Drug updated on 3/28/2024
| Dosage Form | Injection (subcutaneous/intravenous; 100mg/mL (30 mg/0.3 mL, 40 mg/0.4 mL, 60 mg/0.6 mL, 80 mg/0.8 mL, 100 mg/1 mL, 300 mg/3 mL)) Injection (subcutaneous/intravenous; 150 mg/mL (120 mg/0.8 mL, 150 mg/1 mL) |
| Drug Class | Low molecular weight heparin (LMWH) |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- For prophylaxis of deep vein thrombosis (DVT) in abdominal surgery, hip replacement surgery, knee replacement surgery, or medical patients with severely restricted mobility during acute illness
- For inpatient treatment of acute DVT with or without pulmonary embolism.
- For outpatient treatment of acute DVT without pulmonary embolism.
- For prophylaxis of ischemic complications of unstable angina and non–Q-wave myocardial infarction (MI).
- For treatment of acute ST-segment elevation myocardial infarction (STEMI) managed medically or with subsequent percutaneous coronary intervention (PCI).
Summary
- Enoxaparin sodium (Lovenox) is indicated for the prophylaxis of deep vein thrombosis in abdominal surgery, hip replacement surgery, knee replacement surgery or medical patients with severely restricted mobility during acute illness.
- It is also used for inpatient treatment of acute DVT with or without pulmonary embolism; outpatient treatment of acute DVT without pulmonary embolism; prophylaxis of ischemic complications of unstable angina and non–Q-wave myocardial infarction (MI); and treatment of acute ST-segment elevation myocardial infarction managed medically or with subsequent percutaneous coronary intervention.
- A systematic review and meta-analysis was conducted to compare the efficacy and associated harms between aspirin versus enoxaparin as VTE prophylaxis following elective arthroplasty procedures on the hip or knee.
- The study included four trials involving 1507 participants who underwent elective lower limb arthroplasty but found no significant difference in overall VTE rates when comparing aspirin versus enoxaparin.
- There were also no significant differences observed in major bleeding events such as compromise organ function requiring unplanned re-operation, nor minor bleeding events like wound ooze between both groups treated either by Aspirin or Lovenox after surgeries.
- However, it should be noted that current evidence from randomized controlled trials supporting use of aspirin over Lovenox as initial postoperative chemoprophylaxis lacks high quality data especially regarding critical event data for VTE incidence/mortality rate along with major/minor bleeding incidents which are crucial factors while prescribing these drugs to patients undergoing total hip/knee arthroplasty procedures.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Lovenox (enoxaparin sodium) Prescribing Information. | 2021 | Sanofi-aventis, Bridgewater, NJ |
Systematic Reviews / Meta-Analyses
| Document Title | Year | Source |
|---|---|---|
| Aspirin versus enoxaparin for the initial prevention of venous thromboembolism following elective arthroplasty of the hip or knee: a systematic review and meta-analysis. | 2021 | Orthopaedics & Traumatology: Surgery & Research |