Enoxaparin - Injection | HealthLink BC (2023)


Common brand(s):Lovenox

Important: How to use this information

This is a summary and does NOT contain all possible information about this product. This information does not guarantee that this product is safe, effective, or suitable for you. This information is not individual medical advice and is not a substitute for the advice of your healthcare professional. Always ask your healthcare professional for complete information about this product and your specific health needs.


People using this medication may bleed near the spinal cord after certain spinal procedures. Bleeding from this area can cause paralysis that lasts a long time or can become permanent. Talk to your doctor about the benefits and risks before undergoing any spinal procedure. Your doctor may tell you to stop taking this medicine for a certain amount of time before and after the procedure. Carefully follow your doctor's instructions.

The risk of bleeding may be higher if you have a deformed spine or have had previous spinal procedures/surgery (such as epidural catheter placement, severe spinal/epidural puncture) or if you are taking other medications that can cause bleeding/bruising (including antiplatelet agents). medicines). medicines such as clopidogrel, 'blood thinners' such as warfarin/rivaroxaban, non-steroidal anti-inflammatory drugs - NSAIDs such as ibuprofen). Tell your doctor right away if you notice symptoms such as back pain, numbness/tingling/weakness in the legs, loss of bowel or bladder control (incontinence).


Enoxaparin is used to prevent and treat harmful blood clots. This helps reduce the risk of stroke or heart attack. This medication helps maintain smooth blood flow by reducing the clotting activity of proteins in the blood. Enoxaparin is an anticoagulant, also known as a "blood thinner." It is a type of heparin.

Conditions that increase the risk of developing blood clots include certain types of surgery (such as knee/hip replacement, abdominal surgery), long periods of immobility, certain types of heart attacks, and a specific type of chest pain called unstable angina. . For some medical conditions, enoxaparin may be used in combination with other "blood thinners."

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How to use

Read the Patient Information Leaflet if available from your pharmacist before you start using enoxaparin and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

This medication is injected under the skin as directed by your doctor, usually once or twice daily in the abdomen (at least 2 inches from the belly button). Do not inject into a muscle. Dosage and length of treatment are based on your medical condition and response to treatment. The dosage may also be based on your age and weight for some conditions. Use this medication regularly to get the most benefit from it. To make it easier to remember, use it every day at the same time.

If you are using this medication at home, learn all preparation and usage instructions from your healthcare professional and from the product packaging. Visually check product for particles or discoloration before use. If there are, do not use the liquid. Before injecting each dose, clean the injection site with isopropyl alcohol. Change the injection site each time to minimize damage under the skin. To reduce bruising, do not rub the injection site after the injection. Learn how to safely store and dispose of medical supplies.

This medication may also be given by injection into a vein by a healthcare professional, as directed by your doctor.

Side effects

See also the Notifications section.

Mild irritation, pain, bruising, redness, and swelling at the injection site may occur. Fatigue or fever may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist immediately.

You should know that this medication has been prescribed for you because your doctor has determined that the benefit to you is greater than the risk of side effects. Many people using this medication do not experience serious side effects.

This medicine can cause bleeding if the effect on blood clotting proteins is too strong. Tell your doctor right away if you have serious signs of bleeding, including:

  • unusual pain/swelling/discomfort
  • unusual or prolonged bleeding
  • unusual or easy bruising
  • dark urine
  • black chairs
  • intense headache
  • confusion
  • vision changes
  • unusual dizziness
  • Fainting
  • seizures
  • weakness
  • obamrlot

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you experience any symptoms of a severe allergic reaction, including:

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  • skin irritation
  • itching/swelling (especially face/tongue/throat)
  • severe dizziness
  • Respiratory problems

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the USA -

Call your doctor for medical advice on side effects. You may report side effects to the FDA at 1-800-FDA-1088 orwww.fda.gov/medwatch.

In Canada: Call your doctor for medical advice on side effects. You can report side effects to Health Canada at 1-866-234-2345.


Before using enoxaparin, tell your doctor or pharmacist if you are allergic to it; or heparin or products derived from pork; or if you have other allergies. This product may contain inactive ingredients that can cause allergic reactions or other problems. Consult your pharmacist for more details.

