Lovenox

Lovenox is the brand name for enoxaparin, a low molecular weight heparin (LMWH) anticoagulant. It is used to prevent and treat thromboembolic disorders and is administered by subcutaneous injection; in some settings it may be given intravenously.

Mechanism: Enoxaparin enhances antithrombin III activity, preferentially inhibiting factor Xa with less effect on thrombin. Compared with unfractionated heparin, LMWH has more predictable pharmacokinetics and a longer half-life, permitting fixed dosing without routine laboratory monitoring for many indications.

Indications: Prophylaxis of DVT after hip or knee replacement or abdominal surgery; prevention of thromboembolism in at-risk medical patients; treatment of established DVT or PE, often as a bridge to oral anticoagulation.

Dosing and administration: Dosing is weight-based and indication-specific. Prophylaxis examples include 30–40 mg once daily (or 30 mg every 12 hours in some hip/knee protocols). Treatment typically uses 1 mg/kg subcut every 12 hours (some regimens use 1.5 mg/kg once daily). Dose adjustments are needed for renal impairment; avoid intramuscular injections; spinal or epidural procedures require careful timing and guidelines to prevent spinal hematoma.

Contraindications and precautions: Active major bleeding; history of heparin-induced thrombocytopenia; known allergy to enoxaparin or heparin; significant renal impairment. Consider pregnancy considerations and careful use with neuraxial procedures.

Adverse effects and interactions: Bleeding is the most common adverse effect; injection-site reactions and rare heparin-induced thrombocytopenia may occur. Interactions with other anticoagulants, antiplatelet agents, or NSAIDs increase bleeding risk.