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.
Lovenox may also be used for purposes not listed in this medication guide.
Important information
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 Lovenox.
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.
Before taking this medicine
You should not use Lovenox if you are allergic to enoxaparin, heparin, benzyl alcohol, or pork products, or if you have:
Lovenox may cause you to bleed more easily, especially if you have:
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a bleeding disorder that is inherited or caused by disease;
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hemorrhagic stroke;
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an infection of the lining of your heart (also called bacterial endocarditis);
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stomach or intestinal bleeding or ulcer; or
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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:
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you have a spinal cord injury;
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you have a spinal catheter in place or if a catheter has been recently removed;
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you have a history of spinal surgery or repeated spinal taps;
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you have recently had a spinal tap or epidural anesthesia;
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you are taking an NSAID (nonsteroidal anti-inflammatory drug)--ibuprofen (Advil, Motrin), naproxen (Aleve), diclofenac, indomethacin, meloxicam, and others; or
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you are using a blood thinner (warfarin, Coumadin) or other medicines to treat or prevent blood clots.
To make sure Lovenox is safe for you, tell your doctor if you have:
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kidney or liver disease;
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uncontrolled high blood pressure;
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eye problems caused by diabetes;
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recent stomach ulcer; or
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if you have ever had low blood platelets after receiving heparin.
FDA pregnancy category B. Lovenox is not expected to harm an unborn baby. However, some forms of this medication contain a preservative that may be harmful to a newborn. Tell your doctor if you are pregnant or plan to become pregnant during treatment. If you use Lovenox during pregnancy, make sure your doctor knows if you have a mechanical heart valve.
See also: Pregnancy and breastfeeding warnings (in more detail)
It is not known whether enoxaparin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using Lovenox.
How should I use Lovenox?
Lovenox is usually given every day until your bleeding condition improves. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.
Lovenox is injected under the skin or into a vein through an IV. You may be shown how to use injections at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.
You should be sitting or lying down during the injection. Do not inject Lovenox into a muscle.
Use a different place on your stomach each time you give an injection under the skin. Your care provider will show you the best places on your body to inject the medication. Do not inject into the same place two times in a row.
Prepare your dose in a syringe only when you are ready to give yourself an injection. Do not mix Lovenox with other medications in the same IV. Do not use Lovenox if it has changed colors or has particles in it. Call your pharmacist for new medication.
Use a disposable needle only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.
Tell any doctor who treats you that you are using Lovenox. If you need surgery or dental work, tell the surgeon or dentist ahead of time that you are using this medication.
While using Lovenox your blood and your stool (bowel movement) may need to be tested often. Your nerve and muscle function may also need to be tested. Visit your doctor regularly.
Store Lovenox vials (bottles) at room temperature away from moisture and heat. Once you have used a vial for the first time, the medicine will keep at room temperature for up to 28 days. Throw away the vial after 28 days have passed since you first used the vial, even if there is still medicine left in it.
What happens if I miss a dose?
Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose may cause excessive bleeding.
What should I avoid while using Lovenox?
Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.
Lovenox side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Lovenox: hives; itching or burning skin; difficulty 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:
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unusual bleeding (nose, mouth, vagina, or rectum), bleeding from wounds or needle injections, any bleeding that will not stop;
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easy bruising, purple or red pinpoint spots under your skin;
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pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;
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black or bloody stools, coughing up blood or vomit that looks like coffee grounds;
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sudden weakness, severe headache, confusion, or problems with speech, vision, or balance; or
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trouble breathing.
Common Lovenox side effects may include:
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nausea, diarrhea;
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fever;
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swelling in your hands or feet; or
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mild pain, irritation, redness, or swelling 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.
See also: Side effects (in more detail)
What other drugs will affect Lovenox?
Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Lovenox, especially other medicines used to treat or prevent blood clots, such as:
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abciximab, anagrelide, cilostazol, clopidogrel, dipyridamole, eptifibatide, ticlopidine, tirofiban;
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alteplase, reteplase, tenecteplase, urokinase;
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apixaban, argatroban, bivalirudin, dabigatran, desirudin, fondaparinux, lepirudin, rivaroxaban, tinzaparin; or
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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 interactions are listed in this medication guide.
