enoksapariini

Enoksapariini, known in many languages as enoxaparin, is a low molecular weight heparin (LMWH) used as an anticoagulant. It is derived from heparin and prepared as a preparation of shorter polysaccharide chains that exert anticoagulant effects by enhancing the activity of antithrombin III.

Mechanism of action is primarily the inhibition of factor Xa, with some activity against factor IIa (thrombin). Compared with unfractionated heparin, enoxapariini provides more predictable pharmacokinetics and a longer half-life, allowing for less frequent monitoring in many patients. Its anticoagulant effect can be reversed partially with protamine sulfate in case of overdose, though reversal is not complete.

Common indications include prevention of venous thromboembolism after surgery or prolonged immobilization, treatment of deep vein thrombosis and pulmonary embolism, and use as part of initial therapy for certain acute coronary syndromes. Dosing is weight-based and varies by indication. For treatment of DVT or PE, regimens typically involve 1 mg/kg subcutaneously every 12 hours or 1.5 mg/kg once daily. For postoperative prophylaxis, fixed or weight-based regimens such as 20–40 mg once daily or 30 mg every 12 hours are used, depending on the procedure and guidelines.

Administration is by subcutaneous injection. Monitoring is not routinely required for most patients, but anti-Xa activity may be checked in certain populations (e.g., renal impairment, obesity, pregnancy). Contraindications include active major bleeding, history of heparin-induced thrombocytopenia, and severe hypersensitivity to heparin or pork products; caution is advised in renal impairment and with neuraxial anesthesia due to bleeding risk. Enoksapariini is widely used and is included in many national essential medicines lists.