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enoxaparin
enoxaparin
Brand names: Enoxaparin Sodium
| Form | Strength | ANAN | ASMP | LACH | LALK | LOHH | LOLR | LOWC | SDSD | SESE | SFSF | Formulary Status |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SOLUTION, INJECTABLE | 30 mg/0.3 mL; 40 mg/0.4 mL; 60 mg/0.6 mL; 80 mg/0.8 mL; 100 mg/mL; 120 mg/0.8 mL; 150 mg/mL; 300 mg/3 mL |
Last updated: Nov. 30, 2021
- Black Box Warning: Spinal/epidural hematoma risk
- Therapeutic Interchange: T.I.
Renal Dosing Protocol
Indications
Starting dose
CrCl >30mL/min
CrCl <30mL/min
DVT prophylaxis (general)
40mg Daily
No change
30mg daily
DVT prophylaxis (bariatric surgery)
40mg BID
No change
30mg daily
DVT prophylaxis (hip/knee replacement*, trauma)
30mg BID
No change
30mg daily
DVT/PE treatment, NSTEMI/STEMI treatment
1mg/kg q12h
No change
1mg/kg q24h
DVT/PE Treatment **
1.5mg/kg Daily
No change
1mg/kg q24h
* typical dose 30mg BID, but 40mg daily is used too
**usually outpatient dose
Medications Approved for Automatic Therapeutic Interchange Dosage Conversion Guidelines
(Note: “Therapeutic Interchange” should be placed in the order comments)
Medication Ordered
Brand Name
Route
Substituted Medication
Criteria for Use
Enoxaparin 30 mg Q12 Hours
Lovenox
SC
Enoxaparin 40 mg SC Daily
Hip-Replacement surgery: Extended Prophylaxis in Hip Replacement; Abdominal surgery at Risk for thromboembolic complications. (Continue use of enoxaparin 30 mg SC Q12H for post knee surgery & Trauma Patients)
Enoxaparin Dose Rounding based on weight**
Lovenox
SC
Wt range (kg)
Dose
Syringe Size to dispense
40-45
40 mg
40 mg
46-55
50 mg
60 mg
56-65
60 mg
60 mg
66-75
70 mg
80 mg
76-85
80 mg
80 mg
86-95
90 mg
100 mg
96-105
100 mg
100 mg
<40kg
Exact dose will be made by pharmacy in a syringe.
>105 to 150 kg
Dose will be rounded to the nearest 10 mg increment
Nearest Syringe
>150kg Insufficient data in ACS and DVT treatment. Physician will be contacted
Note: If the dosing falls outside of the above dosing, contact the MD to clarify conversion.
**Dosages were rounded in the ESSENCE trial: Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q Wave Coronary Events
Medications Approved for Automatic Therapeutic Interchange Dosage Conversion Guidelines
(Note: “Therapeutic Interchange” should be placed in the order comments)
Low Molecular Weight Heparins
Medication
Ordered
Brand Name
Available Dosages
Indication
Frequency
Formulary Medication
Equivalent Dose
Frequency
Dalteparin
Fragmin
2500 units
Prophylaxis
Daily
Enoxaparin
40 mg
Daily
Dalteparin
Fragmin
5000 units
Prophylaxis
Daily
Enoxaparin
40 mg
Daily
Dalteparin
Fragmin
**
**
**
Enoxaparin
30 mg
Q12 Hours
Dalteparin
Fragmin
120 units/kg
Unstable angina or non-Q-wave myocardial infarction
Q12 Hours
Enoxaparin
1 mg/kg+
Q12 Hours
Dalteparin
Fragmin
200 units/kg
VTE*
Daily
Enoxapain
1 mg/kg
Q12 Hours
Note: If the dosing falls outside of the above dosing, contact the MD to clarify conversion.
+Dosage adjustment necessary in patients with CrCl less than 30 ml/min
**Fragmin Does not have an indication for Knee Replacement
*Indication for VTE in Cancer Only for Fragmin
enoxaparin