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Lovenox (enoxaparin) is an anticoagulant that helps prevent the formation of blood clots.
Lovenox is used to treat or prevent a type of blood clot called deep vein thrombosis (DVT), which can lead to blood clots in the lungs (pulmonary embolism). A DVT can occur after certain types of surgery, or in people who are bed-ridden due to a prolonged illness.
Lovenox is also used to prevent blood vessel complications in people with certain types of angina (chest pain) or heart attack.
You should not use Lovenox if you have active bleeding, or a low level of platelets in your blood after testing positive for a certain antibody while using enoxaparin.
Lovenox can cause a very serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural), especially if you have a genetic spinal defect, a history of spinal surgery or repeated spinal taps, or if you are using other drugs that can affect blood clotting, including blood thinners or NSAIDs (ibuprofen, Advil, Aleve, and others). This type of blood clot can lead to long-term or permanent paralysis.
Get emergency medical help if you have symptoms of a spinal cord blood clot such as back pain, numbness or muscle weakness in your lower body, or loss of bladder or bowel control.
You should not use Lovenox if you are allergic to enoxaparin, heparin, benzyl alcohol, or pork products, or if you have:
active or uncontrolled bleeding; or
if you had decreased platelets in your blood after testing positive for a certain antibody while using Lovenox within the past 100 days.
Lovenox may cause you to bleed more easily, especially if you have:
a bleeding disorder that is inherited or caused by disease;
hemorrhagic stroke;
an infection of the lining of your heart (also called bacterial endocarditis);
stomach or intestinal bleeding or ulcer; or
recent brain, spine, or eye surgery.
Lovenox can cause a very serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural). This type of blood clot could cause long-term or permanent paralysis, and may be more likely to occur if:
you have a spinal cord injury;
you have a spinal catheter in place or if a catheter has been recently removed;
you have a history of spinal surgery or repeated spinal taps;
you have recently had a spinal tap or epidural anesthesia;
you take aspirin or an NSAID (nonsteroidal anti-inflammatory drug) - ibuprofen (Advil, Motrin), naproxen (Aleve), diclofenac, indomethacin, meloxicam, and others; or
you are using a blood thinner (warfarin, Coumadin) or other medicines to treat or prevent blood clots.
Tell your doctor if you have ever had:
a bleeding disorder such as hemophilia;
kidney or liver disease;
uncontrolled high blood pressure;
eye problems caused by diabetes;
a stomach ulcer; or
low blood platelets after receiving heparin.
Tell your doctor if you are pregnant. If you use Lovenox during pregnancy, make sure your doctor knows if you have a mechanical heart valve.
It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.
Lovenox is usually given every day until your bleeding condition improves. Follow all directions on your prescription label and read all medication guides or instruction sheets.
Lovenox is injected under the skin, or as an infusion into a vein. A healthcare provider may teach you how to properly use the medication by yourself.
Read and carefully follow any Instructions for Use provided with your medicine. Do not use Lovenox if you don't understand all instructions for proper use. Ask your doctor or pharmacist if you have questions.
Prepare your injection only when you are ready to give it. Do not use if the medicine has changed colors, or has particles in it. Call your pharmacist for new medicine.
You should be sitting or lying down during the injection. Do not inject this medicine into a muscle.
Your care provider will show you where on your body to inject Lovenox. Use a different place each time you give an injection. Do not inject into the same place two times in a row.
You will need frequent medical tests to help your doctor determine how long to treat you with Lovenox.
If you need surgery or dental work, tell your surgeon or dentist you currently use this medicine. You may need to stop for a short time.
Store at room temperature away from moisture and heat.
Each single-use prefilled syringe is for one use only. Throw it away after one use, even if there is still medicine left inside.
After your first use of an Lovenox vial (bottle), you must use the medicine within 28 days. Throw away the vial after 28 days.
Use a needle and syringe only once and then place them in a puncture-proof "sharps" container. Follow state or local laws about how to dispose of this container. Keep it out of the reach of children and pets.
Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose may cause excessive bleeding.
Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.
Get emergency medical help if you have signs of an allergic reaction to Lovenox: hives; itching or burning skin; difficult breathing; swelling of your face, lips, tongue, or throat.
Also seek emergency medical attention if you have symptoms of a spinal blood clot: back pain, numbness or muscle weakness in your lower body, or loss of bladder or bowel control.
Call your doctor at once if you have:
unusual bleeding, or any bleeding that will not stop;
easy bruising, purple or red spots under your skin;
nosebleeds, bleeding gums;
abnormal vaginal bleeding, blood in your urine or stools;
coughing up blood or vomit that looks like coffee grounds;
signs of bleeding in the brain - sudden weakness (especially on one side of the body), sudden severe headache, problems with speech or vision; or
low red blood cells (anemia) - pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet.
