Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Austria: Lovenox; Belgium: Clexane; Cyprus: Clexane; Czech Republic: Clexane; Denmark: Klexane; Estonia: Clexane; Finland: Klexane; France: Lovenox; Germany: Clexane, Klexane, Lovenox, Qualiop; Greece: Clexane; Hungary: Clexane; Ireland: Clexane; Italy: Clexane; Latvia: Clexane; Luxembourg: Clexane; Malta: Clexane; Netherlands: Clexane; Poland: Clexane; Portugal: Lovenox; Romania: Clexane; Slovakia: Clexane; Spain: Clexane; Sweden: Klexane; UK: Clexane.

North America

Canada: Lovenox; USA: Lovenox.

Latin America

Argentina: Clexane, Dilutol-Lazar, Enoxaparina, Fibrinox, Omatex; Brazil: Clexane, Dripanina; Mexico: Clexane.


Japan: Clexane.

Drug combinations


Enoxaparin Sodium: Sodium salt of a low-molecular weight heparin obtained by alkaline depolymerization of the benzyl ester of heparin from porcine mucosa. CAS-679809-58-6 (1995).

Pharmacologic Category

Antithrombotic Agents; Anticoagulants; Heparins, Low Molecular Weight. (ATC-Code: B01AB05).

Mechanism of action

A low molecular weight heparin (LMWH) prepared by alkaline degradation of unfractionated benzylated heparin of porcine intestinal mucosa origin, enoxaparin acts as an anticoagulant by enhancing the inhibition rate of clotting proteases by antithrombin III, impairing normal hemostasis and inhibition of factor Xa. Low molecular weight heparins have a small effect on the activated partial thromboplastin time and strongly inhibit factor Xa.

Therapeutic use

Unstable angina, non-ST-segment elevation, and ST-segment elevation MI. Hip or knee replacement surgery, abdominal surgery, or in severely-restricted mobility. Inpatient treatment (with and without pulmonary embolism) and outpatient treatment (without pulmonary embolism).

Pregnancy and lactiation implications

Available data in humans and animals indicate that enoxaparin does not cross the placenta and has not shown evidence of teratogenicity or fetotoxicity. Maternal and neonatal hemorrhage has occurred. Use caution in pregnant women. Unknown whether enoxaparin is distributed in milk. Caution if used in nursing women.

Unlabeled use

Prophylaxis and treatment of thromboembolism in children.


Hypersensitivity to enoxaparin, heparin, or any component of the formulation. Thrombocytopenia. Hypersensitivity to pork products. Active major bleeding. Not for I.M. use.

Warnings and precautions

Patients with recent or anticipated neuraxial anesthesia (epidural or spinal anesthesia) are at risk of spinal or epidural hematoma and subsequent paralysis. Use with extreme caution in patients with increased risk of hemorrhage (with bacterial endocarditis, congenital or acquired bleeding disorders, active ulceration and angiodysplastic GI disease, hemorrhagic stroke, or recent brain, spinal, or ophthalmologic surgery). Increased risk for hemorrhage in patients treated concomitantly with platelet inhibitors. Use with caution in bleeding diathesis, uncontrolled arterial hypertension, or history of recent GI ulceration, diabetic retinopathy, or hemorrhage. Risk of bleeding may be increased in low weight patients. Cases of heparin-induced thrombocytopenia with thrombosis reported, including complications such as organ infarction, limb ischemia, or death. Use with extreme caution in history of heparin-induced thrombocytopenia and also in congenital or drug-induced thrombocytopenia or platelet defects. Heparin can cause hyperkalemia by affecting aldosterone; similar reactions could occur with LMWHs. Not recommended for thromboprophylaxis in prosthetic heart valves (especially pregnant women). Use with caution in renal failure. Use with caution in the elderly. Multidose vials contain benzyl alcohol and should not be used in pregnant women. In neonates, large amounts of benzyl alcohol (>100 mg/kg/day) have been associated with fatal toxicity («gasping syndrome»). Do not administer I.M.. Not to be used interchangeably (unit for unit) with heparin or any other LMWHs.



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