Before using enoxaparin, tell your doctor or pharmacist about your medical history, especially about:

  • artificial heart valve(s)
  • nephropathy
  • liver disease
  • bleeding/blood problems (such as low platelets)
  • low platelet count after previous heparin treatment
  • AVC
  • high pressure
  • certain eye problems (such as diabetic retinopathy)
  • certain stomach/intestinal problems (such as new or active ulcers)
  • recent spinal procedure or puncture
  • spinal problems (such as spinal deformity)
  • recent eye/brain/spinal cord surgery

Limit alcohol intake while taking this medication, as it may increase the risk of stomach bleeding.

Before surgery, tell your doctor or dentist about all the products you use (including prescription drugs, over-the-counter drugs, and herbal products).

To reduce the chance of cuts, bruises, or injury, use caution with sharp objects such as razors and nail clippers, and avoid activities such as contact sports.

The elderly may be more sensitive to the side effects of this drug, especially bleeding.

During pregnancy, this medicine should be used only when necessary. Discuss the risks and benefits with your doctor. Pregnant women with artificial heart valves should be carefully monitored (see Notes).

It is not known if this medicine passes into breast milk. Consult your doctor before breastfeeding.

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Drug interactions

Drug interactions can change the way your medicines work or increase your risk of serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/over-the-counter products and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dose of any medicine without your doctor's approval.

A product that may interact with this drug is:

  • mifepristona

This medication is sometimes used along with other medications that cause "blood thinning" or antiplatelet effects, such as aspirin, clopidogrel, or warfarin. When your doctor prescribes these combinations, you will need closer monitoring to reduce the risk of bleeding. Keep all medical and laboratory appointments.

Check all prescription and over-the-counter medicine labels carefully, as many medicines contain pain relievers/fever reducers (NSAIDs such as ibuprofen, naproxen, or aspirin) that may increase the risk of bleeding/antiplatelet effects when taken with enoxaparin. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually 81 to 162 milligrams per day), you should continue to take it unless your doctor tells you otherwise. Ask your doctor or pharmacist for more details.


If someone has taken an overdose and has severe symptoms, such as fainting or trouble breathing, call 911. If not, call a poison control center immediately. US residents can call their local poison control center at 1-800-222-1222. Canadian residents can call a provincial poison control center. Overdose symptoms may include: excessive bleeding and bruising.


Do not share this medicine with others.

Laboratory and/or medical tests (eg, blood counts including platelets, blood in stool) should be performed periodically to monitor your progress or check for side effects. In certain cases, additional laboratory tests (anti-factor Xa blood levels) may be done, especially if you have kidney disease, are pregnant and have artificial heart valves, or to see if enoxaparin is working well for you. Check with your doctor for more details.

Missed dose

If you miss a dose, use it as soon as you remember. If it is almost time for the next dose, skip the missed dose. Take the next dose at the usual time. Do not double the dose to compensate.


Keep in a room at room temperature away from light and moisture. Do not store in the bathroom. Keep all medicines out of the reach of children and pets.

Do not store multidose vials for more than 28 days after first use.

Do not flush medicine down the toilet or drain unless told to do so. Dispose of this product properly when it has expired or is no longer needed. Consult your pharmacist or local waste disposal company.

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medical warning

Your condition can cause complications in emergency medical care. For information on how to enroll in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

Data last reviewed August 2021.

Copyright(c) 2021. First Databank, Inc.

Selected from data included with permission and copyright of First DataBank, Inc. This copyrighted material was taken from a licensed data provider and is not intended for distribution unless permitted by the applicable terms of use .

Terms of Use: The information contained in this database is intended to supplement and not replace the experience and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects, nor should it be construed as an indication that the use of a particular drug is safe, appropriate, or effective for you or anyone else. Before taking any medicine, changing the diet or starting or stopping any treatment, it is necessary to consult a health professional.


How do you know if enoxaparin is effective? ›

Your doctor will monitor your level of platelets. This is done to make sure you're not at a high risk of bleeding or that you're not having side effects. Anti-Xa levels. These levels can help let your doctor know how well this drug is working for you.

How long does it take for enoxaparin to work? ›

Response and effectiveness. The average time to peak effects on various clotting factors is anti-Xa (3 hours), anti-IIa (4 hours), and Heptest (2.5 hours). Activity against anti-Xa persists for about 12 hours following a once-daily dose of enoxaparin 40mg.

How long do you have to inject enoxaparin? ›

Most people need shots for 5 to 10 days, but in some cases it can be longer. Your doctor will tell you how long you need to have the shots. Enoxaparin is used to: Treat deep vein thrombosis (DVT), which is a blood clot in the legs, pelvis, or arms.

