Clexane

What is it?

An anticoagulant preparation produced in pre-filled syringes for injection containing 20mg (low molecular weight heparin) enoxaparin per 0.2ml, or 40mg enoxaparin per 0.4ml, or 60mg per 0.6ml, or 80mg 0.8ml, or 100mg per ml. Also, CLEXANE FORTE, containing 150m of enoxaparin per ml in single dose, prepared syringes.

Medical Uses

Prevention of deep vein thrombosis especially associated with orthopaedic and general surgery and in people who are immobile and bed-ridden. Prevention of blood clot formation during hnemodialysis; treatment of non-Q wave heart attack and angina which is unstable. Treatment of thromboembolic disease of the veins in which there is pulmonary embolism and/or deep vein thrombosis.

Dosage

Adults, low to medium risk of thrombosis (in general surgery), 20mg 2 hours before operation by deep subcutaneous injection and then 20mg once each day for 7 to 10 days. High risk of thrombosis (orthopaedic surgery), 40mg 12 hours before operation by deep subcutaneous injection, and 40mg once a day for 7 to 10 days. Prevention in illness, 40mg once each day by deep, subcutaneous injection for at least 6 days, continuing until the patient is able to walk, but for a maximum period of 2 weeks, with alternating injection sites. Haemodialysis, 1mg per kg of body weight with a further dose of 0.5 to 1mg/kg if process lasts for longer than 4 hours. Treatment of venous thromboembolism, 1.5mg per kg of body weight each day for 5 days by subcutaneous injection, until the patient is able to take anticoagulation tablets by mouth. Treatment of angina which is unstable, 1mg per kg of body weight every 12 hours by subcutaneous injection for at least 2 days or until stabilised (usually, 2 to 8 days), with 100 to 325mg of aspirin taken by mouth.

Special Care

Pregnancy, breast-feeding, hypertension, history of liver disorders or ulcers, spinal anaesthesia or epidural, spinal puncture.

Avoid Use

Children, patients with peptic ulcer, serious bleeding disorders (e. g. haemophilia), those at risk of haemorrhage, thrombocytopenia, acute bacterial endocarditis, artificial heart valves, haemorrhagic CVA.

Possible Drug and Food Interactions

Aspirin, NSAIDs, dextran, anticoagulants taken by mouth, antiplatelet drugs, locoregional anaesthesia.

Known Side Effects

Effects on liver, thrombocytopenia, less commonly, bruising and haemorrhage. Hypoa1dosteronism (low secretion of aldosterone, an adrenal gland hormone) causing elevated blood levels of potassium. Blood potassium levels should be monitored with longer term use of drug and in patients with diabetes, acidosis, chronic kidney failure or those who have been taking potassium-sparing drugs.