Your child needs to take the medicine called enoxaparin (say: ee-noks-a-PA-rin). This information sheet explains what enoxaparin does, how to give it, and what side effects or problems your child may have when they take this medicine.
What is enoxaparin?
- You may hear enoxaparin called by its brand name, Lovenox.
- Enoxaparin comes as a clear liquid for injection. It is given by a needle just under the skin (subcutaneously or sc).
- Enoxaparin is a medicine called an anticoagulant (blood thinner). It belongs to group of drugs known as low molecular weight heparins.
- Enoxaparin works by changing the normal way the blood clots together. It helps to prevent unwanted blood clots or break up harmful blood clots.
Before giving enoxaparin to your child
Tell your doctor if your child:
- Is allergic to enoxaparin, other low molecular weight heparins, heparin, sulfites, benzyl alcohol or pork products.
- Has any blood clotting problems, other conditions that increase the risk of bleeding or any active major bleeding.
- Has had a blood clotting reaction to heparin called thrombocytopenia (low platelet count).
Talk with your doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:
- kidney or liver problems
- stomach ulcers
- high blood pressure
How should you give your child enoxaparin?
Your child's first dose of enoxaparin will likely be given in the hospital or in clinic. If your child is to receive enoxaparin at home, arrangements may be made to have a nurse come into the home to give it. Alternatively, you may be taught by one of the nurses to give your child the subcutaneous (sc) injections (injections under the skin) at home. If you give the injections at home:
- Make sure you understand and are comfortable with the way to prepare and inject enoxaparin, and know how to dispose of the needle and syringe.
- Please see the "Enoxaparin: Injecting at home" Family Med Aid for more information.
- Dispose of needles in a needle/sharps disposal container
How much enoxaparin should you give your child?
Enoxaparin is available in several different strengths. The dosing information below applies to the 100 mg/mL (3 mL) multidose vials.
Enoxaparin is usually injected using insulin syringes that are specially designed for injections into the skin. It is important to note that the volume is measured in "units" on an insulin syringe, and that one unit on the insulin syringe is equal to 1 mg enoxaparin.
1 unit on the insulin syringe = 1 mg of enoxaparin.
Your child has been prescribed _______ mg of enoxaparin each dose. This dose is equivalent to _______units on an insulin syringe.
The doctor may sometimes need to change the dose. Please bring this Med-aid to all your child's Thrombosis Clinic appointments. If your child's dose of enoxaparin changes, please ask one of the nurses or the pharmacist to complete the dose chart at the end of this Med-aid for you.
Enoxaparin dosing chart
| Date | Dose of enoxaparin (mg) | Volume per dose (mL) | Units on an insulin syringe |
|---|---|---|---|
For more information, see
Enoxaparin: Injecting at Home.
What should you do if your child misses a dose of enoxaparin?
- Enoxaparin is usually given every 12 hours (no less than 10 hours and no more than 14 hours in between doses).
- Give the missed dose as soon as you remember.
- If it is more than two hours after the dose should have been given, skip the missed dose. Give the next dose at the regular time.
- Do not give your child two doses to make up for one missed dose.
What are the possible side effects of enoxaparin?
Your child may have some of these side effects while they take enoxaparin:
- irritation, pain or redness at the place of injection
- back pain
- headache
- dizziness
- for older girls, longer or heavier menstrual periods
- bleeding or bruising more easily than normal
Most of the following side effects are not common, but they may be a sign of a serious problem. Call the Thrombosis Team or your child's doctor right away or take your child to Emergency if your child has any of these side effects:
- signs of a life-threatening reaction, including: wheezing; shortness of breath, chest tightness or chest pain; fever; itching; bad cough; blue skin colour; swelling of face, lips, tongue or throat
- rash
- deep, dark purple bruise, pain or swelling at the site of injection.
- unusual bleeding; for example, a very long nosebleed, blood in the urine, coughing or throwing up blood, bleeding at the place of injection, bleeding or oozing from the surgical site
- black, sticky, tarry stools or stools with red streaks
What safety measures should you take when your child is using enoxaparin?
- Talk to your doctor immediately if your child has a bad fall, especially if your child hits their head.
- Head protection is important for sports, such as bicycling or rollerblading. Do not let your child play rough sports, like hockey or football. They can get bruised or injured.
- Before your child has any kind of surgery (including dental work), medical procedure or emergency treatment, tell the doctor or dentist that your child is taking enoxaparin. Please call the Thrombosis Service, in advance.
- It may be recommended that your child wear a Medic Alert bracelet or necklace while on enoxaparin. The Thrombosis Team will tell you depending on how long your child will be on enoxaparin.
There are some medicines that should not be taken together with enoxaparin or in some cases the dose of enoxaparin or the other medicine may need to be adjusted. It is important that you tell your doctor and pharmacist if your child takes any other medications (prescription, over the counter or herbal) including:
What other important information should you know about enoxaparin?
- Once opened, the vial is only good for up to 28 days. After 28 days the vial must be discarded, even if there is still some enoxaparin remaining.
- Keep a list of all medications your child is on and show the list to the doctor or pharmacist.
- Do not share your child's medicine with others. Do not give anyone else's medicine to your child.
- Make sure you always have enough enoxaparin to last through weekends, holidays and vacations. Call your pharmacy at least two days before your child runs out of medicine to order refills.
- Keep enoxaparin at room temperature in a cool, dry place away from sunlight. Do NOT store it in the bathroom or kitchen.
- Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
Personal stories about the use of low molecular weight heparins
Two families share their experiences with using low molecular weight heparins. This video will help to answer any questions you may have if you or someone you know will be taking this medication.
If you are using a printout of this page you can watch two videos at www.aboutkidshealth.ca/enoxaparin.
Thrombosis Learning Hub
For more information on thrombosis, post-thrombotic syndrome and the management of these conditions, please visit the Thrombosis Learning Hub.
Gardez le enoxaparin hors de la vue et de la portée de votre enfant. Conservez-le sous clé dans un endroit sécuritaire. Si votre enfant ingère trop de enoxaparin, téléphonez à votre centre antipoison local à l'un des numéros suivants. Ces appels sont gratuits.
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Composez le 1-800-POISON-X, ou 1-844-764-7669, de n'importe où au Canada sauf au Québec.
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Composez le 1-800-463-5060 si vous habitez au Québec.