Enoxaparin for Prophylaxis

FDA labeled uses of enoxaparin contain 2 different dosing recommendations:

Benefits of Enoxaparin 40mg SC QD over the 30mg SC Q12h regimen:

To the Hospital –

Once daily dosing suggests cost savings from both the drug and administration time.

FY00 Expenditures for enoxaparin 30mg and 40mg syringes were approximately $95,000.  Savings from the conversion of two-thirds of the 30mg SC q12hr prophylactic dosing to 40mg SC Q day is estimated to be approximately $17,000 for the next fiscal year.  This does not include unit/nursing savings as a result of reducing the frequency of administration.

To the Patient –

Reduced number of injections as a result of once daily dosing.

Dosing Conversion

1)     Dosing of Enoxaparin 30mg SC Q12h will be automatically converted by the clinical pharmacist to Enoxaparin 40mg SC QD for the following indications:    

a)     Patients undergoing hip-replacement surgery

b)     Extended prophylaxis in hip replacement

c)     Patients undergoing abdominal surgery at risk for thromboembolic complications.

2)      Dosing post knee surgery will not be automatically converted from Enoxaparin 30mg SC Q12h.

3)     An order will be written “Per Medical Staff Executive Committee” on the patient’s chart to indicate this change in dosing, and then signed by the pharmacist.

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