Neonatal Intensive Care Drug Manual




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Enoxaparin (Clexane)


Revision Date : 27/04/2021

Approved : TC, KOH




Alert

Enoxaparin is one type of low molecular weight heparin (LMWH).

Commonly known as Clexane.

High risk medication. An overdose can be fatal.

Treatment must be discussed with the Haematologist on-call before commencement.

LMWH is not a suitable choice of anticoagulant in patients with significant bleeding risk (unfractionated heparin (UFH) is preferred), who are clinically unstable or about to have invasive procedures. This is due to longer half-life than UFH and only partial reversal with protamine.

Monitoring is performed with anti-factor Xa levels. The APTT is not useful in monitoring LMWH therapy. Please check with your local pathology department on what time of the day/night anti-factor Xa sample processing is performed.



Indication

Prophylaxis of thromboembolic disorder.
(Note: Enoxaparin/heparin does not treat the clot that has already occurred but rather its role is to prevent clot extension, i.e. secondary prophylaxis)

Action

It binds to and potentiates anti-thrombin III activity leading to irreversible inactivation of factor Xa, and to a lesser degree inactivation of factor IIa; in turn, inhibiting thrombin and fibrinogen generation.


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Neonatal Intensive Care Drug Manual

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