When is lovenox therapeutic

Anti-factor Xa and anti-factor IIa activity results in anticoagulation. For enoxaparin, the ability to neutralize factor Xa and factor IIa is approximately a ratio. The volume of distribution of enoxaparin, based on anti-factor Xa activity, is 6 liters in an average patient. The elimination half-life of enoxaparin administered subcutaneously, based on anti-factor Xa activity, is 4. The maximum anti-factor Xa and anti-factor IIa activity occurs 3 to 5 hours after injection.

In addition, the anti-factor Xa activity persists in the plasma for about 12 hours after a 40 mg dose. Monitoring of Enoxaparin Activity In general, because response to enoxaparin at usual doses is consistent from patient to patient, the anticoagulant response to enoxaparin does not need to be monitored.

However, anticoagulant activity of enoxaparin can be monitored by measuring factor Xa inhibition anti-factor Xa activity.

For enoxaparin patients, this test is called the low molecular weight heparin assay. The therapeutic range for anticoagulation is 0. In general surgery the efficacy of enoxaparin to prevent venous thromboembolism is similar to UFH but the tolerability is better. In patients undergoing cancer, orthopedic or vascular surgery the efficacy of enoxaparin is significantly higher with similar rates of bleeding complications.

The database for enoxaparin in nonsurgical patients is smaller compared with surgical groups. There is evidence that the efficacy of enoxaparin may be superior to UFH in patients with severe cardiac disease. Efficacy and safety of UFH and enoxaparin are similar for the treatment of deep vein thrombosis.

Dosage Recommendation Please input further information to calculate recommended dosage. DVT prophylaxis dosing information. In Acutely Ill Medical Patients. Lovenox has proven outcomes in once-daily dosing of medically ill patients, offering: Once-daily dosing for DVT prophylaxis in medically ill patients Fixed dosing of 40 mg for up to 14 days No monitoring of aPTT Periodic complete blood counts, including platelet count, and stool occult blood tests are recommended during the course of treatment with Lovenox No dose adjustments for concomitant medication If coadministration is essential, conduct close clinical and laboratory monitoring Prophylaxis in medical patients.

Medical patients during acute illness Dosing 40 mg subcutaneous once daily Duration of therapy Median: 7 days Usual: 6 to 11 days Maximum: 14 days. Patient Type.

Medical patients during acute illness. Median: 7 days Usual: 6 to 11 days Maximum: 14 days. Average hospital length of stay LOS vs recommended duration of prophylaxis 1,2. Thrombosis prophylaxis indications for Lovenox.

Approved length of DVT prophylaxis with Lovenox. Acute medical illness. In Surgical Patients. Prophylaxis of DVT in hip or knee replacement surgery patients 1. Continued prophylaxis in hip replacement surgery Dosing 40 mg subcutaneously once daily following initial phase of thromboprophylaxis 40 mg SC once daily may be considered Duration of therapy 3 weeks recommended.

Knee replacement surgery Dosing 30 mg subcutaneously every 12 hours initiated 12 to 24 hours postoperatively provided hemostasis has been established at the wound site Duration of therapy Usual: 7 to 10 days Administered up to 14 days in clinical trials.

Hip replacement surgery, during and following hospitalization. Usual: 7 to 10 days Administered up to 14 days in clinical trials. Continued prophylaxis in hip replacement surgery. Knee replacement surgery. Prophylaxis of DVT in abdominal surgery patients 1. Abdominal surgery Dosing 40 mg subcutaneously once daily initiated 2 hours prior to surgery Duration of therapy Usual: 7 to 10 days Administered up to 12 days in clinical trials.

Abdominal surgery. Usual: 7 to 10 days Administered up to 12 days in clinical trials. Inpatient and Outpatient. Inpatient and outpatient treatment of acute DVT 3. Minimum: 2 days and continued until clinical stabilization Usual: 2 to 8 days Administered up to Minimum: 2 days and continued until clinical stabilization Usual: 2 to 8 days. In pivotal trial, first subcutaneous dose given within 15 minutes of intravenous bolus 1 Duration of therapy Lovenox treatment duration in the pivotal clinical trial was 8 days or until hospital discharge, whichever came first.

An optimal duration of treatment is not known, but it is likely to be longer than 8 days. In pivotal trial, first subcutaneous dose given within 15 minutes of intravenous bolus 1. Lovenox treatment duration in the pivotal clinical trial was 8 days or until hospital discharge, whichever came first. No initial intravenous bolus; 0. Patients transitioned to PCI 1. No additional dosing needed Administer Lovenox 0. Dose modifications.