What is the best way to inject enoxaparin? ›

o Wash your hands with soap and dry thoroughly. o Sit or lie in a comfortable position, so that you can see your abdomen. o You will be injecting into the right or left side of your abdomen at least 2 inches away from your belly button (see figure below). Avoid injecting where you have scars or bruises.

What should I monitor when taking enoxaparin? ›

  • Bleeding. The patient should be monitored closely for signs and symptoms of bleeding. ...
  • Thrombocytopenia. Thrombocytopenia can occur, but it is less common than conventional heparin. ...
  • Renal impairment. Enoxaparin dose requires adjustment with a creatinine clearance of less than 30 mL/minute.[44]
  • Surgery.
Sep 10, 2022

How long does it take for Lovenox to dissolve a clot? ›

Enoxaparin works by blocking specific proteins that help form a clot. If you already have a blood clot, enoxaparin gives your body time to break down the clot. It also prevents new clots from forming. It can take the body weeks or months to fully break down a clot.

Can you still get a blood clot while on enoxaparin? ›

If you have epidural or spinal anesthesia or a spinal puncture while taking a 'blood thinner' such as enoxaparin, you are at risk for having a blood clot form in or around your spine that could cause you to become paralyzed.

What is the peak effect of enoxaparin? ›

When given intravenously, enoxaparin has a time to peak effect of 5 to 10 minutes compared with 3 to 5 hours when administered subcutaneously. Enoxaparin's 5- to 7-hour half-life is dose independent; however, dose adjustment is required in patients with renal insufficiency.

When is the best time to take enoxaparin injection? ›

For prevention of deep venous thrombosis (abdominal or stomach surgery): Adults—40 milligrams (mg) injected under the skin once a day for 7 to 10 days. The first dose should be given 2 hours before the surgery.

Should you take enoxaparin at night or morning? ›

Timing of dose: Enoxaparin should be administered at approximately the same time each day. 6pm has been traditional, but if anti-factor Xa levels are required (very infrequently required and normally only on the advice of a specialist), 8am is preferred as blood samples are required 4 hours post dose.

Does enoxaparin have to be given 12 hours apart? ›

Enoxaparin is usually given every 12 hours (no less than 10 hours and no more than 14 hours in between doses). Give the missed dose as soon as you remember.

Should Lovenox injections be given at night or morning? ›

Injections of LOVENOX are given to yourself once a day. The injection should be given at the same time each day, either in the morning or the evening.

Do you pinch skin for enoxaparin? ›

Hold the syringe in the hand you write with (like a pencil). With your other hand, gently pinch the area of your abdomen between your forefinger and thumb to make a fold in the skin. Make sure you hold the skin fold throughout the injection.

Do you pinch skin for Lovenox injection? ›

It's important to keep pinching that fold of skin until the injection is done—that way the medication doesn't enter any muscle, which could be painful. Once the syringe is empty, pull the needle straight out and then let go of your skin. Don't try to put the needle cap back on the syringe after the injection.

Do you massage after enoxaparin injection? ›

Release the finger pressure you apply at the skin and inject the enoxaparin slowly. Take the needle out quickly, at the same angle in which you put it. If you start to bleed, gently apply pressure to the site for 5 to 10 seconds. Do not rub or massage the area.

What to avoid when taking enoxaparin? ›

Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers. Enoxaparin may cause bleeding problems.

What happens if Lovenox is injected into muscle? ›

Lovenox should never be injected into muscle. This could cause bleeding into the muscle. By gently pinching the skin between your fingers all through the injection, the medicine only enters the fatty tissue of your stomach and not muscle.

How do you inject enoxaparin in the thigh? ›

The easiest way to do this is to pinch up a fold of skin using your thumb and forefinger if you are injecting into your stomach, thigh, or buttock area, or use your knee to create a pinched up area if you are injecting into your upper, outer arm (or have somebody else administer the injection for you).

Does Lovenox make you tired? ›

Mild irritation, pain, bruising, redness, and swelling at the injection site may occur. Fatigue or fever may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Is walking good for blood clots? ›

The Importance of Exercise if You Have DVT

Aerobic activity -- things like walking, hiking, swimming, dancing, and jogging -- can also help your lungs work better after a pulmonary embolism. Studies show that exercise also can improve symptoms of DVT, including swelling, discomfort, and redness.

