Lovenox Dosage, forms & strengths
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Lovenox (enoxaparin sodium) is an anticoagulant (blood thinner) that is manufactured by Sanofi-Aventis U.S. It blocks the actions of proteins that are necessary for the formation of blood clots. Lovenox is typically given by subcutaneous injection for outpatient treatment. Lovenox was approved by the U.S. Food and Drug Administration (FDA) in 1993 and is indicated to treat the following:
- Coronary syndromes such as acute ST-segment elevation myocardial infarction (STEMI), Non-ST elevation myocardial infarction, and unstable angina
- Prophylaxis of ischemic complications of unstable angina and non–Q-wave myocardial infarction (MI)
- Deep vein thrombosis (DVT) prophylaxis in abdominal surgery, hip replacement surgery, knee replacement surgery, or bedridden patients
- Pulmonary embolism (PE)
- Prevention and treatment of venous thromboembolism (VTE)
- Treatment for prosthetic valve thrombosis in pregnancy
- Percutaneous coronary intervention (PCI)
- Medical patients at risk for thromboembolic complications due to severely restricted mobility during acute illness
How does Lovenox work?
Blood clots are formed when your blood thickens into a semisolid mass. This is usually a result of an injury. Sometimes blood clots form in your veins or arteries (thrombus) without any sign of injury. If this thrombus breaks off and travels to another part of the body (embolus), it can cause complications such as a pulmonary embolism, heart attack, or stroke.
Lovenox (enoxaparin sodium) is a low molecular weight heparin (LMWH) that binds to antithrombin III and inactivates clotting factor Xa. This inactivation stops the clotting process and prevents the formation of new blood clots. Lovenox also prevents existing clots from getting larger and gives your body time to naturally dissolve them.
Lovenox dosage forms and strengths
Lovenox is available as an injectable solution in the following strengths:
- 30mg/0.3ml single-dose prefilled syringe
- 40mg/0.4ml single-dose prefilled syringe
- 60mg/0.6ml single-dose prefilled syringe
- 80mg/0.8ml single-dose prefilled syringe
- 100mg/1ml single-dose prefilled syringe
- 120mg/0.8ml single-dose prefilled syringe
- 150mg/1ml single-dose prefilled syringe
- 300mg/3ml multiple-dose vial
The recommended starting dose of Lovenox will depend on several factors including age, weight, liver function, kidney function, and the condition being treated.
Lovenox adult dosage chart
Treatment Regimen and Duration
DVT prophylaxis in abdominal surgery
40mg injected under the skin once daily for up to 12 days.
DVT prophylaxis in knee replacement surgery
30mg injected under the skin every 12 hours for up to 14 days.
DVT prophylaxis in hip replacement surgery
30mg injected under the skin every 12 hours or 40mg once daily for up to 14 days.
DVT prophylaxis in medical patients
40mg injected under the skin once daily for up to 14 days.
Inpatient treatment of acute DVT with or without pulmonary embolism
1mg/kg of body weight injected under the skin every 12 hours or 1.5mg/kg of body weight with warfarin for up to 17 days.
Outpatient treatment of acute DVT without pulmonary embolism
1mg/kg of body weight injected under the skin every 12 hours with warfarin for up to 17 days.
Unstable angina and non-Q-wave MI
1mg/kg of body weight injected under the skin every 12 hours with aspirin for up to 8 days.
Acute STEMI in patients <75 years of age
30mg single intravenous bolus and a 1mg/kg of body weight dose followed by 1mg/kg injected under the skin every 12 hours with aspirin for at least 8 days.
Acute STEMI in geriatric patients 75 years of age and older
0.75mg/kg of body weight injected under the skin every 12 hours with aspirin for at least 8 days.
While Lovenox is not indicated to treat patients under the age of 18, it is sometimes used off-label to treat DVT in children and infants.
Lovenox dosage restrictions
- No dose adjustment is needed in patients with a creatinine clearance (CrCl) of 30-50ml/min or 50-80ml/min.
- A dose adjustment is necessary for patients with severe renal impairment (CrCl <30ml/min)
- Caution should be taken if giving Lovenox to patients with liver disease or impairment.
How to take Lovenox
- Read the Full Prescribing Information including the Black Boxed Warning, Instructions for Use, and Medication Guide that comes with this medication.
- Take Lovenox exactly as your doctor prescribes it to you. Do not change your dose or stop taking this medication without first discussing it with them.
