Medicine details

ImageClaxo 40 SC/IV
NameClaxo 40 SC/IV
DosageInjection
Generic NameEnoxaprin
Classes Anticoagulant
Diseases
CompanyGeneral Pharmaceuticals Ltd.

Drug Package Details

Strength40 mg/.4 ml
Storage Condition
Origin CountryBangladesh
Commercial Pack1
Price per pack351.06
Cost per pack308.93
Package unit0.4 ml pre-filled syringe
Price per unit351.06
Cost per unit308.93
Discount0
Coupon
Remarks

Enoxaprin

Enoxaparin binds to antithrombin III, a serine protease inhibitor, forming a complex that inactivates factor Xa irreversibly. Enoxaparin is released after factor Xa is inactivated and binds to other anti-thrombin molecules. Enoxaparin inhibits Factor IIa (thrombin) directly. The cascade of effects caused by enoxaparin binding prevents thrombin from converting fibrinogen to fibrin and forming a clot, thereby preventing thromboembolic events.

Enoxaparin is indicated in the following conditions-

  • Prophylaxis of deep vein thrombosis (DVT) in abdominal surgery, hip replacement surgery, knee replacement surgery, or medical patients with severely restricted mobility during acute illness
  • Inpatient treatment of acute DVT with or without pulmonary embolism
  • Outpatient treatment of acute DVT without pulmonary embolism.
  • Prophylaxis of ischemic complications of unstable angina and non-Q wave myocardial infarction
  • Treatment of acute ST-segment elevation myocardial infarction [STEMI] managed medically or with subsequent percutaneous coronary intervention [PCI] 

The recommended dosage of enoxaparin is as follows-

  • Abdominal Surgery: The recommended dose is 40 mg once a day, administered by SC injection, with the first dose given 2 hours before operation. The typical administration period is 7 to 10 days.
  • Hip or Knee Replacement Surgery: 30 mg subcutaneously every 12 hours up to 14 days.
  • Deep vein thrombosis in medical patients: 40 mg subcutaneously once daily up to 14 days.
  • Inpatient treatment of acute DVT with or without pulmonary embolism: 1 mg/kg SC every 12 hours or 1.5 mg/kg SC once daily (with warfarin) up to 17 days.
  • Outpatient treatment of acute DVT without pulmonary embolism: 1 mg/kg SC every 12 hours (with warfarin) up to 17 days
  • Unstable angina and non-Q-wave MI: 1 mg/kg SC every 12 hours (with aspirin) 2 to 8 days
  • Acute ST-segment elevation myocardial infarction (STEMI) in patients <75 years of age:  30 mg single IV bolus plus a 1 mg/kg SC dose followed by 1 mg/kg SC every 12 hours at least 8 days (with aspirin)
  • Acute STEMI in patients ≥75 years of age: 0.75 mg/kg SC every 12 hours (no bolus) at least 8 days (with aspirin).

The commonly reported side effects were-

  • bleeding/hemorrhage
  • anemia
  • thrombocytopenia
  • hepatic dysfunction
  • diarrhea
  • nausea

WARNING: SPINAL/EPIDURAL HEMATOMA

Epidural or spinal hematomas may occur in patients who are anticoagulated with low molecular weight heparins (LMWH) or heparinoids and are receiving neuraxial anesthesia or undergoing spinal puncture. These hematomas may result in long-term or permanent paralysis. Consider these risks when scheduling patients for spinal procedures. Factors that can increase the risk of developing epidural or spinal hematomas in these patients include: 

  • Use of indwelling epidural catheters
  • Concomitant use of other drugs that affect hemostasis, such as non-steroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, other anticoagulants
  • A history of traumatic or repeated epidural or spinal punctures
  • A history of spinal deformity or spinal surgery.

Monitor patients frequently for signs and symptoms of neurological impairment. If neurological compromise is noted, urgent treatment is necessary. Consider the benefits and risks before neuraxial intervention in patients anticoagulated or to be anticoagulated for thromboprophylaxis

General:

  • Increased risk of hemorrhage: Use with caution in patients at risk
  • Percutaneous coronary revascularization: Obtain hemostasis at the puncture site before sheath removal
  • Concomitant medical conditions: Use with caution in patients with bleeding diathesis, uncontrolled arterial hypertension or history of recent gastrointestinal ulceration, diabetic retinopathy, renal dysfunction, or hemorrhage 
  • History of heparin-induced thrombocytopenia: Use with caution
  • Thrombocytopenia: Monitor thrombocytopenia closely
  • Interchangeability with other heparins: Do not exchange with heparin or other LMWHs 
  • Pregnant women with mechanical prosthetic heart valves and their fetuses, may be at increased risk and may need more frequent monitoring and dosage adjustment.

Contraindication

  • Contraindicated in patients hypersensitive to enoxaparin sodium.
  • Contraindicated in hypersensitivity to-

Contraindicated in-

  • Active bleeding
  • Thrombocytopenia with a positive in vitro test for anti-platelet antibody in the presence of enoxaparin sodium