What is enoxaparin? 

Enoxaparin is an anticoagulant (blood thinner) that prevents the formation of blood clots. 

Enoxaparin is used to prevent blood clots that are sometimes called deep vein thrombosis (DVT), which can lead to blood clots in the lungs. A DVT can occur after certain types of surgery, or in people who are bed-ridden due to a prolonged illness. DVT sometimes occurs suddenly for other reasons. 

Enoxaparin is also used to prevent blood vessel complications in people with certain types of angina (chest pain) or heart attack. 

Enoxaparin may also be used for other purposes not listed in this medication guide. 

What is the most important information I should know about enoxaparin? 

You should not receive this medication if  you are allergic to enoxaparin, heparin,  or pork products, or if you have uncontrolled bleeding, a severe lack  of platelets in your blood, or if you are having surgery with spinal  or epidural anesthesia. 

Before  you receive enoxaparin, tell  your doctor if you have eye problems caused by diabetes, an infection of your heart, uncontrolled high blood pressure, a history of stroke, a bleeding  or blood clotting disorder, stomach or intestinal bleeding or ulcer, kidney or liver disease, a genetic spinal defect or recent surgery, recent eye or brain surgery; an allergy to benzyl alcohol, or if you have ever had low blood platelets after receiving heparin. 

Avoid taking aspirin unless your doctor recommends it as part of your treatment. Aspirin can increase your risk of bleeding. 

Tell  your doctor about all medications you use. Many other drugs (including some over-the-counter medicines) can increase your  risk of bleeding, and it is very important to tell your doctor if you are using any of them before you start using  enoxaparin. This includes blood thinners, aspirin, NSAIDs (such as Advil, Motrin Aleve, Orudis), or other medications used to treat or prevent blood clots. 

If you need surgery, dental work, or a medical procedure (especially  with spinal or epidural anesthesia), tell the doctor or dentist ahead of time that you are using enoxaparin. You may need special care to prevent bleeding. 

What should I discuss with my healthcare provider before receiving enoxaparin? 

You should not receive enoxaparin if you are allergic to it, or if you have: 

• uncontrolled bleeding; 
• a severe lack of platelets in your blood;  or
• if you are allergic to heparin or pork products. 

If you have any  of these other conditions, you may need a enoxaparin dose adjustment or special tests: 

• eye problems caused  by diabetes; 
• an infection of  the lining of your heart (also called bacterial endocarditis); 
• a history of stroke; 
• uncontrolled high blood pressure; 
• a bleeding or blood clotting disorder, such as hemophilia; 
• stomach or intestinal bleeding or ulcer; 
• kidney or liver disease; 
• a genetic spinal defect; 
• recent eye, brain, or spinal surgery; 
• an allergy to benzyl alcohol; or 
• if you have ever had low blood platelets after receiving heparin. 

FDA pregnancy category B.  Enoxaparin is not expected to harm  an unborn baby. However, some forms of this medication contain  a preservative that may  be harmful. Tell  your doctor if  you are pregnant or plan to become pregnant during treatment. If you  use this medication during pregnancy, make sure  your doctor knows if  you have a mechanical heart valve. It is  not known whether enoxaparin passes into breast milk  or if  it could harm a nursing baby. Do not receive this medication without telling  your doctor if you are breast-feeding a baby. 

How should I use enoxaparin? 

Enoxaparin is injected under the skin. You may be shown how to use injections at home.  Do not self-inject this medicine if  you do not fully understand  how to give the injection and properly dispose of used needles and syringes. 

Enoxaparin is sometimes injected into a vein through an IV. 

You should be sitting or lying down while receiving an enoxaparin injection. 

Do not mix enoxaparin with other medications in the same syringe unless your doctor tells you to. 

Use  a different place on your stomach each time you give the injection. Your care provider will show  you the best places on  your body to inject the medication.  Do not inject into  the same place two times in a row. Do not inject enoxaparin into a muscle. 

Use a disposable  needle only once. Throw  away used needles in a puncture-proof container (ask your pharmacist where you can get one  and how to dispose of it). Keep this container  out of the reach of children and pets. 

To be sure this medication is not causing harmful effects,  your blood may need to be tested often. Your stool (bowel movement) may also need to be tested. Visit your doctor regularly. 

If you need surgery, dental work, or a medical procedure (especially with spinal or epidural anesthesia), tell  the doctor or dentist ahead  of time that you are using 
enoxaparin. You may need special care  to prevent bleeding. Store at room temperature away from moisture and heat. 

Do not use any medication that is discolored  or that has particles in it. Call  your doctor for a new prescription. 

What happens if I miss a dose? 

Use  the missed dose as soon as you remember. Skip  the missed dose if it is almost  time for your next scheduled dose.  Do not use extra medicine to make up  the missed dose. 

What happens if I overdose? 

Seek emergency medical attention or call the Poison Help line. 

Overdose may cause excessive bleeding. 

What should I avoid while using enoxaparin? 

Avoid taking aspirin unless  your doctor recommends it as part of your treatment. Aspirin can increase your risk of bleeding. 

Enoxaparin side effects 

Get emergency medical help if you have any  of these signs  of an allergic reaction: hives; itching or burning skin; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using enoxaparin and call your doctor  at once  if you have a serious side effect such as: 

• easy bruising, unusual bleeding (nose, mouth, vagina,  or rectum),  any bleeding that will not stop; 
• purple  or red pinpoint spots under  your skin; 
• blood in  your urine or stools, black or tarry stools; 
• coughing up blood or vomit that looks like coffee grounds; 
• pale skin, feeling light-headed or short  of breath, rapid heart rate, trouble concentrating; 
• bruising, bleeding, swelling, or skin changes where the medicine was injected; 
• sudden numbness or weakness, especially on one side  of the body; 
• sudden headache, confusion, problems with vision, speech,  or balance; 
• pain or swelling in one or both legs; or 
• Trouble breathing. 

Less serious side effects include mild pain, redness, or warmth where the medicine was injected. 

• diarrhea;
• fever;
• swelling in your hands or feet; or 
• Mild pain, irritation, or redness where the medicine was injected. 

This is not a complete list of side effects and others may occur. Call  your doctor for medical advice about side effects. You may report side effects  to FDA 

What other drugs will affect enoxaparin? 

There  are many other drugs  that can increase your risk of bleeding, and it is very important to tell  your doctor if you are using any of them before you start using enoxaparin. This includes: 

• a blood thinner such as warfarin (Coumadin); 
• other medications used to prevent blood clots, such as alteplase (Activase), clopidogrel (Plavix), dipyridamole (Persantine), ticlopidine (Ticlid), and urokinase (Abbokinase); 
• salicylates such as aspirin, Backache Relief Extra Strength, Novasal, Nuprin Backache Caplet, Doan's Pills Extra Strength, Pepto-Bismol, Tricosal, and others; or 
• NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Cataflam, Voltaren), etodolac (Lodine), indomethacin (Indocin), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), piroxicam (Feldene), and others. 

This list is not complete and other drugs may interact with enoxaparin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. 

Where can I get more information? 

• Your doctor or pharmacist can provide more information about enoxaparin. 
• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. 
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. 

Notes: FCbinderMD

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EditText of this page (last edited April 13, 2010)