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Enoxaparin

DVT/PE treatment, ACS adjunct, VTE prophylaxis

Indications

  • DVT/PE treatment
  • ACS adjunct
  • VTE prophylaxis

Adult dosing

  • treatment: dose: 1; unit: mg/kg; route: SC; interval: q12h; weightBased: true; maxDose: 150; maxDoseAbsolute: true; acs: dose: 1; unit: mg/kg; route: SC; interval: q12h (with initial 30mg IV bolus); weightBased: true; maxDose: 150; maxDoseAbsolute: true; prophylaxis: dose: 40; unit: mg SC daily; route: SC; fixed: true

Pediatric dosing

  • treatment: dose: 1; unit: mg/kg; route: SC; interval: q12h; weightBased: true

Contraindications

  • Active major bleeding
  • HIT history
  • CrCl <15

Clinical pearls

  • Dose reduction required in renal impairment — CrCl <30 use q24h dosing
  • Anti-Xa level for monitoring if needed (obese, renal impairment, pregnancy)
  • Partial reversal with protamine — only ~60% effective
  • Do NOT interchange with other LMWHs — not equivalent

Source and review

  • ACCP Guidelines 2016; AHA/ACC NSTEMI Guidelines. Last reviewed: 2024-11-01