Does Lovenox dissolve existing clots? ›

What does this medicine do? Enoxaparin (e noks ah PAIR in) is an anticoagulant, which helps prevent blood clots from forming in the blood vessels. It does not dissolve clots, although you may hear people call it a "blood thinner." In order for this medicine to safely help your child, it must be given correctly.

What are the odds of getting a blood clot on Lovenox? ›

DVT/PE/death occurred in 10.1% (95% CI: 8 to 13) of Lovenox-treated patients and 11.3% (95% CI: 9 to 14) of heparin-treated patients. Adverse Events: Major bleeding episodes occurred in 4% and 3% of patients in the Lovenox and heparin arms, respectively.

What are the first signs of a blood clot? ›

throbbing or cramping pain, swelling, redness and warmth in a leg or arm. sudden breathlessness, sharp chest pain (may be worse when you breathe in) and a cough or coughing up blood.

How common is it to get a blood clot while on blood thinners? ›

Venous thromboembolism (VTE), also known as blood clots, is a serious, growing public health issue that everyone should know about. Blood clots are preventable, yet an estimated 900,000 Americans are affected each year by a blood clot, resulting in nearly 100,000 deaths.

Is enoxaparin fast acting? ›

Enoxaparin is short-acting. So, it may be used during these times to prevent blood clots.

What organ does enoxaparin affect? ›

Descriptions. Enoxaparin injection is used to prevent deep venous thrombosis, a condition in which harmful blood clots form in the blood vessels of the legs. These blood clots can travel to the lungs and can become lodged in the blood vessels of the lungs, causing a condition called pulmonary embolism.

How long does Lovenox stay in your system? ›

Lovenox (low molecular weight heparin) wears off after about 12 hours.

What happens if you miss a blood thinner injection? ›

If you miss a dose, take it as soon as you remember. If you don't remember until the next day, call your doctor for instructions. If this happens when your doctor is not available, skip the missed dose and start again the next day. Mark the missed dose in a diary or on a calendar.

Does enoxaparin need to be refrigerated? ›

Storing enoxaparin

Vials: Store at room temperature or in the refrigerator until opened. After opening, it is best to store in the refrigerator. Opened vials must be thrown away after 28 days. Unopened vials can be kept until the expiration date printed on the label.

Can you inject enoxaparin in arm? ›

Enoxaparin is given by a subcutaneous injection. A subcutaneous injection is an injection into the tissue just below the skin. The injections can be given in the legs, arms or abdomen. It comes in a vial or pre-filled syringe form.

Can you drink coffee while on enoxaparin? ›

These medications are used to slow blood clotting and include aspirin, clopidogrel (Plavix), ibuprofen (Advil, Motrin, and others), naproxen (Anaprox, Naprosyn, and others), enoxaparin (Lovenox), and more. Health experts advise caution when combining them with coffee, which can also slow blood clotting.

How long does it take for enoxaparin to reach steady state? ›

The peak provides the best indication for enoxaparin anticoagulant activity. [2] Steady state concentration is reached on day 2, after two doses of 1.5 mg/kg every 24 hours or three doses of 1 mg/kg every 12 hours. [1] As a result, anti-Xa concentrations should be drawn 4 hours post-dose on day 2.

Can you give enoxaparin twice a day? ›

Once-daily enoxaparin (1.5 mg/kg) provides 75% of the total drug received via twice-daily dosing (1 mg/kg) (9). The administration of 1 mg/kg twice-daily enoxaparin has been used for in-patient treatment of DVT with or without PE and outpatient treatment of acute DVT without PE as a bridge to warfarin (10).

What is the expected action of enoxaparin? ›

This drug has an immediate onset of action. Enoxaparin increases Thrombin Time (TT) and activated partial thromboplastin time (aPTT), preventing and reducing thromboembolic complications such as DVT, pulmonary embolism, and ischemic cardiac complications.

What is the intended effect of enoxaparin? ›

Enoxaparin prevents blood from clotting so it may take longer than usual for you to stop bleeding if you are cut or injured. Avoid activities that have a high risk of causing injury. Call your doctor if bleeding is unusual.

How do you know if heparin is effective? ›

Patients treated with heparin are monitored by a blood test daily to see if their dose is optimal. The blood test used to check a patient's heparin level is the activated partial thromboplastin time (aPTT). The doctor adjusts the dose of heparin based on these blood test results.


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