More from Ovenox
Other strengths and forms by Synovia Pharma PLC.
Indications & Uses
Enoxaparin Sodium (Noxarin) is used to treat deep vein thrombosis, with or without pulmonary embolism. It is also used for unstable angina and non-Q-wave myocardial infarction, and in these cases it is given together with aspirin. Another use is to prevent thrombus formation in the extra-corporal circulation during haemodialysis. Enoxaparin Sodium is also used for prophylaxis of venous thromboembolic disease (prevention of blood clot formation in the veins), in particular the clots that may be associated with orthopedic or general surgery. The same prophylaxis applies to medical patients who are bedridden due to acute illness, including cardiac insufficiency, respiratory failure, severe infections and rheumatic diseases.
Pharmacology
Enoxaparin Sodium is a low molecular weight heparin. It has a high anti-Xa activity and a low anti-lla or antithrombin activity. At the doses needed for its various indications, Enoxaparin Sodium does not increase bleeding time. At preventive doses it causes no notable change in activated Partial Thromboplastin Time (aPTT), and it has no effect on platelet aggregation or on the binding of fibrinogen to platelets. The liver is the main site where the medicine is metabolised.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Treatment of deep vein thrombosis, with or without pulmonary embolism, uses Enoxaparin Sodium subcutaneously at 100 anti-Xa IU/kg twice daily for 10 days, or 150 anti-Xa IU/kg once daily for 10 days. Oral anticoagulant therapy should be started when appropriate. Enoxaparin Sodium should be continued until a therapeutic anticoagulant effect has been achieved.
For treatment of unstable angina and non-Q-wave myocardial infarction, given together with aspirin, the dose is 100 anti-Xa IU/kg subcutaneously twice daily for 2 to 8 days. It should be given at the same time as oral aspirin (100 to 325 mg once daily). In these patients Enoxaparin Sodium should be prescribed for a minimum of 2 days and continued until clinical stabilization.
For prevention of thrombus formation in extra corporeal circulation during hemodialysis, the recommended dose is 100 anti-Xa IU/kg. If the patient has a high risk of hemorrhage, the dose should be reduced to 50 anti-Xa IU/kg for double vascular access or 75 anti-Xa IU/kg for single vascular access. During hemodialysis, Enoxaparin Sodium should be introduced into the arterial line of the circuit at the beginning of the dialysis session.
For prophylaxis of venous thromboembolic disease in surgical patients, the dose depends on the type of surgery. Patients undergoing general surgery with a moderate risk of thromboembolism (e.g. abdominal surgery) receive 2000 anti-Xa IU (0.2 ml) or 4000 anti-Xa IU (0.4 ml) subcutaneously once daily for 7 to 10 days. The first injection should be given 2 hours before the surgical procedure. Patients undergoing orthopedic surgery with a high risk of thromboembolism receive 4000 anti-Xa IU (0.4 ml) subcutaneously once daily for 7 to 10 days, and here the first injection should be given 12 hours before the surgical procedure. A longer treatment duration may be appropriate in some patients. For example, continuing 4000 anti-Xa IU once daily for 3 weeks after the initial therapy has been proven to be beneficial in orthopaedic surgery.
For prophylaxis of venous thromboembolic disease in medical patients, the dose is 4000 anti-Xa IU (0.4 ml) subcutaneously once daily for 6 to 14 days.
Side Effects
Enoxaparin Sodium can cause haemorrhage (bleeding), thrombocytopenia and raised serum aminotransferase levels. At the injection site, people may get pain, bluish marks or a skin rash. There have also been cases of neuraxial hematomas when Enoxaparin Sodium was used together with spinal or epidural anesthesia or a spinal puncture, and these have led to neurologic injuries of varying degrees.
Cautions & Contraindications
Warnings & Precautions
Enoxaparin Sodium is injected deep under the skin (deep subcutaneous route) for both prophylactic and curative treatment. During hemodialysis it is given by the intravascular route. Don't give it by the intramuscular route. Use Enoxaparin Sodium with caution in conditions where the risk of bleeding is higher. These include impaired hemostasis, a history of peptic ulcer, recent ischemic stroke, uncontrolled severe arterial hypertension, diabetic retinopathy, recent neuro- or ophthalmologic surgery, and the concomitant use of medicines that affect hemostasis. Platelet counts should be measured before treatment starts and then regularly while treatment continues.
