Enoxaparin

• Treatment of venous thromboembolism in pregnancy:
  • Up to 50kg : SC 40 mg BD
  • 50-69kg: SC 60 mg BD
  • 70-89kg: SC 80 mg BD
  • 90kg and over: 100 mg BD

• Treatment of DVT with/without PE:
  • SC 1 mg/kg/dose BD 

• Treatment of DVT without PE outpatient:
  • SC 1 mg/kg/dose BD
  • Continue for >5 days and overlap with warfarin until INR 2-3 x24h

• DVT prophylaxis in moderate risk surgical patients:
  • SC 20 mg x1 given approx. 2 hours before surgery, then 20 mg OD 12 hours post-op *7-10 days 

• DVT prophylaxis in high risk surgical patients (e.g. orthopedic surgery):
  • SC 40 mg x1 approx. 12 hours before surgery, then 40 mg OD12 hours post-op *7-10 days 

• DVT prophylaxis in medical patients:
  • SC 40mg OD *6-11 days 

• Treatment of DVT/PE in uncomplicated patients with low risk of recurrence:
  • SC 1.5mg/kg OD until adequate oral anticoagulation established 

• Treatment of DVT/PE in patients with risk factors such as obesity, cancer, recurrent VTE or proximal thrombosis:
  • SC 1mg/kg BD until adequate oral anticoagulation established 

• Treatment of acute ST-segment elevation MI (patients NOT undergoing percutaneous coronary intervention):
  • Adult 18-74 years:
    • Initially IV 30 mg, then SC 1mg/kg x1 then SC 1mg/kg BD (Max.per dose 100 mg) for up to 8 days
    • Max dose applies for the first two SC doses only, then IV 300mcg/kg x1, dose to be given at the time of procedure if the last SC dose was given more than 8 hours previously

• Adult 75 years and over:
  • SC 750 mcg/kg BD. Max per dose 75 mg
  • Maximum dose applies for the first two doses only

• Treatment of acute ST-segment elevation MI (patients undergoing percutaneous coronary intervention):
  • Adult 18–74 years:
    • Initially IV 30mg, followed by SC 1 mg/kg x1 dose, 1mg/kg BD. Max per dose 100 mg for up to 8 days
    • Max dose applies for the first two SC doses only, then IV 300 mcg/kg x1.
    • Dose to be given at the time of procedure if the last SC dose was given more than 8 hours previously

• Adult 75 years and over:
  • SC 750 mcg/kg BD. Max per dose 75 mg
  • Max dose applies for the first two doses only, then IV 300 mcg/kg x1, dose to be given at the time of procedure if the last SC dose was given more than 8 hours previously

• Unstable angina/Non-ST-segment-elevation MI:
  • Adult: SC 1mg/kg BD usually for 2-8 days. Min 2 days.

• Thromboembolism in pediatric patients:
  • Prophylaxis:
    • < 2 months: SC 0.75 mg/kg/dose BD
    • ≥2 months: SC 0.5 mg/kg BD 

• • Treatment:
    • <2 months: SC 1.5 mg/kg BD
    • ≥2 months: SC 1 mg/kg BD

Dosing modifications in renal impairment

• Severe (CrCl <30 mL/min): Dosage reductions required
• Prophylaxis in high risk surgery: SC 30 mg OD
• DVT treatment (inpatient or outpatient) coadministered with warfarin: SC 1 mg/kg OD
• Non-Q-wave MI: SC 1 mg/kg OD
• Treatment of acute STEMI (<75 years): 30 mg IV single bolus plus 1 mg/kg SC, then SC 1mg/kg OD
• Treatment of acute STEMI (>75 years): No initial bolus; maintenance SC 1mg/kg OD