| Clinical data | |
|---|---|
| Trade names | Lovenox, Clexane |
| AHFS/Drugs.com | monograph |
| MedlinePlus | a696006 |
| Pregnancy cat. | B |
| Legal status | POM (UK) ℞-only (US) |
| Routes | Subcutaneous (SC) Injection and intervenous (IV) per package insert |
| Pharmacokinetic data | |
| Bioavailability | 92% |
| Protein binding | 80% bound-albumin |
| Metabolism | primarily by kidneys |
| Half-life | 4.5 hours |
| Identifiers | |
| CAS number | 9005-49-6 |
| ATC code | B01AB05 |
| PubChem | CID 772 |
| DrugBank | APRD00068 |
| UNII | 8NZ41MIK1O |
| KEGG | D07510 |
| ChEMBL | CHEMBL1201685 |
| Chemical data | |
| Formula | (C26H40N2O36S5)n |
| Mol. mass | 4500 daltons (average) |
| (what is this?) (verify) |
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Enoxaparin is a low molecular weight heparin marketed under the trade names Lovenox and Clexane, among others. It is an anticoagulant used to prevent and treat deep vein thrombosis or pulmonary embolism, and is given as a subcutaneous injection (by a health care provider or the patient). Its use is evolving in acute coronary syndromes (ACS).
Enoxaparin is manufactured by Sanofi and is derived from the intestinal mucosa of pigs.
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Enoxaparin binds to and accelerates the activity of antithrombin III. By activating antithrombin III, enoxaparin preferentially potentiates the inhibition of coagulation factors Xa and IIa. The anticoagulant effect of enoxaparin can be directly correlated to its ability to inhibit factor Xa. Factor Xa catalyzes the conversion of prothrombin to thrombin, so enoxaparin’s inhibition of this process results in decreased thrombin and ultimately the prevention of fibrin clot formation.
Enoxaparin is an FDA pregnancy category B drug, and is not expected to harm an unborn baby. Enoxaparin does not cross the placenta. In animal models, there was no evidence of teratogenic effects or fetotoxicity due to enoxaparin. Pregnancy alone can raise a woman's risk of life threatening thromboembolic event. Enoxaparin can be used during all stages of pregnancy, however it should be closely monitored by a physician.
Decreased dose is recommended in renal failure or ESRD patients. For DVT prophylaxis in a patient with GFR < 30, a dose of 30 mg daily is recommended. For DVT prophylaxis in a patient with GFR > 30, full dose (40 mg daily) can be given. For treatment of DVT/PE, the standard recommended dose is 1.5 mg/kg once daily or 1mg/kg every 12 hours. If the GFR < 30, the dose should be changed to 1 mg/kg daily.
100 mg/mL concentration
150 mg/mL concentration
Annual sales approx $3.1bn. Enoxaparin is no longer protected by US patent due to inequitable conduct on the filing of Patent No. 5,389,618 (Fed. Cir. 2008 No. 2007-1280 Aventis Pharma v. Amphastar and Teva)
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