Enoxaparin (Systemic)

Brand Names : Lovenox

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For enoxaparin, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to enoxaparin or to heparin. Also tell your health care professional if you are allergic to any other substances, such as foods, especially pork or pork products, preservatives, or dyes.

Pregnancy - Enoxaparin has not had adequate studies performed in pregnant women. However, if you are pregnant your doctor will need to closely monitor you because of an increased risk of bleeding. In pregnant women who have an artificial heart valve, enoxaparin is not recommended.

Breast-feeding - It is not known whether this medicine passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are using this medicine and who wish to breast-feed should discuss this with their doctor.

Children - Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of enoxaparin in children with use in other age groups.

Older adults - This medicine has been tested and has been shown to cause an increased risk of side effects or problems in older people than it does in younger adults. You doctor may adjust your dose, especially if you are less than 45 kg (99 lbs.) of body weight or in elderly patients with decreased kidney function.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are using enoxaparin, it is especially important that your health care professional know if you are taking any of the following:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) including:
• Ketorolac tromethamine (e.g., Toradol) - use of this drug when receiving spinal or epidural anesthesia can lead to long term neurological problems

• Drugs affecting platelet aggregation or affect blood clotting ability such as:
• Aspirin or
• Dipyridamole (e.g., SK-Dipyridamole) or
• Divalproex (e.g., Depakote) or
• Inflammation or pain medicine, except narcotics, or
• Plicamycin (e.g., Mithracin) or
• Salicylates (e.g., choline salicylate (Arthropan), magnesium salicylate (Doan's), salsalate (Disalcid), or
• Sulfinpyrazone (e.g., Anturane) or
• Thrombolytic agents (e.g. alteplase (Activase), anistreplase (Eminase), streptokinase (Streptase), urokinase (Abbokinase) or
• Ticlopidine (e.g., Ticlid)
• Valproic acid (e.g., Depakene) - Using any of these medicines together with enoxaparin may increase the risk of bleeding

Other medical problems - The presence of other medical problems may affect the use of enoxaparin. Make sure you tell your doctor if you have any other medical problems, especially:

• Blood disease or bleeding problems or
• Blood vessel problems or
• Heart infection or
• Heart valves, prosthetic or
• High blood pressure (hypertension) or
• Kidney disease or
• Liver disease or
• Septic shock or
• Stomach ulcer (active) or
• Threatened miscarriage - The risk of bleeding may be increased

Also, tell your doctor if you have received enoxaparin or heparin before and had a reaction to either of them called thrombocytopenia, or if new blood clots formed while you were receiving the medicine.

In addition, tell your doctor if you have recently given birth, fallen or suffered a blow to the body or head, or had medical or dental surgery . These events may increase the risk of serious bleeding when you are taking enoxaparin.