Enoxaparin precautionary changes

Enoxaparin precautionary changes

Prescribing information for the injectable anticoagulant enoxaparin (Lovenox) has recently changed in its use in those who are obese, underweight, elderly, or renally impaired.

Obese individuals may have delayed clearance of the medications and require closer monitoring and dosage adjustment. Patients who are underweight need close observation for the signs and symptoms of bleeding. To detect overt or occult blood loss, nurses should watch for abnormal physical assessment findings, such as increased pulse, decreased blood pressure, and hematuria, and monitor laboratory tests (hematocrit and hemoglobin, urinalysis, stool for occult blood) in acute care and post–acute care settings. Likewise, home health nurses or other caregivers must monitor and educate patients who are discharged on the drug.

Patients who have renal impairment, identified as a creatinine clearance <30>

Continued caution and close monitoring are especially important for elderly patients taking enoxaparin. The risk for medication-associated bleeding has been shown to increase with age and polypharmacy.

Obtain a detailed medication history for all medications, including prescription, over-the-counter, and herbal or natural health preparations. Pay special attention to substances with anticoagulant and antiplatelet properties, such as aspirin-containing products and herbal supplements like ginkgo biloba, garlic supplements, black cohosh, and red clover. For an extensive list of herbal supplements, visit: www.drugs.com/PDR/Coumadin_Tablets.html.

For additional information: visit www.LOVENOX.com and www.fda.gov/medwatch/SAFETY/2004/Lovenox_PI.pdf.

Reference

Lovenox. Available at: www.fda.gov/medwatch/SAFETY/2004/Lovenox_HCP.pdf. Accessed October 4, 2004.

Caution

Review current drug information before administering and monitoring medications.

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Drug News is compiled by Susanne J. Pavlovich-Danis, RN, MSN, ARNP-C, CDE, who maintains a private practice in Plantation, FL, and is professor and area chair for nursing at the University of Phoenix, Fort Lauderdale.