medical help if you have any of these signs of an allergic reaction: hives; itching or burning skin; difficulty breathing; swelling of your face, lips, tongue, or throat.

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Stop using enoxaparin and call your doctor at once if you have a serious side effect such as:

  • unusual bleeding (nose, mouth, vagina, or rectum), bleeding from wounds or needle injections, any bleeding that will not stop;
  • easy bruising, purple or red pinpoint spots under your skin;
  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;
  • black or bloody stools, coughing up blood or vomit that looks like coffee grounds;
  • numbness, tingling, or muscle weakness (especially in your legs and feet);
  • loss of movement in any part of your body;
  • sudden weakness, severe headache, confusion, or problems with speech, vision, or balance; or
  • trouble breathing.

Less serious side effects may include:

  • nausea, diarrhea;
  • fever;
  • swelling in your hands or feet; or
  • mild pain, irritation, redness, or swelling where the medicine was injected.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect enoxaparin?

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Many other drugs (including some over-the-counter medicines) can increase your risk of bleeding, or your risk of developing blood clots around the brain or spinal cord during a spinal tap or epidural. It is very important to tell your doctor about all medicines you have recently used, especially:

  • dextran (Gentran, Hyskon);
  • abciximab (ReoPro), eptifibatide (Integrilin), ticagrelor (Brilinta), tirofiban (Aggrastat);
  • anagrelide (Agrylin), cilostazol (Pletal), clopidogrel (Plavix), dipyridamole (Persantine, Aggrenox), eltrombopag (Promacta), oprelvekin (Neumega), prasugrel (Effient), romiplostim (Nplate), ticagrelor (Brilinta), ticlopidine (Ticlid);
  • argatroban (Acova), bivalirudin (Angiomax), dabigatran (Pradaxa), lepirudin (Refludan);
  • dalteparin (Fragmin), fondaparinux (Arixtra), heparin, rivaroxaban (Xarelto), tinzaparin (Innohep), warfarin (Coumadin, Jantoven);
  • alteplase (Activase), reteplase (Retavase), tenecteplase (TNKase), urokinase (Abbokinase);
  • an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others; or
  • salicylates such as aspirin, Nuprin Backache Caplet, Kaopectate, KneeRelief, Pamprin Cramp Formula, Pepto-Bismol, Tricosal, Trilisate, and others.

This list is not complete and other drugs may interact with enoxaparin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your doctor or pharmacist can provide more information about enoxaparin.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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