📋 Indications & Clinical Dosage
*Prophylaxis Of Venous Thromboembolism Associated with General surgery, low risk:*
BY DEEP SC INJ: Adult: 20 mg by deep SC injection 2 hrs pre-op, than 20 mg once daily for 7-10 days or until risk.
*Orthopedic surgery, high risk:*
BY DEEP SC INJ: Adult: 40 mg by deep SC injection 12 hrs pre-op, then 40 mg once daily for 7- I0 days or until risk.
*Prophylaxis in acute illness and for bed-ridden patients:*
BY DEEP SC INJ: Adult: 40mg by deep SC injection 12 hrspre-op, then 40 mg once daily forminimum 6 days and continue untilfull ambulation; max 14 days.
*Treatment of deep venous thrombosis, pulmonary embolism:*
BY DEEP SC INJ: Adult: 1.5 mg/kg by SC inj daily for minimum 5 days or until adequate oral anticoagulants is established.
*Treatment of unstable Angina and non-Q wave MI:*
1 mg/kg by SC inj every 12 hr for minimum 2 days or until clinical stabilization, usually 2-8 days alongwith oral aspirin, 100-325 mg once daily.
*Prevention of thrombus formation in the extracorporeal circulation during haemodialysis:*
BY DEEP SC INJ: Adult: 1 mg/kg into arterial line of circuit prior to session. A further dose of 0.5-1 mg/kg may be given if session exceeds 4 hr. If high risk of haemorrhage, 0.5mg/kg for double vascular access or 0.75 mg/kg for single vascular access
Children: Not recommended.
💊 Mode of Administration
By deep SC injection to the left or right anterolateral and left or right posterolateral abdominal wall, alternate injection site between left and right. To avoid loss of drug from the 30 mg and 40 mg syringes, do not expel the air bubble from the syringe prior to injection. In order to minimize bruising, do not rub injection site. When administered in conjunction with a thrombolytic, enoxaparin should be given between 15 min before and 30 min after thestart of thrombolytic therapy.
⛔ Contraindications
Acute bacterial endocarditis, major bleeding disorders, increased risk of haemorrhage. thrombocylopenia, active peptic ulcer, haemorrhagic CVA
⚠️ Precautions & Warnings
Hepatic insufficiency, hypertension, history of GI ulceration. Spinal or epidural anaesthesia, spinal puncture
🔄 Drug Interactions
Oral anticoagulants, heparin treatment, locoregional anaesthesia, antiplatelet agents, NSAIDs, aspirin. Dextran.
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Caution advised
Lactation / Breastfeeding:
Caution advised
🧪 Compatibility & Storage Stability
Compatibility: Stable in NS.
Stability & Storage: Store at 15.C-25C (59F-77F). Do not freeze. Do not mix with other injections or infusions.
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.