Lovenox

What is Lovenox

Lovenox is an anticoagulant (blood thinner). Lovenox prevents the formation of blood clots.

Lovenox is used to prevent blood clot formation following knee or hip replacement surgery and following abdominal surgery in patients at high risk of developing a blood clot. Lovenox is also used with aspirin to prevent complications of certain types of angina and heart attacks, and with warfarin (Coumadin) to treat deep vein thrombosis (a type of blood clot).

Lovenox may also be used for purposes other than those listed in this medication guide.

General medical information about Lovenox

There is a risk of bleeding in the spinal or epidural space, possibly resulting in paralysis, when Lovenox is used along with spinal or epidural anesthesia or spinal puncture. This risk may be increased by the use of indwelling epidural catheters or by the concomitant use of drugs that affect blood clotting.

Do not inject this medication intramuscularly (into the muscle) or intravenously (into the vein).

Do not take aspirin, ibuprofen (Motrin, Advil, Nuprin, and others), ketoprofen (Orudis KT, Orudis, Oruvail), naproxen (Aleve, Naprosyn, Anaprox, and others), indomethacin (Indocin), or any other nonsteroidal anti-inflammatory medication without first talking to your doctor. These medicines may lead to bleeding when taken with Lovenox. Ask your pharmacist or doctor before taking any prescription or over-the-counter medication during treatment with Lovenox.

What you should discuss with your doctor before using Lovenox

Do not use Lovenox without first talking to your doctor if you
- have a low level of platelets in your blood;
- have uncontrolled active bleeding;
- have an allergy to pork products; or
- cannot have accurate blood testing done prior to and during dosing.

Before using Lovenox, tell your doctor if you
- have bacterial endocarditis;
- have high blood pressure that is not being controlled;
- have eye problems due to diabetes (diabetic retinopathy);
- need to have surgery or another invasive procedure;
- have hemophilia or another blood disorder;
- have a stomach ulcer;
- have a prosthetic heart valve;
- have liver disease; or
- have kidney disease.

You may not be able to use Lovenox, or you may require a dosage adjustment or special monitoring during therapy if you have any of the conditions listed above.

Lovenox is in the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby. Do not use Lovenox without first talking to your doctor if you are pregnant or could become pregnant during treatment.

It is not known whether Lovenox passes into breast milk. Do not use this medication without first talking to your doctor if you are breast-feeding a baby.

How should you use Lovenox

Use Lovenox exactly as directed by your doctor. If you do not understand these directions, ask your doctor, nurse, or pharmacist to explain them to you.

Lovenox must be used as a subcutaneous (under the skin) injection.

Do not inject this medication intramuscularly (into a muscle) or intravenously (into a vein).

Your doctor or nurse will give you detailed instructions on how to inject Lovenox. It should be injected into the fat of the stomach. Follow your doctor's instructions.

When using a prefilled syringe, to prevent the loss of medication do not expel the air bubble before the injection.

Sit or lie down before receiving an injection. Lift a fold of skin and insert the needle completely into the fold. Continue to pinch the skin until the injection is complete. To lessen bruising, do not rub the area after injecting the medication. Rotate your injection sites as directed by your doctor.

Do not use any medication that is discolored or that has particles in it.

It is important to use Lovenox regularly to get the most benefit.

Do not stop using this medication without first talking to your doctor.

Your doctor may want you to have blood tests or other medical evaluations during treatment with Lovenox to monitor progress and side effects.

Store Lovenox at room temperature away from moisture and heat.

If you miss a dose:

Use the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and use only the next regularly scheduled dose. Do not use a double dose of this medication.

Notify your doctor if you miss a dose of Lovenox.

What happens if you overdose:

Seek emergency medical attention if an overdose is suspected.

Symptoms of an overdose include unusual bleeding from wounds or injection sites; nosebleeds; black, bloody, or tarry stools; blood in the urine; and easy bruising or bleeding.

What should you avoid while using Lovenox

Do not take aspirin, ibuprofen (Motrin, Advil, Nuprin, and others), ketoprofen (Orudis KT, Orudis, Oruvail), naproxen (Aleve, Naprosyn, Anaprox, and others), indomethacin (Indocin), or any other nonsteroidal anti-inflammatory drug (NSAID) without first talking to your doctor. These medicines may lead to bleeding when taken with Lovenox. Ask your pharmacist or doctor before taking any prescription or over-the-counter medication during treatment with Lovenox.

Possible side effects of Lovenox

If you experience any of the following serious side effects, stop using Lovenox, and seek emergency medical attention or contact your doctor immediately:
- an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
- prolonged or unexplained bleeding;
- pain, warmth, or redness in an arm or leg, or difficulty breathing, which could indicate a blood clot; or
- ulceration at the injection site.

Other less serious side effects may be more likely to occur. Continue to use Lovenox and notify your doctor if you experience
- mild pain, redness, or warmth at the injection site;
- rash or itching;
- fever;
- nausea; or
- swelling or water retention.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Lovenox

Do not use Lovenox with any of the following medicines without first talking to your doctor:
- aspirin,
- ibuprofen (Motrin, Advil, Nuprin, and others), ketoprofen (Orudis KT, Orudis, Oruvail), naproxen (Aleve, Naprosyn, Anaprox, and others), indomethacin (Indocin), diclofenac (Cataflam, Voltaren), diflunisal (Dolobid), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), ketorolac (Toradol), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), tolmetin (Tolectin), meloxicam (Mobic), or any other nonsteroidal anti-inflammatory medication;
- warfarin (Coumadin);
- ardeparin (Normiflo), dalteparin (Fragmin), danaparoid (Orgaran), or tinzaparin (Innohep);
- aspirin and dipyridamole (Aggrenox);
- ticlopidine (Ticlid) or clopidogrel (Plavix); or
- dipyridamole (Persantine).

The drugs listed above may increase the effects of Lovenox, which could be dangerous. You may not be able to use Lovenox, or you may require a dosage adjustment or special monitoring during your treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with Lovenox. Talk to your doctor and pharmacist before using any prescription or over-the-counter medicines, including herbal products.