- Lovenox is typically given as an injection under the skin of your abdominal wall once daily. Rotate the injection site with each dose. You should sit or lie down when you give the injection. Your doctor should show you how to administer Lovenox before you give your first dose.
- Lovenox is a clear, colorless, or pale yellow solution available in various concentrations. Do not use Lovenox if the color has changed or has particles in it.
- Only use the Lovenox needle and syringe for one injection and then place them in a sharps container. Follow your local or state laws on how to dispose of your sharps container.
- Store Lovenox in its original carton or packaging at room temperature between 15°C-30°C (59°F-86°F). It should be stored in a cool, well-ventilated, dry place away from direct sunlight. Dispose of any unused Lovenox from the multiple-dose vial 28 days after its first use.
Lovenox dosage FAQs
What are some common side effects of Lovenox?
Some of the most common adverse effects of Lovenox include:
- Increased risk of bleeding
- Injection site reactions
- Elevated liver enzymes
- Shortness of breath
Lovenox can cause serious adverse reactions, including:
- Major bleeding (nosebleeds, blood in your urine, coughing or throwing up blood)
- Serious allergic reactions
- Increased incidence of hemorrhage or bleeding disorders
- Epidural or spinal hematomas
Contact your healthcare provider for medical advice about any side effects you experience while taking Lovenox. You can report your side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
What are some drug interactions with Lovenox?
When Lovenox is taken with other medications, they may interact and change how they work or the frequency and severity of side effects. Make sure your doctor is aware of all prescription and over-the-counter medications, vitamins, and herbal supplements you take, including:
- Anticoagulants, platelet inhibitors, or other drugs that affect hemostasis such as Coumadin (warfarin), Plavix (clopidogrel), or unfractionated heparin
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen), and Aleve (naproxen)
- Supplements such as fish oil, ginger, and garlic.
Are there any contraindications or precautions with Lovenox?
Lovenox is contraindicated in patients who suffer from any of the following:
- Active major bleeding.
- History of heparin-induced thrombocytopenia (HIT) within the past 100 days or if you have antibodies to Lovenox circulating in your blood.
- Allergic reaction to Lovenox, heparin, or pork products.
- Allergic reaction to the preservative, benzyl alcohol (multi-dose vial only).
The use of Lovenox should be used with caution in the following:
- Increased risk of hemorrhage. You should be monitored for signs of bleeding.
- Increased risk of low platelet levels. Your platelet count should be monitored very closely.
- Increased risk of bleeding around the spinal cord if you receive epidural, spinal anesthesia, or are undergoing a spinal puncture.
- Thromboprophylaxis with Lovenox in pregnant women with mechanical prosthetic heart valves can result in valve thrombosis.
- Safety and efficacy were not established in obese patients (BMI>30 kg/m²) in clinical trials.
How long does it take for Lovenox to start working?
Lovenox has a half-life of 4.5 to 7 hours, so it will stay in your bloodstream for about 1.5 days after your last dose.
Does Lovenox dissolve blood clots?
No, Lovenox does not dissolve blood clots. It does prevent blood clots from forming while also keeping existing clots from growing larger until your body can dissolve them naturally.
Can I drink alcohol while taking Lovenox?
If you do drink alcohol, you should not have more than 2 drinks (a can of beer, a glass of wine, a shot of liquor) per day for men or 1 drink per day for women. Drinking more than this can increase your risk of bleeding.
How do I store Lovenox?
You should store Lovenox in the original carton or packaging at room temperature between 15°C-30°C (59°F-86°F). It should be stored in a cool, dry place away from direct sunlight. Dispose of any unused Lovenox from the multiple-dose vial 28 days after its first use.
Is it safe to use Lovenox while pregnant or breastfeeding?
Lovenox doesn’t cross the placenta in pregnant women so it is not expected to affect the fetus. It is not known whether Lovenox is found in breast milk or the effects it may have on the infant. You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.
Will lab monitoring be done when taking Lovenox?
You should have blood tests to check your PT/INR (if on warfarin), potassium, or platelet levels. You should be monitored closely for signs and symptoms of bleeding. Anti-Factor Xa may also be used to monitor the anticoagulant effect of Lovenox in patients with severe renal impairment. Your dose of enoxaparin will need to be adjusted if your creatinine clearance (CrCl) is less than 30 ml/minute.
Is there a generic for Lovenox?
Currently, there is a generic for Lovenox available on the market. However, you may still pay less for the brand-name drug Lovenox through NiceRx if ellgible for assistance.
Related resources for Lovenox
The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.