enoxaparin

What is the most important information I should know about enoxaparin?

Enoxaparin 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.

What is enoxaparin?

Enoxaparin is an anticoagulant that helps prevent the formation of blood clots.

Enoxaparin 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.

Enoxaparin is also used to prevent blood vessel complications in people with certain types of angina (chest pain) or heart attack.

Enoxaparin may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using enoxaparin?

• active or uncontrolled bleeding; or
• if you had decreased platelets in your blood after testing positive for a certain antibody while using enoxaparin within the past 100 days.

Enoxaparin may cause you to bleed more easily, especially if you have:

• a bleeding disorder that is inherited or caused by disease;
• hemorrhagic stroke;
• an infection of the lining of your heart (also called bacterial endocarditis);
• stomach or intestinal bleeding or ulcer; or
• recent brain, spine, or eye surgery.

• you have a spinal cord injury;
• you have a spinal catheter in place or if a catheter has been recently removed;
• you have a history of spinal surgery or repeated spinal taps;
• you have recently had a spinal tap or epidural anesthesia;
• you take aspirin or an NSAID (nonsteroidal anti-inflammatory drug)--ibuprofen (Advil, Motrin), naproxen (Aleve), diclofenac, indomethacin, meloxicam, and others; or
• you are using a blood thinner (warfarin, Coumadin) or other medicines to treat or prevent blood clots.

Tell your doctor if you have ever had:

• a bleeding disorder such as hemophilia;
• kidney or liver disease;
• uncontrolled high blood pressure;
• eye problems caused by diabetes;
• a stomach ulcer; or
• low blood platelets after receiving heparin.

How should I use enoxaparin?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Enoxaparin is injected under the skin, or as an infusion into a vein. A healthcare provider may teach you how to properly use the medication by yourself.

Read and carefully follow any Instructions for Use provided with your medicine. Do not use enoxaparin if you don't understand all instructions for proper use. Ask your doctor or pharmacist if you have questions.

Prepare your injection only when you are ready to give it. Do not use if the medicine has changed colors, or has particles in it. Call your pharmacist for new medicine.

Your care provider will show you where on your body to inject enoxaparin. Use a different place each time you give an injection. Do not inject into the same place two times in a row.

You will need frequent medical tests to help your doctor determine how long to treat you with enoxaparin.

If you need surgery or dental work, tell your surgeon or dentist you currently use this medicine. You may need to stop for a short time.

Each single-use prefilled syringe is for one use only. Throw it away after one use, even if there is still medicine left inside.

After your first use of an enoxaparin vial (bottle), you must use the medicine within 28 days. Throw away the vial after 28 days.

Use a needle and syringe only once and then place them in a puncture-proof "sharps" container. Follow state or local laws about how to dispose of this container. Keep it out of the reach of children and pets.

What happens if I miss a dose?

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

What should I avoid while using enoxaparin?

What are the possible side effects of enoxaparin?

• unusual bleeding, or any bleeding that will not stop;
• easy bruising, purple or red spots under your skin;
• nosebleeds, bleeding gums;
• abnormal vaginal bleeding, blood in your urine or stools;
• coughing up blood or vomit that looks like coffee grounds;
• signs of bleeding in the brain --sudden weakness (especially on one side of the body), sudden severe headache, problems with speech or vision; or
• low red blood cells (anemia) --pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet.

Common side effects may include:

• nausea, diarrhea;
• anemia;
• confusion; or
• pain, bruising, redness, or irritation 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.

What other drugs will affect enoxaparin?

Tell your doctor about all your other medicines, especially other medicines to treat or prevent blood clots, such as:

• abciximab, anagrelide, cilostazol, clopidogrel, dipyridamole, eptifibatide, ticlopidine, tirofiban;
• alteplase, reteplase, tenecteplase, urokinase;
• apixaban, argatroban, bivalirudin, dabigatran, desirudin, fondaparinux, lepirudin, rivaroxaban, tinzaparin; or
• heparin.

This list is not complete. Other drugs may affect enoxaparin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your doctor or pharmacist can provide more information about enoxaparin.