SC (Adults): Knee replacement surgery — 30 mg q 12 hr starting 12–24 hr after surgery; Hip replacement — 40 mg 12 hr before surgery then once daily; may be continued for up to 3 wk after hospital discharge; Abdominal surgery — 40 mg 2 hr prior to surgery, then every 24 hr postop for 7–12 days or until ambulatory (up to 14 days); Medical patients with acute illness — 40 mg once daily.
Treatment of DVT/PE
SC (Adults): Outpatient — 1 mg/kg every 12 hr; Inpatient — 1 mg/kg every 12 hr or 1.5 mg/kg every 24 hr. Warfarin should be started within 72 hr; enoxaparin may be continued for 5–17 days or until therapeutic anticoagulation with warfarin is achieved (INR >2 for two consecutive days).
SC (Adults): 1 mg/kg q 12 hr for 2–8 days (up to 12.5 days)
SC (Adults CCr < 30 ml/min): DVT prophylaxis for abdominal, knee or hip surgery — 30 mg once daily; Angina/Non–Q-wave MI, treatment of DVT — 1 mg/kg once daily; .
Hypersensitivity to enoxaparin, heparin, benzyl alcohol (multidose formulation only), or pork products; active major bleeding; thrombocytopenia associated with positive in vitro test for antiplatelet antibody in the presence of enoxaparin.
The risk of severe bleeding may be increased. Close clinical and laboratory monitoring (aPTT and/or anti-Xa) is indicated during coadministration of enoxaparin and antithrombin. Adjust the dose of enoxaparin accordingly. Reduced doses of enoxaparin are recommended when coadministered with antithrombin III.
Drugs that increase the risk of bleeding (eg, oral anticoagulants [eg, warfarin], platelet inhibitors [eg, dipyridamole], NSAIDs, salicylates, sulfinpyrazone, ticlopidine)
Use enoxaparin with caution because of increased risk of hemorrhagic reactions.
SSRIs (eg, fluoxetine)
The risk of severe bleeding may be increased. Carefully monitor the coagulation status of the patient and observe the patient for bleeding. Adjust therapy as needed.