Common Lovenox side effects may include:
nausea, diarrhea;
anemia;
confusion; or
pain, bruising, redness, or irritation where the medicine was injected.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Tell your doctor about all your other medicines, especially other medicines to treat or prevent blood clots, such as:
abciximab, anagrelide, cilostazol, clopidogrel, dipyridamole, eptifibatide, ticlopidine, tirofiban;
alteplase, reteplase, tenecteplase, urokinase;
apixaban, argatroban, bivalirudin, dabigatran, desirudin, fondaparinux, lepirudin, rivaroxaban, tinzaparin; or
heparin.
This list is not complete. Other drugs may interact with enoxaparin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Lovenox only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Lovenox (www.drugs.com/lovenox.html).
Note: This document contains side effect information about enoxaparin. Some of the dosage forms listed on this page may not apply to the brand name Lovenox.
Common side effects of Lovenox include: anemia and hemorrhage. Other side effects include: fever. See below for a comprehensive list of adverse effects.
Applies to enoxaparin: solution
Injection route (Solution)
Epidural or spinal hematomas, which may result in long-term or permanent paralysis, may occur in patients who are anticoagulated with low molecular weight heparins or heparinoids and are receiving neuraxial anesthesia or undergoing spinal puncture. Factors that can increase the risk of developing these hematomas include: use of indwelling epidural catheters, concomitant use of drugs affecting hemostasis such as NSAIDs, platelet inhibitors, or other anticoagulants, or history of traumatic or repeated epidural or spinal puncture, spinal deformity, or spinal surgery. Optimal timing between the administration of enoxaparin sodium and neuraxial procedures is not known. Monitor patients frequently for neurological impairment. If neurological compromise is noted, urgent treatment is necessary. Consider risks/benefits before neuraxial intervention in patients anticoagulated or to be anticoagulated for thromboprophylaxis.
Along with its needed effects, enoxaparin (the active ingredient contained in Lovenox) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking enoxaparin:
More common
Less common
Rare
Incidence not known
Some side effects of enoxaparin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Applies to enoxaparin: injectable solution
The most common adverse reactions were bleeding, anemia, thrombocytopenia, elevation of serum aminotransferase, diarrhea, and nausea.
Common (1% to 10%): Major hemorrhage
Uncommon (0.1% to 1%): Atrial fibrillation, heart failure
Frequency not reported: Hemorrhage
Postmarketing reports: Shock, valve thrombosis in patients with prosthetic heart valves
Common (1% to 10%): Thrombocytopenia, anemia, platelet counts between 100,000 and 50,000/mm3
Uncommon (0.1% to 1%): Platelet counts less than 50,000/mm3
Frequency not reported: Thrombocytosis
Postmarketing reports: Hemorrhagic anemia, platelet count increased, eosinophilia
Common (1% to 10%): ALT increased asymptomatically, AST increased asymptomatically
Frequency not reported: Hepatic enzymes increased
Postmarketing reports: Hepatocellular liver injury, cholestatic liver injury
Common (1% to 10%): Nausea, diarrhea
Uncommon (0.1% to 1%): Retroperitoneal hemorrhage
Common (1% to 10%): Injection site hematoma, injection site pain, other injection site reaction
Uncommon (0.1% to 1%): Local irritation, injection site skin necrosis
Postmarketing reports: Injection site nodules
Common (1% to 10%): Urticaria, pruritus, erythema
Uncommon (0.1% to 1%): Bullous dermatitis
Postmarketing reports: Cutaneous vasculitis, skin necrosis, alopecia
Common (1% to 10%): Peripheral edema, edema
Rare (less than 0.1%): Hyperkalemia
Postmarketing reports: Hyperlipidemia, hypertriglyceridemia
Common (1% to 10%): Allergic reaction
Rare (0.01% to 0.1%): Anaphylactic/anaphylactoid reaction
Very rare (less than 0.01%): Immuno-allergic thrombocytopenia
Postmarketing reports: Immuno-allergic thrombocytopenia with thrombosis
Common (1% to 10%): Dyspnea
Uncommon (0.1% to 1%): Lung edema, pneumonia
Uncommon (0.1% to 1%): Hematuria
Common (1% to 10%): Confusion
Common (1% to 10%): Fever
Uncommon (0.1% to 1%): Intracranial hemorrhage
Postmarketing reports: Headache, spinal hematoma
Postmarketing reports: Osteoporosis following treatment longer than 3 months
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Lovenox (www.drugs.com/lovenox.html).
March 28, 2020
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