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What Is a Lovenox (Enoxaparin Sodium Injection)?

Lovenox (enoxaparin sodium) Injection is an anticoagulant specifically designed to prevent blood clots, including deep vein thrombosis (DVT), which leads to potentially dangerous conditions such as pulmonary embolism (PE). Post-surgery or in cases of prolonged immobility due to illness, DVT risk escalates. Lovenox plays a crucial role in preventing these complications.

How Does It Work?

Enoxaparin is crucial in preventing and treating harmful blood clots. As a result, it lowers the risk of strokes or heart attacks. By regulating clotting proteins in the blood, this medication ensures smooth blood flow. It functions as an anticoagulant, commonly known as a “blood thinner”, and falls under the heparin category.

Either used alone or in conjunction with other anticoagulants, enoxaparin is a crucial intervention in cases and several factors that increase the risk of blood clots, including:

  • Specific surgeries (e.g., knee/hip replacements, abdominal procedures), 
  • Extended periods of immobility
  • Certain heart attack types
  • Unstable angina

Dosage of Lovenox

The dosage of this medicine varies for different patients. Adhere to your doctor’s instructions or the label directions. The information provided here outlines the average doses; only alter your dosage if instructed by your doctor. The dosage depends on the medicine’s strength, the number of daily doses, the time intervals between doses, and the duration of medication. Your specific medical condition determines the appropriate regimen.

Injection Dosage for Lovenox in Adults

Prevention of Blood Clots after Non-Q-Wave Myocardial Infarction or Unstable Angina: The dosage of Lovenox is tailored to your weight and prescribed by your doctor. Usually, it is 1 mg/kg of body weight, administered under the skin every 12 hours for a period ranging from 2 to 8 days. This treatment is combined with aspirin, taken once a day at a dosage between 100 to 325 mg.

Preventing DVT After Abdominal or Stomach Surgery: 40 mg injected under the skin once a day for 7 to 10 days, with the initial dose given 2 hours before surgery.

Preventing DVT After Knee/Hip Replacement Surgery: 30 mg injected under the skin every 12 hours for 7 to 10 days. Alternatively, for hip replacement, a 40 mg dose under the skin once daily for 3 weeks.

Preventing DVT in Seriously Ill Patients: 40 mg injected under the skin once daily for 6 to 11 days.

Treatment of Acute DVT with or without PE: 1 mg/kg of body weight under the skin every 12 hours for 7 days.

Treatment of Certain Types of Acute Heart Attack: A dosage of 30 mg is usually injected into a vein, and 1 mg per kilogram of body weight is injected under the skin every 12 hours for eight days, after which 1 mg/kg of body weight is injected under the skin every 12 hours. Aspirin 75 to 325 mg orally once daily may also be prescribed.

Older Adults: The starting dose is 0.75 mg per kg of body weight under the skin every 12 hours for 8 days. Aspirin 75 to 325 mg orally once daily may also be given.

(In all cases, the dosage given to Children will be determined by the doctor.)

Missed Dose

  1. If a dose is missed, take it as soon as possible.
  2. If possible, skip the missed dose and return to the regular schedule if it’s almost time for the next one.
  3. Avoid doubling doses.


Spinal Procedure Caution: Individuals taking this medication should know the potential risk of bleeding near the spinal cord following specific spinal procedures. This type of bleeding can lead to long-lasting paralysis or permanent damage. Before undergoing any spinal procedure, it is imperative to discuss the benefits and risks with your doctor. Your primary healthcare provider may instruct you to discontinue this medication before, temporarily and after the procedure.

Increased Risk Factors: The risk of bleeding is increased if you have undergone previous spinal procedures/surgery (like epidural catheter placement challenging epidural/spinal puncture) or have a deformed spine. Additionally, the risk is increased if you are taking other medications that can cause bleeding or bruising, including: 

  • Antiplatelet drugs like clopidogrel
  • Blood thinners such as warfarin/rivaroxaban
  • Nonsteroidal anti inflammatory drugs (NSAIDs) like ibuprofen

If you experience back pain, leg numbness, weakness, tingling or loss of control of the bowels or bladder (incontinence), inform your doctor immediately. Always adhere strictly to your doctor’s instructions in such cases.

Precautions to Take While Using Lovenox Enoxaparin Injection

Before initiating enoxaparin therapy, it is essential to consider the following precautions and consult your healthcare provider:

Allergies: Inform your primary caregiver if you are allergic to enoxaparin, heparin, pork products, or other substances. This medication may contain inactive ingredients that trigger allergic reactions or other complications.

Medical History: Provide your medical history to your healthcare provider or pharmacist, particularly if you have:

  • High blood pressure
  • Liver disease
  • A history of stroke
  • Spine problems (e.g., spinal deformity)
  • Artificial heart valve(s)
  • Specific stomach or intestinal problems (e.g., active or recent ulcers)
  • Kidney disease
  • A history of low platelet counts after or prior to heparin treatment
  • Recent spinal procedures or punctures
  • Bleeding or blood-related issues (e.g., low platelet counts)
  • An eye condition (e.g., diabetic retinopathy)
  • Recent eye/brain/spinal cord surgeries.

