ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Low molecular weight heparin (LMWH)

Enoxaparin sodium

Brand names: Clexane, Inhixa

Adult dose

Dose: VTE prophylaxis: 40mg SC OD (medical/surgical); Treatment: 1.5mg/kg SC OD or 1mg/kg SC BD; ACS: 1mg/kg SC BD
Route: Subcutaneous
Frequency: OD–BD

Clinical pearls

  • NICE NG89 VTE prophylaxis; NICE NG158 VTE treatment
  • Renal dose adjustment essential (CrCl 15–30 → 1mg/kg OD treatment)
  • Reversal: protamine partial; consider andexanet not effective
  • Pregnancy — RCOG GTG 37a (LMWH preferred over warfarin)

Contraindications

  • Active major bleeding
  • Severe thrombocytopenia
  • Recent intracranial/spinal surgery
  • Bacterial endocarditis
  • HIT history (use alternative)
  • Severe renal impairment (CrCl <15) — use UFH

Side effects

  • Bleeding
  • Heparin-induced thrombocytopenia (HIT)
  • Hyperkalaemia
  • Injection-site reactions
  • Osteoporosis (long-term)

Interactions

  • Anticoagulants/antiplatelets/NSAIDs (bleeding)
  • ACEi/ARB (hyperkalaemia)

Monitoring

  • FBC (HIT screening)
  • Renal function
  • Anti-Xa in pregnancy/extremes of weight/renal
  • Bleeding

Reference: BNF; NICE NG89; NICE NG158; RCOG GTG 37a/37b; BSH guidelines; https://bnf.nice.org.uk/drugs/enoxaparin-sodium/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Drugs
Pathways