Enoxaparin

What is Enoxaparin for?

Enoxaparin is a blood thinner that prevents blood clots from forming in your body. It does not remove clots that are already formed, but prevents these clots from becoming bigger. 
You may be given Enoxaparin for: 

• Treatment or prevention of Deep Vein Thrombosis (blood clots in the legs) or Pulmonary Embolism (blood clot in the lungs)
• Prevention of blood clot formation after a hip or knee replacement operation
• Prevention of blood clot formation during haemodialysis (a treatment where a dialysis machine filters wastes, salts, and excess fluid from the blood when the kidneys are not able to do so adequately)
• Treatment of unstable angina (chest pains) and heart attacks, when taken in combination with other medications. 
   

How should I take or use Enoxaparin?

• It may be given as an injection into the fatty tissue under the skin (subcutaneous). You may need to inject once or twice daily as instructed by your doctor.
• Do not stop injecting your medication without first checking with your healthcare professional.\

Step	Directions for use
1	How to prepare the injection Wash and dry your hands thoroughly Peel back the paper strip and remove the syringe from the packaging. Check that the syringe is not damaged. Check that the solution is clear, colourless and does not contain particles or clumps
2	How to inject the medication Sit or lie in a comfortable position so that you are relaxed.
3	Choose an area on your abdomen that is at least five centimetres away (two fingers away) from your belly button. Do not inject around existing scars or bruises.
4	Clean the injection site with an alcohol swab. Let the site dry thoroughly before administering the injection.
5	Carefully pull off the needle cap and throw the needle cap away. The syringe is pre-filled and ready to use. If a drop appears at the tip of the needle, remove the drop by tapping on the syringe with the needle pointing down. Do not expel the air bubble as this may lead to loss of medication.
6	If your dose is less than the full content of the syringe, the 60mg and 80mg graduated prefilled syringe should be used: Hold the syringe with the needle pointing downwards. Gently tap on the syringe so that the air bubble moves to the top of the plunger. \ Refer to the dose markings on the side of the syringe. Gently press the plunger to remove the excess medication.
7	Gently pinch a skin fold at the selected injection site with your thumb and index finger. Hold the skin fold throughout the injection.
8	Hold the syringe (like a pencil) with your other hands. Keep fingers off the plunger. Insert the needle into the skin fold at a 90 degrees angle.
9	Press the plunger fully with your index finger and hold for five seconds. Do not let go of the skin fold while you are injecting. Keep your finger on the plunger and remove the needle by pulling it straight out while keeping the skin pinched. If slight bleeding occurs, gently press over the injection site for a few minutes. Do not rub the injection site, as it might cause bruising.
10	Discard the entire syringe in a puncture proof container, such as a metal tin or thick plastic bottle with a cap or cover (for example, detergent bottles). You may also buy a container specially designed to throw sharp items, known as a sharps box, at pharmacies. This is to prevent any injuries due to needles.
11	Rotate the area where you are injecting for each injection to prevent scarring.

What should I do if I forget to take or use Enoxaparin?

If you forget to take a dose, take it as soon as you remember. Then take your next dose at the usual time. Do not take two doses to make up for the missed dose.

What precautions should I take when taking or using Enoxaparin?

Inform your healthcare professional if:

• You are allergic to this medication or any of the other ingredients of this medication
• You are pregnant, planning to become pregnant, or breastfeeding
• You are taking any other medications, including supplements, traditional medications and herbal remedies.
• There is no need to make drastic changes to your lifestyle. However, avoid sports or activities that may cause you to get injured.  
• See a doctor if you have any fall or injury to any part of your body.
• Inform all doctors, dentists and pharmacists that you are on Enoxaparin. There may be a need to stop the medication for a short period of time if you are going for surgery or medical procedures such as an endoscopy or dental treatment. 
   

What food or medication should I avoid when I take or use Enoxaparin?

Consult your healthcare professional before you take any other medication (either prescription or over-the-counter), nutritional supplements or herbal remedies

What are some common side effects of Enoxaparin?

• Injection-site reactions such as pain or irritation
• You may experience other forms of bleeding such as a gum bleed when brushing teeth, unexplained nose bleeding, or getting bruises more easily.
  • See a doctor if bleeding does not stop within minutes or if you feel unwell.
  • Use a soft toothbrush and floss your teeth gently.
  • Use an electric shaver instead of a blade.
  • For women, it is common to have increased menstrual flow but check with your doctor if you feel unwell.
     

What are some rare but serious side effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following: 

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body 

See a doctor immediately or go to the hospital if you have any of the following symptoms that may indicate internal bleeding, such as: 

• Black, sticky, or bloody stools
• Coughing up blood or brown material
• Unexplained bruises or large dark purple areas on skin, or bruises that get bigger
• Blood in urine
• Pinpoint red spots on the skin
• Shortness of breath
• Sudden giddiness or confusion
• Severe headache that does not go away

Blood clots may still form while you are taking Enoxaparin. The signs and symptoms depend on the site where the blood clots are found. See a doctor immediately or go to the hospital if you experience: 

• Symptoms of deep vein thrombosis such as leg swelling, redness, pain, warmth, numbness
• Symptoms of pulmonary embolism such as chest pain, shortness of breath, coughing up blood
• Symptoms of stroke such as muscle weakness, difficulty talking, blackouts, giddiness, blurred vision 
   

How should I store Enoxaparin?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children. Do not store above 25 degrees Celsius. 

How do I throw away Enoxaparin safely?

Discard the entire syringe in a puncture proof container, such as a metal tin or thick plastic bottle with a cap or cover (for example, detergent bottles). You may also buy a container specially designed to throw sharp items, known as a sharps box, at pharmacies. This is to prevent any injuries due to needles. 
Pack the container in a black trash bag and seal it tightly before throwing it into the rubbish chute or bin