Lovenox: A Potent Anticoagulant in Preventing Blood Clots

Lovenox is a branded medication with the active drug, enoxaparin.  It is an anticoagulant drug and is given as a single-dose injection to prevent blood clots from forming in the blood vessels. The formation of blood clots in the blood vessels may lead to various types of health problems such as heart attack, stroke, pulmonary embolism (PE), angina, and deep vein thrombosis (DVT). 

Lovenox belongs to the anticoagulant drug class, which works by interfering with the blood clotting process and preventing the formation of blood clots. They do not dissolve existing blood clots but can help prevent them from getting larger or forming new clots.

Lovenox can be used alone or in combination with other blood thinner (anticoagulant) medications such as warfarin and aspirin. 

Is There a Generic for Lovenox?

Yes, there is a generic version of Lovenox, which is enoxaparin sodium for injection. The generic version is usually less expensive. Generic enoxaparin is available in the same forms as Lovenox, including prefilled syringes, multiple-dose vials, and autoinjectors. 

Like the brand-name version, generic enoxaparin must be used as directed by a healthcare provider. If you have questions about whether a generic version of Lovenox is right for you, you should discuss this with your doctor or pharmacist.

What Is Lovenox Used To Treat?

The FDA approved Lovenox to treat patients who are at risk of developing blood clots or have a history of blood clots. Some of the conditions this medication may be prescribed for include:

• Deep vein thrombosis (DVT): A condition that occurs as a result of blood clot formation in the deep veins of the arms, legs, or pelvis.
• Pulmonary embolism (PE): A condition that occurs as a result of blood clot movement to the lungs and blockage of blood flow, which can be life-threatening.
• Unstable angina: A type of chest pain that occurs as a result of low blood flow in the heart.
• Acute coronary syndrome: This is a term used to describe a group of conditions that occur when blood flow to the heart muscles is suddenly blocked or reduced.  
• During and after certain types of surgeries: Lovenox may be used to prevent blood clots after surgeries such as abdominal surgery, hip replacement surgery, and knee replacement surgeries.

How Does Lovenox Work?

Lovenox targets a natural protein called antithrombin III (AT III), and it works by enhancing the activity of antithrombin III. This natural protein is responsible for blocking the activity of certain clotting factors in the blood. By enhancing the activity of AT III, Lovenox helps to prevent the formation of blood clots.

Lovenox specifically targets factor Xa, which is a clotting factor that is involved in the formation of blood clots. By inhibiting the activity of factor Xa, it helps to prevent blood clotting. As a result of clotting factors blockage, blood clots are less likely to form in the vessels, which leads to a lower risk of stroke, PE, or DVT in patients. 

Dosage Form and Strength

Lovenox is available in two forms with different concentrations: multi-dose vial and single-dose graduated prefilled syringe. The following are the available forms of Lovenox with different strengths:

• Multi-dose vial with a strength of 300 mg/3 ml
• Single-dose graduated prefilled syringe with strengths of 30 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, and 150 mg/1 ml 

Dosing Information

The dosage of Lovenox depends on several factors, including the patient’s weight, medical condition, and the purpose for which the medication is being used. The following are the typical dosage that is administered either intravenously or subcutaneously once a day. 

Dosage for deep vein thrombosis (DVT) 

• For patients with DVT with or without pulmonary embolism and who are receiving treatment in the hospital, the usual dosage of Lovenox is 1 mg/kg, injected under the skin every 12 hours or 1.5 mg/kg once a day for up to 17 days.
• For an outpatient with acute DVT without pulmonary embolism, the usual dosage of Lovenox is 1 mg/kg, injected under the skin every 12 hours for up to 17 days.
• For the prevention of DVT, the usual dosage of Lovenox is 40 mg once a day or 30 mg every 12 hours.

Dosage for patients undergoing abdominal surgery

The usual dosage of Lovenox is 40 mg, injected under the skin every 12 hours once daily for up to 14 days.

Dosage for patients receiving hip or knee replacement surgery

The usual dosage of Lovenox is 30 mg, administered under the skin every 12 hours once daily for up to 14 days.

Dosage for medical patients with acute illness

For patients who are in bed and not active for a long period of time due to their acute illness, the usual dosage of Lovenox is 40 mg, injected under the skin once a day for up to 6 – 12 days. 

How Is Lovenox Given?

Lovenox single-dose prefilled syringe is given subcutaneously (under the skin of the abdomen, at least 2 inches away from the belly button), and a multi-dose vial is given intravenously (injected into the vein) as directed by the healthcare provider. 

Is Lovenox a Form of Chemotherapy?

No, Lovenox is not a form of chemotherapy but an anticoagulant therapy that is used to treat or prevent the formation of blood clots in deep vessels. 

Side Effects

Like all medications, Lovenox may also cause some common side effects, although not all patients will experience them. Some common side effects may include:

• Bleeding, such as nosebleeds, bleeding gums, or unusual bruising
• Injection site reactions, such as pain, redness, or swelling
• Skin rash or itching
• Nausea or vomiting
• Diarrhea or constipation
• Headache
• Dizziness

In rare cases (>1%), Lovenox may cause more serious side effects, such as:

• Severe bleeding, which may occur in the brain, stomach, or other organs
• Low blood platelet count, which may increase the risk of bleeding
• Anemia (low red blood cells)
• Allergic reactions, which may cause difficulty breathing, hives, or swelling on the area of the face, lips, tongue, or throat

Patients who experience any unusual or severe symptoms while taking Lovenox should seek medical attention immediately. It is important to follow the prescribed dosage and administration instructions carefully and to discuss any concerns or questions about the medication with a healthcare provider.

Precautions

Patients who are taking Lovenox should take the following precautions:

• Do not take Lovenox if you are pregnant or intend to become pregnant, as the risks of Lovenox on pregnancy have not been studied yet. 
• You should not take Lovenox if you are undergoing certain medical procedures, such as a spinal puncture or epidural anesthesia.
• You should not take Lovenox if you have a history of bleeding disorders such as hemophilia or active bleeding.
• You should not take Lovenox if you have a history of thrombocytopenia or a low platelet count.
• You should not take Lovenox if you have severe liver or kidney disease.
• You should not take Lovenox if you have uncontrolled high blood pressure.
• Tell your healthcare provider if you are taking other anticoagulant drugs.

Cost

The cost of Lovenox can vary depending on many factors, such as the dosage, the number of injections needed, and the pharmacy dispensing the medication. Additionally, the cost may differ for patients with insurance versus those without insurance. That said, below are some typical prices you might pay for this medication.

• The current cost of a multi-dose vial with a concentration of 300 mg/3 ml is about $77.05. 
• The cost of a single-dose prefilled syringe with a concentration of 30 mg/0.3 ml is about $77.05.
• The cost of a single-dose prefilled syringe with a concentration of 40 mg/0.4 ml is about $99.42.
• The cost of a single-dose prefilled syringe with a concentration of 60 mg/0.6 ml is about $144.53.
• The cost of a single-dose prefilled syringe with a concentration of 80 mg/0.8 ml is about $189.49.
• The cost of a single-dose prefilled syringe with a concentration of 100 mg/1 ml is about $234.53.
• The cost of a single-dose prefilled syringe with a concentration of 120 mg/1 ml is about $279.48.
• The cost of a single-dose prefilled syringe with a concentration of 150 mg/1 ml is about $346.99.