Tell your doctor you are using enoxaparin before having certain spinal procedures (spinal puncture or spinal/epidural anesthesia). Use of this medication before or after these procedures has rarely caused major bleeding or blood clots in or around the spine. This effect may cause paralysis that may be permanent. Your doctor may try to decrease the risk of these side effects by having you stop the medication for a certain amount of time before and after the procedure. Follow your doctor's instructions carefully. Discuss the risks and benefits of treatment with your doctor. Get medical help right away if you have any of these serious side effects: tingling, weakness, numbness, pain, or loss of control over your bladder or bowels.
This risk is increased if you use a type of device placed in the spine to deliver pain medications (epidural catheter). In addition, the risk is higher if you use other "blood thinning" or anti-platelet medications such as aspirin, clopidogrel, warfarin, or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. Tell your doctor if you are taking any of these medications. Do not stop taking any prescribed medication without first consulting your doctor.Who should not take enoxaparin subcutaneous?
Enoxaparin is used to prevent and treat harmful blood clots. This helps to reduce the risk of a stroke or heart attack. This medication helps keep your blood flowing smoothly by lowering the activity of clotting proteins in the blood. Enoxaparin is an anticoagulant, also known as a "blood thinner." It is a type of heparin.
Conditions which increase your risk of developing blood clots include certain types of surgeries (such as knee/hip replacement, abdominal), long periods of being immobile, certain types of heart attack, and a specific type of chest pain called unstable angina. For some medical conditions, enoxaparin may be used in combination with other "blood thinners."
Read the Patient Information Leaflet if available from your pharmacist before you start using enoxaparin and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
This medication is given by injection under the skin as directed by your doctor, usually once or twice a day in the abdomen (at least 2 inches from your belly button). Do not inject into a muscle. The dosage and length of treatment are based on your medical condition and response to treatment. The dosage may also be based on your age and weight for some conditions. Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time(s) each day.
If you are using this medication at home, learn all preparation and usage instructions from your health care professional and the product package. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Before injecting each dose, clean the injection site with rubbing alcohol. Change the injection site each time to lessen injury under the skin. To minimize bruising, do not rub the injection site after a shot. Learn how to store and discard medical supplies safely.
This medication may also be given by injection into a vein by a health care professional, as directed by your doctor.
See also Warning section.
Mild irritation, pain, bruising, redness, and swelling at the injection site may occur. Fatigue or fever may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
This medication can cause bleeding if its effect on your blood clotting proteins is too much. Tell your doctor right away if you have any serious signs of bleeding, including: unusual pain/swelling/discomfort, unusual or prolonged bleeding, unusual or easy bruising, dark urine, black stools, severe headache, confusion, vision changes, unusual dizziness, fainting, seizures, weakness, numbness.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Before using enoxaparin, tell your doctor or pharmacist if you are allergic to it; or to heparin or pork products; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using enoxaparin, tell your doctor or pharmacist your medical history, especially of: serious active bleeding, artificial heart valve(s), kidney disease, liver disease, bleeding or blood disorders (such as low platelet counts), low platelet counts after previous heparin treatment, stroke, uncontrolled severe high blood pressure, certain eye problems (such as diabetic retinopathy), certain stomach/intestinal problems (such as active or recent ulcers), recent spinal procedure or puncture, spine problems (such as spinal deformity), recent eye/brain/spinal cord surgery.
Limit alcohol while taking this drug because it may increase the risk of stomach bleeding.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.
Older adults may be more sensitive to the side effects of this drug, especially bleeding.
During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. Pregnant women with artificial heart valves need close monitoring (see Notes).
It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
A product that may interact with this drug is: mifepristone.
This medication is sometimes used together with other drugs that have "blood thinning" or anti-platelet effects such as aspirin, clopidogrel, or warfarin. When these combinations are prescribed by your doctor, you will require closer monitoring to minimize your risk of bleeding. Keep all medical and laboratory appointments.
Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (NSAIDs such as ibuprofen, naproxen, or aspirin) which can increase the risk of bleeding/anti-platelet effect when used with enoxaparin. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.
If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: excessive bleeding and bruising.
Do not share this medication with others.
Laboratory and/or medical tests (such as blood counts including platelets, checking your stool for blood) should be performed periodically to monitor your progress or check for side effects. Additional lab tests (anti-factor Xa blood levels) should be performed in certain cases, especially if you have kidney disease, are pregnant and have artificial heart valves, or to check if enoxaparin is working well for you. Consult your doctor for more details.
If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not store the multiple dose vials for more than 28 days after the first use.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised November 2013. Copyright(c) 2013 First Databank, Inc.
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