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Vikramaditya Gangakar: A Comprehensive Overview of Enoxaparin
Jun 8, 2026, 14:45

Vikramaditya Gangakar: A Comprehensive Overview of Enoxaparin

Vikramaditya Gangakar, Pharmacy Technician at Ain Al Khaleej Hospital, shared a post on LinkedIn:

365 Drugs/365 Days Pharmacy Mastery Challenge

Day 55 Drug – Enoxaparin (Clexane®)

Drug Snapshot

  • Generic Name: Enoxaparin Sodium
  • Brand: Clexane®/Lovenox®
  • Class: Low Molecular Weight Heparin (LMWH)
  • Route: Subcutaneous (SC), IV (selected ACS cases)
  • Prescription: Rx Only

Mechanism of Action

  • Enhances Antithrombin III activity
  • Primarily inhibits Factor Xa
  • Mild inhibition of Thrombin (Factor IIa)
  • Prevents formation and growth of blood clots.

Main Uses 

  • Acute Coronary Syndrome (ACS)
  • Deep Vein Thrombosis (DVT)
  • Pulmonary Embolism (PE)
  • Post-operative thrombosis prevention
  • Anticoagulation bridging therapy

Key Adult Doses

  • DVT Prophylaxis: 40 mg SC once daily
  • DVT/PE Treatment: 1 mg/kg SC every 12 hrs or 1.5 mg/kg SC once daily
  • CrCl less than 30 mL/min: Dose adjustment required

Contraindications

  • Active major bleeding
  • History of HIT (Heparin-Induced Thrombocytopenia)
  • Severe thrombocytopenia
  • Hypersensitivity to heparins

Common Adverse Effects

  • Injection-site bruising/pain
  • Bleeding
  • Thrombocytopenia
  • Elevated liver enzymes

Serious 

  • Major hemorrhage
  • HIT
  • Spinal/Epidural hematoma

Monitoring

  • CBC (Hb, Hct, Platelets)
  • Signs of bleeding
  • Renal function (SCr, CrCl)
  • Anti-Xa levels (special populations)

Major Interactions

  • Aspirin
  • NSAIDs
  • Warfarin
  • Clopidogrel/Ticagrelor
  • Thrombolytics
  • Increased bleeding risk

Patient Counseling

  • Inject into abdomen fat layer
  • Rotate injection sites
  • Do not rub after injection
  • Do not expel air bubble from prefilled syringe
  • Seek medical help for unusual bleeding, black stools, or blood in urine

Pharmacy Pearl

LMWH of choice for DVT/PE treatment and prophylaxis. Routine aPTT monitoring is not required (unlike unfractionated heparin).

Memory Trick 

‘ENOXA = Xa Blocker’ Enoxaparin – Factor Xa – Clot Formation

Exam Point

Enoxaparin causes less hit and has more predictable anticoagulation than unfractionated heparin.”

Vikramaditya Gangakar: A Comprehensive Overview of Enoxaparin

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