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Related to Clexane: heparin

enoxaparin sodium

Clexane (UK), Lovenox

Pharmacologic class: Low-molecular-weight heparin

Therapeutic class: Anticoagulant

Pregnancy risk category B

FDA Box Warning

• During epidural or spinal anesthesia or puncture, patients receiving drug or scheduled to receive it for thromboprophylaxis are at risk for epidural or spinal hematoma, which can lead to long-term or permanent paralysis. Risk increases with use of indwelling epidural catheter for analgesia administration and with concurrent use of drugs affecting hemostasis (such as nonsteroidal anti-inflammatory drugs [NSAIDs], platelet inhibitors, and other anticoagulants). Risk also rises with traumatic or repeated epidural or spinal puncture or history of spinal deformity or spinal surgery. Before neuraxial intervention, physician should weigh drug's potential benefit against risk.

• Monitor patient frequently for signs and symptoms of neurologic impairment. If these occur, provide urgent treatment.


Inhibits thrombus and clot formation by blocking factor Xa and factor IIa. This inhibition accelerates formation of antithrombin III-thrombin complex (a coagulation inhibitor), thereby deactivating thrombin and preventing conversion of fibrinogen to fibrin.


Solution for injection: 30 mg/0.3 ml, 40 mg/0.4 ml, 60 mg/0.6 ml, 80 mg/0.8 ml, 120 mg/0.8 ml, 100 mg/1 ml, 150 mg/1 ml (all in prefilled syringes); 300 mg/3 ml (in multidose vials)

Indications and dosages

Patients at risk for thromboembolic complications due to severely restricted mobility during acute illness

Adults: 40 mg subcutaneously daily for up to 14 days

Prevention of pulmonary embolism and deep-vein thrombosis (DVT) after abdominal surgery

Adults: 40 mg subcutaneously 2 hours before surgery, repeated 24 hours after initial dose (provided hemostasis has been established) and continued once daily for 7 to 10 days until risk of DVT has diminished

Prevention of pulmonary embolism and DVT after hip or knee replacement surgery

Adults: 30 mg subcutaneously 12 to 24 hours after surgery (provided hemostasis has been established), repeated q 12 hours for 7 to 10 days until risk of DVT has diminished. Alternatively, hip-replacement patient may receive 40 mg subcutaneously 12 hours before surgery and then once daily for 3 weeks, for a total of 4 weeks of therapy.

Prevention of ischemic complications of unstable angina or non-Q-wave myocardial infarction

Adults: 1 mg/kg subcutaneously q 12 hours, given with aspirin 100 to 325 mg P.O. once daily until patient is clinically stable

Hospitalized patients with acute DVT with or without pulmonary embolism (PE) (given with warfarin sodium)

Adults: 1 mg/kg subcutaneously q 12 hours or 1.5 mg/kg subcutaneously once daily for 5 to 7 days until therapeutic effect is established. Warfarin therapy usually begins within 72 hours of enoxaparin injection.

Outpatients with acute DVT without PE (given with warfarin sodium)

Adults: 1 mg/kg subcutaneously q 12 hours for 5 to 7 days until therapeutic effect is established. Warfarin therapy usually begins within 72 hours of enoxaparin injection.

Dosage adjustment

• Patients weighing less than 45 kg (99 lb)

• Creatinine clearance below 30 ml/minute

Off-label uses

• Prevention of clots associated with hemodialysis

• Prevention of thrombosis during pregnancy


• Hypersensitivity to drug, heparin, sulfites, benzyl alcohol, or pork products

• Thrombocytopenia

• Active major bleeding


Use cautiously in:

• severe hepatic or renal disease, retinopathy (hypertensive or diabetic), uncontrolled hypertension, hemorrhagic stroke, bacterial endocarditis, GI bleeding or other bleeding disorders

• recent history of ulcer disease, history of congenital or acquired bleeding disorder, history of thrombocytopenia related to heparin use

• recent CNS surgery

• pregnant or breastfeeding patients

• children.


Be aware that enoxaparin is a high-alert drug.

• Use tuberculin syringe with multidose vial to ensure accurate dosage.

