Enoxaparin

Enoxaparin is an anticoagulant (blood thinner) medicine. It is used to treat and prevent deep vein thrombosis and pulmonary embolism, including during pregnancy and after certain surgeries. It is also used in patients with acute coronary syndrome (ACS) and heart attacks. Enoxaparin is also used to assist with hemodialysis. It is administered by injection directly under the skin or into a vein.

Pharmacodyamics

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.

Pharmacokinetics

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.

Drug Interactions

Enoxaparin should not be used together with other anticoagulants.

Side effects

• bleeding, especially of the skin and mucous membranes, bleeding anaemia, thrombocytopenia, thrombocytosis
• allergic reactions like urticaria, pruritus, erythema
• Headache
• Transaminase increase
• injection site reactions
• accumulation in renal insufficiency