#lovenox

Fuck these lovenox injections

I am on blood thinners, which isn’t great when you need surgery. They have to “bridge” you off your normal oral meds to either heparin (IV, usually at the hospital) or they prescribe Lovenox injections for you to do at home.

I’ve been doing the injections since yesterday morning and have to keep doing them till tomorrow morning. They are the worst. I thought the actual process of administering the injections was going to be the worst part. Nooooooo. I have been sooooooo nauseous I want to die and have horrible diarrhea 🥲🥺😩 these are both unfortunately common side effects and can’t do anything about it.

But fuck man, being nauseous is the #1 worst thing for me. It makes me so uncomfortable and anxious ☹️ I can barely eat or drink without wanting to vomit, which sucks because I need to hydrate!

Common Brand Names: Lovenox

Therapeutic Class: A low-molecular weight heparin

Common Injectable Dosage Forms:

Solution for Injection (prefilled syringes): 30 mg/0.3 mL, 40 mg/0.4 mL, 60 mg/0.6 mL, 80 mg/0.8 mL, 100 mg/mL, 90 mg/0.6 mL, 120 mg/0.8 mL, 150 mg/mL

Solution for Injection (multi-dose vials): 100 mg/mL (3 mL vials)

Dosage Ranges:

For the prophylaxis of deep vein thrombosis (DVT) after hip or knee replacement: 30 mg every 12 hours beginning 12-24 hours after operation and continue for 7-10 days. May be use 40 mg once daily for 3 weeks post operation.

For the prophylaxis of DVT after abdominal surgery: 40 mg/day beginning 2 hours prior to surgery and continue for 7-10 days post operation.

For treatment of DVT with or without pulmonary embolism (PE): 1 mg/kg every 12 hours or 1.5 mg/kg/day.

Administration and Stability: Administer by subcutaneous route only. Do not administer intramuscularly. To avoid loss of drug, do not expel air bubble prior to injection. Administer by deep SC injection alternating between left and right anterolateral and left and right posterolateral abdominal wall. Store at controlled room temperature. pH 5.5-7.5

Pharmacology/Pharmacokinetics: Enoxaparin sodium is a low-molecular weight heparin which has antithrombotic properties. In humans, enoxaparin has a higher ratio of anti-Factor Xa to anti-Factor IIa activity compared to heparin. Maximum anti-Factor Xa and antithrombin (anti-Factor IIa) activities occur 3-5 hours after SC injection. Elimination half-life based on anti-Factor Xa activity is 4.5 hours after SC injection. Anti-Factor Xa activity persists for about 12 hours.

Drug and Lab Interactions: Drugs which affect platelet function (ASPIRIN, NSAIDs, DIPYRIDAMOLE, TICLOPIDINE) may increase risk of hemorrhage and should be used with caution. Concomitant use of STREPTOKINASE and UROKINASE may result in hemorrhage and should be avoided. Enoxaparin prolongs prothrombin time and care should be used in evaluating this test in patients in warfarin or other anticoagulants which use this test as a therapeutic monitor. Do not mix with other injections. May cause asymptomatic reversible increases in aspartate (AST) and alanine (ALT) aminotransferase levels.

Contraindications/Precautions: Contraindicated in patients hypersensitive to heparin, pork products, benzyl alcohol, or sulfites, and in patients with a history of heparin-induced thrombocytopenia or active major bleeding. Cases of epidural or spinal hematomas have been reported with the associated use of enoxaparin and spinal/epidural anesthesia or spinal puncture resulting in long-term or permanent paralysis. Pregnancy Category B.

Monitoring Parameters: Platelets, occult blood, anti-Xa activity, PT if applicable

Adverse Effects: The most common adverse reaction of parenteral administration is local reaction at the site of injection. May also cause hemorrhage, edema, and anemia.

Brand Name: Lovenox

Generic Available

Common Dosage Forms:

Injection (prefilled syringes): 30 mg/0.3 mL, 40 mg/0.3 mL, 40 mg/0.4 mL, 60 mg/0.6 mL, 80 mg/0.8 mL, 100 mg/1 mL, 120 mg// 0.8 mL, 150 mg/1 mL

Injection (multi-dose vial): 300 mg/3 mL

FDA Indications/Dosages:

For prophylaxis of deep vein thrombosis (DVT) after abdominal surgery or in medical patients with severely restricted mobility during acute illness: 40 mg once a day for 7-10 days.

For prophylaxis of deep vein thrombosis (DVT) after hip or knee replacement: 30 mg every 12 hours beginning 12-24 hours after operation and continue for 7-10 days. May use 40 mg once daily for 3 weeks post operation.

For treatment of DVT with or without pulmonary embolism (PE): 1 mg/kg every 12 hours or 1.5 mg/kg once daily.

For use in unstable angina or non-Q-wave myocardial infarction: 1 mg/kg given every 12 hours with oral aspirin (100-325 mg).

For the treatment of acute ST-Segment Evaluation myocardial infarction: A single bolus dose of 30 mg followed by 1 mg/kg every 12 hours.

Dose in renal impairment (CrCL<30 mL/min): Lower dose to 30 mg or 1 mg/kg once daily.

Monitor: Platelet count

Pharmacology/Pharmacokinetics: Enoxaparin sodium is a low molecular weight heparin which has antithrombotic properties. In humans, enoxaparin has a higher ratio of anti-Factor Xa to anti-Factor IIa activity compared to heparin. Maximum anti-Factor Xa and antithrombin (anti-Factor IIa) activity occur 3-5 hours after SC injection. Elimination half-life based on anti-Factor Xa activity was 4.5 hours after SC injection. Anti-Factor Xa activity persists in plasma for about 12 hours.

Drug Interactions: Drugs which affect platelet function (ASPIRIN, NSAIDs, DIPYRIDAMOLE, TICLOPIDINE, etc.) may increase risk of hemorrhage and should be used with caution. Concomitant use of STREPTOKINASE AND UROKINASE may result in hemorrhage and should be avoided. Enoxaparin prolongs prothrombin time, and care should be used in evaluating this test in patients of warfarin or other anticoagulants which this test is a therapeutic monitor. Do not mix with other injections. May cause asymptomatic reversible increases in aspartate (AST) and alanine (ALT) aminotransferase levels.

Contraindications/Precautions: Contraindicated in patients hypersensitive to heparin, pork products, benzyl alcohol, or sulfites, and in patients with a history of heparin-induced thrombocytopenia or active major bleeding. Cases of epidural or spinal hematomas have been reported with the associated use of enoxaparin and spinal/epidural anesthesia or spinal puncture resulting in long-term or permanent paralysis. Pregnancy Category B.

Adverse Effects: The most common adverse reaction of parenteral administration is local reaction at the site of injection. May cause hemorrhage, edema, and anemia.

Patient Consultation:

Instruct patients how to properly inject subcutaneously.

Inform patients that it may take them longer than usual to stop bleeding and that they may bruise and/or bleed more easily during use.

Patients should report any unusual bleeding, bruising, or signs of thrombocytopenia (such as a rash of dark red spots under the skin) to their physician.

Patients should tell their physician and dentists they are taking enoxaparin and/or any other product known to affect bleeding before any surgery is scheduled and before any new drug is taken.