Contraindications
Enoxaparin Sodium must not be given to people who are known to be hypersensitive to it, to heparin or to other low molecular weight heparins. It must also not be used in people with active major bleeding, or in conditions that carry a high risk of uncontrolled haemorrhage, including a recent haemorrhagic stroke.
Pregnancy & Breastfeeding
Enoxaparin Sodium is a pregnancy category B medicine. In humans, there is no evidence that it crosses the placental barrier. But there are no adequate and well-controlled studies in pregnant women, so Enoxaparin Sodium should be used during pregnancy only if it is clearly needed. Pregnant women with mechanical prosthetic heart valves may be at a higher risk of thromboembolism.
It is not known whether Enoxaparin is excreted in human milk. Many drugs are excreted in human milk, and there is a potential for serious adverse reactions in nursing infants. So a decision should be made whether to stop nursing or to stop Enoxaparin, taking into account how important Enoxaparin is to the mother and the known benefits of nursing.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Dose in Elderly Patients
No dosage adjustment is needed for elderly patients, unless their kidney function is impaired.
Dose in Renal Impairment
Patients with moderate renal impairment (creatinine clearance: 30 to 50 ml/min) or mild renal impairment (creatinine clearance: 50 to 80 ml/min) don't need a dose change. But all of these patients should be watched carefully for signs and symptoms of bleeding. For severe renal impairment (creatinine clearance <30 ml/min), the following dose adjustments are recommended. The prophylactic dose is 2000 anti-Xa IU once daily, and the therapeutic dose is 100 anti-Xa IU/kg once daily.
Dose in Hepatic Impairment
Use Enoxaparin Sodium with caution in patients whose liver function is impaired.
Overdose
If Enoxaparin Sodium is given by accident in too large an amount, bleeding complications can follow. The injected Enoxaparin Sodium can be largely neutralized with a slow i.v. injection of protamine sulfate (1% solution). The protamine sulfate dose should match the dose of Enoxaparin Sodium that was injected, so 1 mg of protamine sulfate is given to neutralize 1 mg of Enoxaparin Sodium.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Enoxaparin Sodium in a cool, dry place and protect it from light and moisture. Don't store it above 25°C, and don't put it in a refrigerator or freezer. Keep it out of the reach of children.
Drug Interactions
Common questions about Ovenox 0.4 ml
What is Ovenox 0.4 ml SC Injection?
Ovenox 0.4 ml SC Injection is a medicine that contains Enoxaparin Sodium. It is made by Synovia Pharma PLC. It belongs to the Parenteral anti-coagulants group of medicines.
What is Ovenox used for?
Enoxaparin Sodium (Noxarin) is used to treat deep vein thrombosis, with or without pulmonary embolism. It is also used for unstable angina and non-Q-wave myocardial infarction, and in these cases it is given together with aspirin.
What are the side effects of Ovenox?
Enoxaparin Sodium can cause haemorrhage (bleeding), thrombocytopenia and raised serum aminotransferase levels. At the injection site, people may get pain, bluish marks or a skin rash.
Can I take Ovenox during pregnancy or while breastfeeding?
Enoxaparin Sodium is a pregnancy category B medicine. In humans, there is no evidence that it crosses the placental barrier. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Ovenox?
If Enoxaparin Sodium is given by accident in too large an amount, bleeding complications can follow. The injected Enoxaparin Sodium can be largely neutralized with a slow i.v. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Ovenox?
Keep Enoxaparin Sodium in a cool, dry place and protect it from light and moisture. Don't store it above 25°C, and don't put it in a refrigerator or freezer.
Can I take other medicines with Ovenox?
Some medicines can interact with Enoxaparin Sodium, for example: Ticagrelor, Ketorolac Tromethamine, Clopidogrel, Ticlopidine Hydrochloride. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Ovenox?
Ovenox is a prescription (Rx) medicine. Take it as your doctor advises.