Lovenox

Medically Reviewed by HaVy Ngo, Pharm.D.

Last Reviewed: Jun 10, 2022

Warnings

What are the risks of taking Lovenox?

Lovenox can cause serious health problems in certain groups of people. You should talk to your healthcare provider if you have any concerns or other treatment options.

Increased risk of spinal hemorrhage (bleeding around the spinal cord):
Risk factors:

Epidural or spinal anesthesia (getting anesthesia near the spine); Spinal tap (lumbar puncture); history of spinal surgery or spinal procedures; using NSAID (nonsteroidal anti-inflammatory drug) and other blood thinners.

If you are getting a spinal tap or an epidural (often used in childbirth or surgeries of the lower belly and legs), using Lovenox will put you at a higher risk of bleeding around the spinal cord, which can cause permanent paralysis. Your doctor will give you instructions on safely stopping Lovenox before a back surgery or procedure. Taking NSAIDs (ibuprofen, Advil, naproxen, Aleve) and other blood thinners such as warfarin can also increase this risk. Let your healthcare provider know immediately if you experience midline back pain, numbness, or weakness in your legs, bladder, and bowel dysfunction.

Increased risk of major bleeding:
Risk factors:

Using other blood thinners; recent surgery; history of bleeding problems; uncontrolled arterial hypertension (uncontrolled high blood pressure); history of recent stomach ulcer; diabetic retinopathy (poor eyesight as a complication from diabetes); kidney disease; spine problems (such as spinal deformity)

If you have one of the above factors, Lovenox increases your risk of major bleeding events, such as those in the belly or brain, which can be life-threatening. You should familiarize yourself with the signs and symptoms of uncontrolled bleeding, as early detection can be life-saving.

Risk of heparin-induced thrombocytopenia (HIT):
Risk factors:

History of heparin-induced thrombocytopenia (HIT); history of low platelet.

HIT is an immune-mediated adverse drug reaction that can occur with Lovenox or any heparin-containing product; this happens when your immune system recognizes heparin as a foreign body and develop antibodies that bind to heparin. As a result, the platelets clump together, reducing the number of available platelet in the blood and becoming clots. If you have a history of HIT or low platelets, talk to your doctor about whether Lovenox is a safe choice for you. HIT usually occurs between 5 to 14 days after beginning heparin or Lovenox therapy.

Increased risk of blood clots in pregnant women with prosthetic heart valves:

Pregnancy increases the risk of blood clots due to hormonal changes. Prosthetic heart valves require long-term anticoagulant therapy to prevent blood clots from forming in the heart. If you have a prosthetic heart valve and become pregnant, Lovenox as the monotherapy may not be effective enough. Let your doctor know when you become pregnant. You may need more frequent medical tests to ensure that Lovenox works well for you.

Risk of serious adverse reactions in infants due to the benzyl alcohol preservative:

Levonox multiple-dose vails are not approved for use in neonates or low birth weight infants. Lovenox multiple-dose vials and other benzyl alcohol-preserved drugs can cause severe and even fatal adverse reactions, including “gasping syndrome.” The “gasping syndrome” is characterized by central nervous system depression, metabolic acidosis (a condition where there is too much acid in the body fluids), and gasping respirations. Benzyl alcohol may cross the placenta and get to the unborn baby. Pregnant women should use preservative-free formulations.

What should I tell my doctor before starting Lovenox?

Tell your doctor if you are allergic to enoxaparin, heparin, benzyl alcohol (only the multiple-dose formulation of Lovenox), pork products, or if you have:

Active or uncontrolled bleeding
History of immune-mediated heparin-induced thrombocytopenia (HIT) within the past 100 days or still have the antibody that causes HIT is still in your blood.
- HIT is a condition that causes low blood platelets after receiving heparin

Lovenox increases your risk of bleeding. Tell your doctor if you have:

Bacterial endocarditis (a bacterial infection of the lining of your heart)
A bleeding disorder such as hemophilia
Kidney or liver disease
Uncontrolled high blood pressure
Prosthetic (artificial) heart valves
Diabetic retinopathy (poor eyesight as a complication from diabetes)
Hemorrhagic stroke (a stroke caused by an artery bleeding into the brain)
Recent brain, spine, or eye surgery
Stomach ulcer or intestinal bleeding
Currently using a platelet inhibitor such as Plavix (clopidogrel) or Brillinta (ticagrelor)
Upcoming surgery, including dental surgery

Tell your doctor if you are pregnant or plan to get pregnant. If you use Lovenox during pregnancy, make sure you let your doctor know if you have a mechanical heart valve or thrombophilia ( a condition that increases your risk of blood clots).

It is unknown whether Lovenox is excreted in human breast milk. Discuss the risks and benefits of Lovenox with your doctor.

What proper medical care should I take while on Lovenox?

You should be familiarized with all the signs and symptoms of increased bleeding so you can inform your doctor immediately and seek emergency medical attention if needed.
Watch for signs of skin necrosis at the injection site, such as severe pain, warmth, skin redness, and swelling.
Ensure that you rotate injection sites and lie down during injection.
Do not use NSAIDs, aspirin, or other anticoagulants without talking to your doctor first.
If you miss a dose, administer the missed dose as soon as you remember it. However, you should inform your healthcare provider about the missed dose as Lovenox should be given on a regular schedule.

What drugs can interact with Lovenox?

If possible, medications that enhance the risk of bleeding should be discontinued before initiation of Lovenox therapy. These agents include anticoagulants, platelet inhibitors, NSAIDs, dipyridamole, and sulfinpyrazone.

Examples of medications used to treat or prevent blood clots:

Heparin
Apixaban (Eliquis), rivaroxaban (Xarelto), argatroban, fondaparinux
Alteplase, reteplase, tenecteplase, urokinase
Abciximab, cilostazol, clopidogrel, eptifibatide

Other drugs, including prescriptions, over-the-counter products, herbal supplements, and vitamins, may interact with Lovenox. Not all potential drug interactions are listed in this guide. It is highly recommended to keep a list of all the drug products you are using (prescriptions, over-the-counter products, herbal supplements, natural products, and vitamins) and share it with your doctor and pharmacist.

Find the best discount on Lovenox »