14 - enoxaparin ( levonox ) ( lupenox )

How does it work?

Enoxaparin is a medicine known as a low molecular weight heparin. It is an anti-clotting or anticoagulant medicine, and works by interfering with the body's natural blood clotting mechanism. Blood clotting involves a complex series of pathways. Enoxaparin inactivates a compound in this pathway called thrombin, which plays an important role in blood clot formation. Therefore, enoxaparin prevents the formation of blood clots (thrombosis) in the body. Blood clots within the body can be dangerous as they can travel in the blood vessels and potentially block off blood supply to the heart, lungs or brain. Enoxaparin is given by injection under the skin, and is used to prevent clots forming in the blood. This can occur in various conditions where the normal blood circulation is disturbed. Surgery, particularly abdominal surgery, produces a risk of thrombosis, as does a heart attack and poorly controlled angina (unstable angina). Clots can also occur when people are bed-ridden for long periods of time. Enoxaparin is given to prevent thrombosis in these groups of people. In addition, enoxaparin is used to prevent blood clotting when it is filtered through a kidney dialysis machine. Enoxaparin is also used to treat blood clots which have formed in the veins of the leg (deep vein thrombosis), as these may otherwise detach and travel in the circulation to the lungs causing a pulmonary embolism.

What is it used for?

 Angina not well controlled by medical treatment

 Blood clot lodged in a vein of the leg

 Heart attack

 Prevention of blood clot formation in the veins after surgery

 Prevention of blood clot formation in the veins in people bedridden due to illness

 Prevention of blood clots during haemodialysis

Warning!

 This medicine is not recommended for use in children as no dose has been established.

 It is recommended that blood tests to monitor the levels of platelets in the blood are performed prior to and during treatment with this medicine.

 Blood potassium levels should be measured before starting treatment and at regular intervals throughout, particularly if treatment lasts longer than 7 days.

Use with caution in

 Decreased liver function

 Diabetes affecting the eyes

 History of reduced platelet count (thrombocytopenia) caused by heparin treatment

 People who have previously had a peptic ulcer

 People who have recently had a stroke

 People who have recently had eye surgery

 People who have recently had surgery of the brain or spinal cord (neurosurgery)

 People with problems stopping bleeding

 Severe uncontrolled high blood pressure

 Severely decreased kidney function

Not to be used in

 Active peptic ulcer

 Bacterial infection of the heart valves and the lining surrounding the heart (bacterial endocarditis)

 Major bleeding disorders such as haemophilia

 People with an increased risk of bleeding (haemorrhage)

 Reduced platelet count in the blood

 Stroke associated with internal bleeding of the brain

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

 This medicine is not recommended for use in pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.

 It is not known whether this medicine passes into breast milk. Mothers who need to take this medicine should not breastfeed. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

 Allergy to active ingredients (hypersensitivity)

 Alteration in results of liver function tests

 Bleeding (haemorrhage)

 High blood potassium level (hyperkalaemia)

 Thinning of the bones (osteoporosis) with long term use

 Decrease in the number of platelets in the blood (thrombocytopenia)

 Presence of blood clots in the spinal cord (intra-spinal haematoma)

 Blood clots which form a solid swelling at the injection site (haematoma)

 Pain and irritation at the injection site

 Death of skin cells (necrosis) at the site of injection

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.