Enoxaparin sodium

An anticoagulant medication used to prevent and treat blood clots

Chemical structure of Enoxaparin Sodium

Enoxaparin sodium is a low molecular weight heparin (LMWH) used as an anticoagulant to prevent and treat thrombosis. It is commonly used in the prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing surgery or those who are immobile. Enoxaparin is also used in the treatment of acute coronary syndromes, including unstable angina and myocardial infarction.

Pharmacology

Enoxaparin sodium works by inhibiting the formation of fibrin clots. It achieves this by enhancing the activity of antithrombin III, which in turn inhibits factor Xa and thrombin (factor IIa). The inhibition of factor Xa is more pronounced than that of thrombin, which distinguishes enoxaparin from unfractionated heparin.

Administration

Enoxaparin is administered via subcutaneous injection. The dosage and duration of treatment depend on the condition being treated and the patient's risk factors. For surgical prophylaxis, a typical dose is 40 mg once daily, while treatment of DVT or PE may require higher doses.

Side Effects

Common side effects of enoxaparin include bleeding, anemia, and thrombocytopenia. Serious bleeding events can occur, especially in patients with other risk factors for bleeding. Heparin-induced thrombocytopenia (HIT) is a rare but serious complication.

Contraindications

Enoxaparin is contraindicated in patients with active major bleeding, a history of HIT, or hypersensitivity to enoxaparin or pork products. Caution is advised in patients with renal impairment, as the drug is primarily excreted by the kidneys.

Mechanism of Action

Ball-and-stick model of Enoxaparin Sodium

Enoxaparin binds to antithrombin III, causing a conformational change that accelerates the inactivation of factor Xa. This action reduces the conversion of prothrombin to thrombin, thereby decreasing the formation of fibrin clots. The specific structure of enoxaparin allows it to preferentially inhibit factor Xa over thrombin.

Clinical Use

Enoxaparin is widely used in both inpatient and outpatient settings. It is often preferred over unfractionated heparin due to its more predictable pharmacokinetics and ease of administration. In the context of acute coronary syndrome, enoxaparin is used in conjunction with other antiplatelet agents to reduce the risk of myocardial infarction and stroke.

Related pages

• Heparin
• Anticoagulant
• Deep vein thrombosis
• Pulmonary embolism
• Coronary artery disease