• Don't expel air bubble from syringe before administering.

• Inject drug deep subcutaneously with patient in supine position. Alternate left and right anterolateral and posterolateral abdominal wall sites.

• Don't rub injection site.

Don't give by I.M. or I.V. route.

Adverse reactions

CNS: dizziness, headache, insomnia, confusion,cerebrovascular accident

CV: edema, chest pain,atrial fibrillation, heart failure

GI: nausea, vomiting, constipation

GU: urinary retention

Hematologic: anemia,bleeding tendency, thrombocytopenia, hemorrhage

Metabolic: hyperkalemia

Skin: bruising, pruritus, rash, urticaria

Other: fever; pain, irritation, or erythema at injection site


Drug-drug. Warfarin, other drugs that affect platelet function (including abciximab, aspirin, clopidogrel, dextran, dipyridamole, eptifibatide, NSAIDs, some penicillins, ticlopidine, tirofiban): increased risk of bleeding

Drug-diagnostic tests. Hepatic enzymes: reversible increases Hemoglobin, platelets: decreased levels

Drug-herbs. Anise, arnica, chamomile, clove, feverfew, garlic, ginger, ginkgo, ginseng: increased risk of bleeding

Patient monitoring

• Monitor CBC and platelet counts. Watch for signs and symptoms of bleeding or bruising.

• Monitor fluid intake and output. Watch for fluid retention and edema.

Patient teaching

• If patient will self-administer drug, teach proper injection technique.

Instruct patient to promptly report irregular heart beat, unusual bleeding or bruising, rash, or hives.

• Teach patient safety measures to avoid bruising or bleeding.

• Advise patient to weigh himself regularly and to report gains.

• Instruct patient to inform dentists and other health care professionals about enoxaparin use.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved


A brand name for ENOXAPARIN.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
The fact that his implanted stents were found unobstructed with the absence of thrombus in the left trunk and three coronary branches could be attributed to the action of the administered platelet aggregation inhibitor ticagrelor and enoxaparin (Clexane).
clexane 20 mg Sol.Inyectable ENOXAPARINA SODICA 20 mg / 0.2 ml Sol.Inyectable clenox 20 mg procaps Sol.Inyectable clasina 20 mg lafrancol Sol.Inyectable enoxpar 20 mg / 0,2 mL chalver Sol.Inyectable Producto Presentacion lantus 100 UI / mL Cja.
The night prior to surgery, all patients were administered with a low molecular weight heparin derivative (Clexane 8000 anti-Xa IU/0,8, Aventis), and prophylaxis for deep vein thrombosis.
Intermittent calf compression stockings and subcutaneous Clexane (40 mg daily) were used as deep vein thrombosis prophylaxis.
Deep vein thrombosis prophylactic measures were taken in all patients by giving them low-molecular weight heparin enoxaparin (Clexane) 40-60 mg subcutaneously once a day.
She had been taking blood thinning medication heparin prior to surgery and was administered another, clexane, the morning after her surgery.
An aqueous solution (200 [micro]l) of enoxaparin (Clexane 100 mg/mL), 1 mL of deionized water, and 0.5% of polyvinyl alcohol (PVA) was first emulsified with an organic phase containing 10 mL of ethyl acetate and 60 mg of PCL under stirring for 1 minute at 6000 rpm to form a water/oil emulsion.
Enoxaparin (Clexane, Sanofi, France) and EGb 761 (Ginaton, Germany) were purchased from the Affiliated Zhongshan Hospital of Dalian University (Dalian, China).
The treatment was initiated immediately with albumin (25%) in doses of 50 g infused over 4 h and repeated at every 12 h in the first 2 days, lactated ringers solution (1000 mL/day) in the first 2 days and low molecular weight heparin (Clexane; 6000 IU daily) during hospitalization.
With thorough evaluation of the patient, the diagnosis of asthma was established and she received Clexane, Betamethasone, Venofer, and Azithromycin and was discharged after 7 days with stable condition.
clexane 60 mg subcutaneous started post operatively and continued for 10 days.
Here, one of the skills they must master is self-administering Clexane injections, which prophylactically prevent blood clotting after surgery.