Generic Name: enoxaparin (ee-nox-AP-a-rin)
Brand Name: Lovenox

Tell your doctor you use Lovenox before you have any type of spinal or epidural procedure. Patients who have these procedures while they use Lovenox are at risk for developing bleeding around your spine. This could result in long-term or permanent paralysis.

The risk is increased in patients who have an indwelling epidural catheter. It is also increased in patients with a history of traumatic or repeated epidural or spinal puncture, a deformed spine, or spinal surgery. It is also increased in patients who use medicines that may affect blood clotting, such as other anticoagulants (eg, warfarin), aspirin, platelet inhibitors (eg, clopidogrel), and nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen, naproxen).

If you have a spinal or epidural procedure while you use Lovenox, tell your doctor at once if you notice any symptoms of nerve problems (eg, back pain; numbness or tingling, especially in the legs and feet; muscle weakness; paralysis; loss of bladder or bowel control).

Talk with your doctor if you have recently had or will be having a spinal or epidural procedure. Some time may need to pass between the use of Lovenox and your procedure. Discuss any questions or concerns with your doctor.


Lovenox is used for:

Preventing blood clots in patients who have certain illnesses or who will be having certain types of surgery. It is also used along with other medicine to treat blood clots. It is also used along with other medicine to prevent certain problems caused by heart attack or unstable angina (chest pain). It is also used to decrease the risk of recurring heart attack in certain patients. It may also be used for other conditions as determined by your doctor.

Lovenox is a low molecular weight heparin (LMWH). It works by blocking the formation of blood clots.

Do NOT use Lovenox if:

  • you are allergic to any ingredient in Lovenox
  • you are allergic to heparin, benzyl alcohol, or pork products
  • you have severe or uncontrolled high blood pressure, or active major bleeding
  • you are taking a salicylate (eg, aspirin) or an NSAID (eg, ibuprofen, naproxen)
  • you have a low platelet count and the presence of antiplatelet antibodies

Contact your doctor or health care provider right away if any of these apply to you.

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Before using Lovenox:

Some medical conditions may interact with Lovenox. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of kidney problems, liver problems, stomach or intestinal problems (eg, ulcers), stroke, or vision problems caused by diabetes
  • if you have inflammation of the heart due to a bacterial infection; severe, uncontrolled high blood pressure; low body weight; or have a mechanical prosthetic heart valve
  • if you have a bleeding disorder, a history of brain bleeding or blood conditions, or von Willebrand disease
  • if you have recently had or are scheduled to have brain, spine, or eye surgery, an epidural catheter, or a spinal puncture
  • if you are taking medicines that affect platelets (eg, aspirin, clopidogrel, ticlopidine)
  • if you have a history of low platelet counts or bleeding problems after taking heparin
  • if you have recently given birth

Some MEDICINES MAY INTERACT with Lovenox. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Activated protein C, anticoagulants (eg, warfarin), dextran, dipyridamole, direct factor XA inhibitors (eg, rivaroxaban), direct thrombin inhibitors (eg, dabigatran), injectable cephalosporins (eg, cephazolin), injectable penicillins (eg, ampicillin), NSAIDs (eg, ibuprofen, ketorolac, naproxen), platelet inhibitors (eg, clopidogrel, ticlopidine), salicylates (eg, aspirin), sulfinpyrazone, or thrombolytics (eg, streptokinase) because the risk of side effects, such as bleeding, may be increased
  • Nitrates (eg, nitroglycerin) because they may decrease the effectiveness of Lovenox

This may not be a complete list of all interactions that may occur. Ask your health care provider if Lovenox may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Lovenox:

Use Lovenox as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Lovenox is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using Lovenox at home, a health care provider will teach you how to use it. Be sure you understand how to use Lovenox. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
  • Use the proper technique taught to you by your doctor. Inject deep under the skin, NOT into muscle.
  • Do not use Lovenox if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
  • Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
  • If you miss a dose of Lovenox, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Lovenox.

Important safety information:

  • Lovenox may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.
  • Tell your doctor or dentist that you take Lovenox before you receive any medical or dental care, emergency care, or surgery.
  • Before you begin taking any new prescription or nonprescription medicine, check the label to see if it has aspirin or ibuprofen in it. If it does or you are not sure, contact your doctor or pharmacist.
  • Some forms of Lovenox contain benzyl alcohol. Do not use medicine with benzyl alcohol in NEWBORNS or INFANTS. It may cause serious and sometimes fatal side effects. If you have questions, check with your doctor or pharmacist.
  • If you have ever had an allergic reaction to benzyl alcohol, ask your doctor or pharmacist if your medicine has benzyl alcohol in it.
  • Lovenox may affect certain lab tests, including liver enzyme. Be sure your doctor and lab personnel know you are using Lovenox.
  • Lab tests, including complete blood cell counts (eg, platelet counts) and tests for blood in the stool, may be performed while you use Lovenox. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use Lovenox with caution in the ELDERLY; they may be more sensitive to its effects, especially bleeding.
  • Lovenox should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Lovenox may contain the preservative benzyl alcohol, which can cause harm to the fetus. If you become pregnant, use a formulation without this preservative. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Lovenox while you are pregnant. It is not known if Lovenox is found in breast milk. If you are or will be breast-feeding while you are using Lovenox, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Lovenox:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; mild pain, irritation, swelling, redness, bleeding, or bruising at the injection site; nausea.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody, black, or tarry stools; confusion; difficulty walking; fainting; fever; pale skin; pink or red urine; severe or persistent dizziness, tiredness, or weakness; swelling; tingling, numbness (especially in the legs and feet), and muscle weakness; unusual bleeding or bruising; vomit that looks like coffee grounds.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include bruising; excessive bleeding.

Proper storage of Lovenox:

Store Lovenox at room temperature, between 59 and 77 degrees F (15 and 25 degrees C). Store away from heat, moisture, and light. Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Keep Lovenox out of the reach of children and away from pets.

General information:

  • If you have any questions about Lovenox, please talk with your doctor, pharmacist, or other health care provider.
  • Lovenox is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take Lovenox or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Lovenox. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Lovenox. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Lovenox.

Issue Date: November 5, 2014
Database Edition 14.4.1.002
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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