Enoxaparin
Brand: Lovenox
Boxed warning · ISMP high-alert drug
Epidural or spinal hematoma, which can cause lasting paralysis, in patients receiving neuraxial anesthesia or spinal puncture.
- Caution
- Bleeding risk rises with kidney impairment and low body weight; contraindicated with heparin-induced thrombocytopenia.
Common side effects
- Bleeding and bruising
- Injection-site bruising
- Low platelet count
- Elevated liver enzymes
Key interactions
- Additive bleeding risk with NSAIDs, aspirin, and other anticoagulants
- Only partially reversed by protamine
Counseling points
- Inject subcutaneously into the abdomen, never into muscle
- Do not expel the air bubble in the prefilled syringe
- Rotate sides of the abdomen with each dose
- Routine INR is not used to follow this drug
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