Alcohol Consumption: Limit alcohol consumption while taking enoxaparin, as it may increase the risk of stomach bleeding.

Surgical Procedures: Before undergoing surgery, discuss with your doctor all the substances you are using, including herbal supplements, over-the-counter medications, and prescription drugs.

Injury Prevention: To minimize the risk of cuts, bruises, or injuries, exercise caution when handling sharp objects like razors and nail cutters. Avoid engaging in activities with a high potential for physical contact, such as contact sports.

Older Adults: Older adults may exhibit increased sensitivity to the side effects of enoxaparin, particularly regarding bleeding.

Pregnancy: During pregnancy Lovenox Enoxaparin Injection should only be used when its benefits outweigh the potential risks. Discuss the pros & cons with your healthcare provider.

Breastfeeding: It is currently unknown whether enoxaparin passes into breast milk. Consult your doctor before breastfeeding to make an informed decision regarding its use.

Side Effects

Immediate Medical Attention Required

  • Difficulty swallowing or breathing
  • Dizziness
  • Black or Red, tarry stools
  • Prolonged bleeding from cuts
  • Nosebleeds
  • Increased menstrual flow or vaginal bleeding
  • Headache
  • Paralysis
  • Bleeding gums
  • Coughing up blood
  • Red or dark brown urine
  • Trouble breathing

Seek Medical Advice for Less Common Symptoms

  • Seizures
  • Chest discomfort or tightness
  • Pain or burning while urinating
  • Bruising
  • Lightheadedness
  • Swelling of the hands or feet
  • Confusion
  • Fever
  • Vomiting of blood or material resembling coffee grounds
  • Collection of blood under the skin
  • Uncontrolled bleeding at the site of injection
  • Irritability
  • Lower back pain
  • Continuing bleeding or oozing from mouth, nose or surgical wound

Drug Interactions

While some medications should never be combined, in some instances, your doctor may adjust doses or recommend precautions. It is crucial to inform your doctor about all the medications you are taking. The following interactions have been identified based on their potential significance:

Not Recommended: Defibrotide

Usually Not Recommended (May Require Adjustments)

  • Rivaroxaban
  • Loxoprofen
  • Lornoxicam
  • Desvenlafaxine
  • Ibuprofen Lysine
  • Diclofenac
  • Valdecoxib
  • Venlafaxine
  • Vilazodone
  • Vorapaxar
  • Vortioxetine
  • Warfarin
  • And Many More…

Medical Conditions

Inform your doctor if you have:

  • Allergies to heparin, benzyl alcohol or pork products.
  • Major bleeding, blood diseases, thrombocytopenia or vessel issues.
  • Recent surgeries or catheter insertions, especially in sensitive areas like the brain, eye or spine.
  • Uncontrolled hypertension, prosthetic valves, septic shock, heart infections or active stomach/intestinal bleeding.
  • History or risk of heparin-induced threatened miscarriage, thrombocytopenia, or low body weight (less than 99 pounds in women or 126 pounds in men).
  • Kidney disease

Frequently Asked Questions

How to use Lovenox injections?

Lovenox Enoxaparin Injections are usually administered by a nurse or a trained healthcare professional in a hospital. However, if your doctor determines that it is safe for you to use this medicine at home, they will provide you with proper training on how to prepare and administer the injection. It’s crucial to fully understand the process before doing it yourself:

  • When using Lovenox at home, your healthcare provider will instruct you on the suitable body areas for the injection. 
  • It’s important to rotate these areas to prevent skin problems. 
  • Avoid injecting into bruised or scarred skin. 
  • The liquid in the prefilled syringe or vial should be colorless, clear, or pale yellow before each injection. 
  • Do not use the medicine if it appears cloudy, discolored, or if you notice any particles. 

Following these guidelines ensures the safe and effective administration of Lovenox injections in the comfort of your home.

Is Lovenox the same as heparin?

Lovenox injection is a type of low molecular weight heparin, which shares similarities with heparin. However, Lovenox targets a specific clotting factor more precisely than heparin. Patients tend to tolerate Lovenox better, and it usually requires fewer injections compared to heparin.

Who should not use Lovenox?

Lovenox cannot be used in patients with any of the following complications:

  • Active major bleeding
  • HIT history within the past 100 days.
  • History of reactions to enoxaparin sodium (e.g., redness, itching, other signs of allergic reaction)
  • History of responses to heparin or pork products.
  • History of responses to the multiple-dose formulation of benzyl alcohol (which is only in the version of Lovenox).

Does Lovenox need to be refrigerated?

There is no need to refrigerate Lovenox; instead, it should be kept at room temperature and protected from heat, moisture, and direct sunlight in a sealed container. Make sure it doesn’t freeze and keep it out of reach of children. Don’t use expired or unneeded medicine. Ask your healthcare provider about proper disposal methods for unused medication.

If you have a bottle of medicine for use with syringes, use it within 28 days of the first shot. Dispose of any leftover medicine in the bottle after this period. Used needles should be discarded in a sturdy, sealed container that prevents them from poking through. Keep this container away from children and pets.

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