Enoxaparin: Uses, Dosage, Side Effects, Precautions and Price in India

At a Glance

What is Enoxaparin?

Enoxaparin is a low molecular weight heparin (LMWH). It is commonly used to prevent and treat deep vein thrombosis (DVT), pulmonary embolism (PE), and other harmful blood clots. It helps lower the risk of clots in people with limited movement after surgery or during illness. It works as a blood thinner and helps keep blood flowing smoothly through the vessels.

How It Works

This medicine enhances the activity of antithrombin, a natural protein that limits clotting. It mainly inhibits Factor Xa and, to a lesser extent, thrombin (Factor IIa). This helps prevent clots from forming and supports smooth blood circulation.

Uses

• DVT prevention: Used to prevent blood clots in the legs after abdominal surgery, hip or knee replacement surgery, and in medical patients with severely restricted mobility during acute illness.
• DVT treatment: Used to treat acute DVT, with or without pulmonary embolism (PE).
• Heart conditions: Used in unstable angina, non-Q-wave myocardial infarction, and ST-elevation myocardial infarction (STEMI), as decided by the treating doctor.

How It Is Given

This medicine is usually given by subcutaneous injection. In specific hospital situations, such as acute STEMI, intravenous (IV) administration may be used under medical supervision. IV use is not something patients do themselves. Your healthcare team will explain how and when any injection is given.

Dosage (General Reference Information)

This section is general reference information. It is not a dosing guide and must not be used for self-medication. Dose selection depends on the indication, body weight, kidney function, age, bleeding risk, and clinical situation, and the doses below are not interchangeable.

Prevention of DVT (adults), by setting

• Abdominal surgery, and medical patients with severely restricted mobility during acute illness: 40 mg once daily.
• Hip or knee replacement surgery: 30 mg every 12 hours is a labelled regimen. 40 mg once daily may also be considered after hip replacement surgery.

Treatment of acute DVT (adults)

• Inpatient treatment: 1 mg/kg every 12 hours, or 1.5 mg/kg once daily in selected patients.
• Outpatient treatment of acute DVT without PE: 1 mg/kg every 12 hours.

Severe kidney impairment (creatinine clearance below 30 mL/min): Dose adjustment is recommended. For prevention, the label lists 30 mg once daily.

Children: US labeling states that safety and effectiveness in children have not been established. Use in children can occur in specific clinical situations. Dosing depends on weight and the indication, and it is decided only by a specialist.

Side Effects

Common:

• Bleeding or easy bruising
• Anemia (low red blood cells)
• Low platelet counts (thrombocytopenia)
• Injection site reactions
• Raised liver enzymes on blood tests

Serious (seek urgent medical help):

• Unusual or heavy bleeding, black stools, or blood in urine
• New numbness or weakness, especially in the legs (possible spinal/epidural hematoma, which can cause long-term or permanent paralysis)
• Sudden drop in platelets, sometimes with new clots (heparin-induced thrombocytopenia)

Who Should Not Take It

This medicine is contraindicated in people with:

• Active major bleeding
• A history of immune-mediated heparin-induced thrombocytopenia (HIT) within the past 100 days, or circulating antibodies to it
• Hypersensitivity to enoxaparin, heparin, or pork products
• Hypersensitivity to benzyl alcohol (multiple-dose vials only)

Precautions

Spinal or epidural procedures: People on this medicine who have spinal anaesthesia, epidural catheters, or spinal puncture are at risk of spinal/epidural hematoma. The risk is higher with other drugs that affect bleeding, such as NSAIDs, platelet inhibitors, and other anticoagulants. Tell every doctor and dentist that you take a blood thinner.

Bleeding risk: Use with care in people with bleeding disorders, uncontrolled high blood pressure, recent stomach ulcers, diabetic retinopathy, or kidney problems. Older adults and low-weight patients need closer observation for bleeding.

Kidney and liver: Severe kidney impairment needs dose adjustment. Use with caution in liver impairment.

Not interchangeable: It should not be swapped with heparin or other low molecular weight heparins unit for unit.

Blood tests and monitoring: Platelet counts and kidney function may be monitored during treatment. Routine INR testing is not used to monitor the anticoagulant effect of enoxaparin, because INR is used for warfarin. Most patients do not need routine anti-Xa monitoring, but it may be considered in selected patients or settings, such as severe kidney impairment, pregnancy, extreme body weight, children, or high bleeding risk.

Pregnancy: Pregnancy itself raises the risk of clots. Enoxaparin and other LMWHs are commonly used during pregnancy when anticoagulation is needed, because LMWHs do not cross the placenta in clinically meaningful amounts. This does not mean it is automatically appropriate for every pregnant patient, and the doctor decides based on the indication and the benefits and risks. Pregnant patients with mechanical prosthetic heart valves need specialist anticoagulation management, because their clot risk and anticoagulation needs are different.

Brand Names in India

Clexane is a widely listed brand. Others listed in India include Lomoh and Enclex. Availability varies by location and may change over time, and these are not the only brands.

Approximate Price in India

Listed MRPs for this pack are approximately ₹465–₹485. These are listed maximum retail prices, not fixed selling prices.

Prices may vary by brand, strength, formulation, pack size, pharmacy, location, and available discounts. This is not a recommendation to buy or use the medicine without a prescription.

How HealthPil Can Help

Medicines should be started, adjusted, or stopped only under the guidance of a qualified healthcare professional. If you have questions about enoxaparin, its side effects, or your treatment plan, you can consult a doctor through HealthPil.