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What is the most important information I should know about enoxaparin?

You should not receive this medication if you are allergic to enoxaparin, heparin, or pork products, or if you have any type of major bleeding or a very low blood platelet count.

Before receiving enoxaparin, tell your doctor if you are allergic to any drugs, or if you have kidney or liver disease, a heart infection, any bleeding or clotting disorder, high blood pressure, diabetes, a stomach ulcer, an artificial heart valve, or a history of stroke or recent brain or spine surgery.

To be sure this medication is helping your condition, your blood will need to be tested often. This will help your doctor determine how long to treat you with enoxaparin. Do not miss any scheduled appointments.

You will most likely be treated with other medications such as aspirin or warfarin (Coumadin). To best treat your condition, use all of your medications as directed by your doctor. During your treatment with enoxaparin, do not use any other medications unless your doctor tells you to.

If you need to have any type of surgery or dental work, tell the surgeon or dentist ahead of time that you are using enoxaparin. You may need to stop using the medicine for a short time, especially if you will be receiving spinal or epidural anesthesia (also called spinal block). This type of anesthesia may increase the risk of paralysis in people who are also using enoxaparin.

Warning

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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What is enoxaparin?

Enoxaparin is a blood thinner, also called anticoagulant (an-tye-koe-AG-yoo-lant). Enoxaparin prevents the formation of blood clots.

Enoxaparin is used to prevent blood clots that are sometimes called deep vein thrombosis (DVT), which can lead to blood clots in the lungs. A DVT can occur after certain types of surgery, or in people who are bed-ridden due to a prolonged illness. DVT sometimes occurs suddenly for other reasons.

Enoxaparin is also used to prevent blood vessel complications in people with certain types of angina (chest pain) or heart attacks called non-Q-wave myocardial infarction or ST-segment elevation myocardial infarction.

Enoxaparin may also be used for other purposes not listed in this medication guide.


Precautions

You should not receive this medication if you are allergic to enoxaparin, heparin, or pork products, or if you have:

  • any type of major bleeding; or
  • a very low blood platelet count.

Before receiving enoxaparin, tell your doctor if you are allergic to any drugs, or if you have:

  • kidney disease;
  • liver disease;
  • bacterial infection of the lining of your heart;
  • a bleeding or blood clotting disorder such as hemophilia;
  • uncontrolled or untreated high blood pressure;
  • a stomach ulcer;
  • eye problems caused by diabetes;
  • a history of hemorrhagic stroke;
  • a history of low blood platelets caused by receiving heparin;
  • if you have recently had surgery on your brain, spine, or eyes;
  • if you have an artificial heart valve.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. If you are pregnant, tell your doctor if you have an artificial heart valve.

It is not known whether enoxaparin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

During your treatment with enoxaparin, avoid taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or any type of blood thinners unless your doctor tells you to. Using these medications together with enoxaparin can increase your risk of bleeding.

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Instructions

Seek emergency medical attention if you think you have received too much of this medicine.

Overdose symptoms may include nosebleeds, blood in your urine or stools, easy bruising or bleeding, or any bleeding that won’t stop.

Use the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up the missed dose.

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Side-effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers or call your doctor at once if you have any of these serious side effects:

  • bleeding that won't stop;
  • pale skin, easy bruising, unusual weakness;
  • swelling, bruising, or bleeding where an incision was made during a surgery or other medical procedure;
  • sudden numbness or weakness, headache, confusion, problems with vision, speech, or balance;
  • pain or swelling in one or both legs; or
  • cough, chest pain, trouble breathing.

Less serious side effects may include:

  • nausea, diarrhea;
  • swelling in your hands or feet; or
  • mild swelling, pain, bruising, or redness where the medicine was injected.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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Interactions

Before you receive enoxaparin, tell your doctor about any blood thinners you have been using recently, such as warfarin (Coumadin).

The following drugs can interact with enoxaparin. Tell your doctor if you are using any of these:

  • sulfinpyrazone (Anturane);
  • salicylates such as Novasal, Doan's Extra Strength, Salflex, Tricosal, and others;
  • aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), indomethacin (Indocin), ketorolac (Toradol), and others; or
  • medication used to prevent blood clots, such as alteplase (Activase), anistreplase (Eminase), clopidogrel (Plavix), dipyridamole (Persantine), streptokinase (Kabikinase, Streptase), ticlopidine (Ticlid), and urokinase (Abbokinase).

This list is not complete and there may be other drugs that can interact with enoxaparin. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

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Disclaimer

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04

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