Enoxaparin is a type of blood-thinning medication used to prevent blood clots; it is typically used in certain post-operative patients who will be restricted to their beds for extended periods of time. It is most commonly used in patients after knee or hip replacement surgery or abdominal surgery, although it may also be used for patients who are bedridden for other reasons. The factors that affect a sufficient enoxaparin dose depend on the type of surgery performed, the weight of the patient, and previous or current medical conditions.
Patients who are on bed rest for an extended period of time run a higher risk of developing a serious type of blood clot called a "deep vein thrombosis," or DVT. These clots often occur in the large veins of the legs, and if left untreated, can travel through the circulatory system into the heart, brain, or lungs. Once they reach those vital organs, they can cause fatal complications, such as a stroke or a pulmonary embolism. Surgeons often prescribe medications like enoxaparin as prophylactic or preventative treatments because it is easier to prevent clots than to treat them once they have occurred. A sufficient enoxaparin dose can help prevent clots from occurring by thinning the blood so it can more easily travel through the circulatory system even when a patient is immobile.
Post-operative knee and hip replacement surgery patients typically receive a 30-milligram (mg) prophylactic dose every 12 hours for between one week and 10 days, starting roughly 12 to 24 hours after surgery. Abdominal surgery patients receive 40 mg each day for approximately the same amount of time. In cases when a deep vein blood clot has already occurred, the enoxaparin dose is usually calculated based on weight, with the average being about 1mg per kilogram (about 2.2 pounds), and may be combined with warfarin, another medication used to thin the blood.
Certain medical conditions can also affect the sufficient enoxaparin dose. For patients with unstable angina, a heart-related condition in which the symptoms appear more erratically and without warning than in those with the stable form of the disease, the enoxaparin dose is typically lower than 30mg. Patients with kidney disease also receive a lower dose than those with healthy kidneys. Enoxaparin is typically not used in patients with liver damage. Other conditions that may affect the dose include diabetes, high blood pressure, and use of a spinal epidural during surgery.
Enoxaparin is given as a subcutaneous injection — one that is inserted just below the skin — and it is often supplied in premeasured single-dose syringes. In most cases, patients continue to take the medicine even after they have been released from the hospital, and education on how to administer the injections is provided during patient discharge procedures. This medication can increase the risk of serious bleeding, so patients will need to exercise extra precautions to avoid injury while taking it. Patients who experience excessive bleeding, blood in their urine, or rapid and extreme swelling of the feet or ankles should seek emergency medical attention.