Enoxaparin sodium

B01AB05

Anticoagulant

Water

Enoxaparin sodium ( Clexane ® trade name, Lovenox ®; manufacturer Sanofi ) is a drug to prevent blood clotting.

Composition

Enoxaparin sodium is one of the low molecular weight heparins, ie, it has the same structural elements as unfractionated standard heparin, but has a lower average molecular size than this. The polysaccharide chains are composed of glucosamine and Uronsäurebausteinen which are glycosidically linked. The molecular chains consist of four to 24 monomers. Most chains possess a 4- Enopyranoseuronat structure at the nonreducing end. Enoxaparin inhibits an important procoagulant factor (factor Xa).

Clinical information

Areas of application (indications )

Enoxaparin sodium is used in the treatment as well as for the prevention of thrombosis ( blood clots). It is suitable with and without pulmonary embolism to the primary prevention of deep vein thrombosis in surgical and nonsurgical patients at risk for thromboembolic events, thrombosis prophylaxis and anticoagulation in extracorporeal circulation during hemodialysis, for the treatment of deep vein thrombosis. Further present low molecular weight heparins (LMWH ) as an alternative to unfractionated heparin (UFH ) in the treatment of unstable angina and non-Q- wave myocardial infarction (UA / NQMI ) dar. In patients with unstable angina or myocardial infarction without ST elevation enoxaparin reduced the incidence of clinical events in the acute phase of treatment by 20%.

Enoxaparin is approved for the following applications:

  • All strengths: antithrombotic prophylaxis and anticoagulation in extracorporeal circulation during hemodialysis.
  • 20 mg / day: Primary prevention of deep vein thrombosis: peri -and postoperatively in patients with low or moderate thromboembolic risk (eg general surgery ).
  • 40 mg / day: Primary prevention of deep vein thrombosis: peri -and postoperatively in patients with high thromboembolic risk (eg in orthopedic surgery ), primary prophylaxis of deep vein thrombosis in non-surgical patients with moderate or high thromboembolic risk in acute severe internal diseases ( NYHA functional class III or IV, infections, respiratory diseases) with working or immobilization.
  • 60-100 mg / day: therapy of deep vein thrombosis with or without pulmonary embolism, treatment of unstable angina and non-ST -segment elevation myocardial infarction, treatment of acute ST -segment elevation myocardial infarction (STEMI ), conservative or with subsequent PCI ( Percutaneous coronary intervention ).

Route of Administration

Enoxaparin is under the skin, most often under the abdominal skin, sprayed. It is intended for subcutaneous injection, and can not be administered intramuscularly. Patients with renal insufficiency may be anticoagulated with a corresponding reduction of the dose bridging with enoxaparin.

Contraindications ( contraindications)

Enoxaparin sodium should not be used with a known or suspected hypersensitivity (allergy ), and in certain disease states, the absence of which the physician must ensure before the first administration, such as certain inflammatory heart disease and acute gastric ulcer. That Clexane is a well-tolerated and effective therapeutic agent for the prophylaxis of thromboembolism in surgical specialties, has been demonstrated in several studies.

Extraction and properties

As a low molecular weight heparin enoxaparin is produced by the chemical depolymerization of porcine intestinal heparin. The manufacturing process (extraction, fractionation) of this starting material of biological origin specifies the properties of the drug.

Enoxaparin sodium, which is a reference for new resources in this area, has a characteristic and reproducible oligosaccharide profile, which is responsible for the specific pharmacological properties: so has enoxaparin sodium, a higher and more consistent bioavailability after subcutaneous administration than unfractionated heparin, has a longer plasma half-life and is less strongly bound to plasma proteins.

Trade names

Trade names Clexane ®, Lovenox ®, among others Xaparin

CAS registry number Glycosidic bond PubChem Anatomical Therapeutic Chemical Classification System DrugBank Active ingredient Hemostasis Fraction (chemistry) European Heart Journal Digital Object Identifier Clinical Pharmacokinectics (journal)
194032
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