Drug updated on 9/4/2024
Dosage Form | Injection (subcutaneous/intravenous; 100mg/mL [30 mg/0.3 mL, 40 mg/0.4 mL, 60 mg/0.6 mL, 80 mg/0.8 mL, 100 mg/1 mL, 300 mg/3 mL]); Injection (subcutaneous/intravenous; 150 mg/mL [120 mg/0.8 mL, 150 mg/1 mL]) |
Drug Class | Low molecular weight heparin |
Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated for prophylaxis of deep vein thrombosis (DVT) in abdominal surgery, hip replacement surgery, knee replacement surgery, or medical patients with severely restricted mobility during acute illness.
- Indicated for inpatient treatment of acute DVT with or without pulmonary embolism.
- Indicated for outpatient treatment of acute DVT without pulmonary embolism.
- Indicated for prophylaxis of ischemic complications of unstable angina and non–Q-wave myocardial infarction (MI).
- Indicated for treatment of acute ST-segment elevation myocardial infarction (STEMI) managed medically or with subsequent percutaneous coronary intervention (PCI).
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Summary
- Lovenox (enoxaparin sodium) is indicated for prophylaxis of deep vein thrombosis (DVT) in abdominal surgery, hip replacement surgery, knee replacement surgery, or medical patients with severely restricted mobility during acute illness; inpatient treatment of acute DVT with or without pulmonary embolism; outpatient treatment of acute DVT without pulmonary embolism; prophylaxis of ischemic complications of unstable angina and non–Q-wave myocardial infarction (MI); and treatment of acute ST-segment elevation myocardial infarction (STEMI) managed medically or with subsequent percutaneous coronary intervention (PCI).
- This summary is based on the review of 10 systematic review(s)/meta-analysis(es). [1-10]
- Enoxaparin 40 mg post-total hip arthroplasty (THA) effectively reduced minor hemorrhages but was not the most effective for reducing deep venous thrombosis (DVT) or pulmonary embolism (PE) rates compared to other drugs.
- In trauma patients, enoxaparin significantly reduced DVT incidence compared to placebo and was comparable to fondaparinux in effectiveness.
- Rivaroxaban demonstrated superior efficacy in reducing venous thromboembolism (VTE) risk compared to enoxaparin (RR: 0.38) in orthopedic surgery, though with a similar safety profile.
- In general surgery patients, weight-tiered and BMI-based enoxaparin dosing regimens achieved higher efficacy in prophylactic anti-Xa levels compared to fixed dosing.
- Enoxaparin 40 mg in THA patients had a lower rate of minor hemorrhages compared to other drugs. In trauma patients, enoxaparin showed no increased bleeding risk compared to placebo and was comparable to fondaparinux. Rivaroxaban presented a higher bleeding risk compared to enoxaparin.
- In THR patients, enoxaparin had comparable bleeding risks to NOACs like apixaban and dabigatran, but rivaroxaban had a higher bleeding risk. In orthopedic surgery, similar safety profiles were observed between rivaroxaban and enoxaparin, with no significant differences in major bleeding events.
- Among pregnant women, bleeding events were non-significantly more frequent for enoxaparin compared to untreated controls, but less frequent compared to aspirin.
- Population-specific findings indicate that weight-tiered and BMI-based dosing regimens for general surgery patients, and specific dosing recommendations for obese patients (BMI ≥ 30 kg/m² or body weight ≥ 100 kg) improve efficacy. In trauma patients, enoxaparin and fondaparinux effectively prevent DVT. In pregnant women, enoxaparin is associated with fewer complications than aspirin, particularly in cases of recurrent pregnancy loss and other placental complications.
Product Monograph / Prescribing Information
Document Title | Year | Source |
---|---|---|
Lovenox (enoxaparin sodium) Prescribing Information. | 2021 | Sanofi-aventis, Bridgewater, NJ |