The mechanism of action of enoxaparin is antithrombin dependent. It acts primarily by accelerating the neutralization of certain activated clotting factors by antithrombin. By activating antithrombin III, enoxaparin preferentially potentiates the inhibition of coagulation factors Xa and IIa, providing anticoagulation.
The bioavailability of enoxaparin after subcutaneous injection is nearly 100%. The drug is 80% bound to plasma proteins. Enoxaparin is metabolized primarily in the liver by desulfation and/or depolymerization to lower molecular weight metabolites with greatly reduced biological potency. Total renal excretion of active and non-active fragments accounts for approximately 40% of the dose. The plasma half-life is approximately 4.5 hours.
Enoxaparin should not be used together with other anticoagulants.