Enoxaparin Dosing at Extremes of Weight: Literature Review and Dosing Recommendations

Ann Pharmacother. 2018 Sep;52(9):898-909. doi: 10.1177/1060028018768449. Epub 2018 Mar 28.

Abstract

Objective: To review the literature on both thromboprophylaxis and treatment of venous thromboembolism (VTE) with enoxaparin in low- and high-body-weight patients and to make dosing and monitoring recommendations in these patient populations.

Data sources: A search using PubMed was conducted (1995 to January 2018) using the following key words: enoxaparin, body weight, AND thromboprophylaxis, or AND treatment. Additional references were identified from a review of citations.

Study selection and data extraction: Studies included examined the effect of body weight and/or body mass index (BMI) on VTE, bleeding, enoxaparin dosing, and/or anti-Xa concentrations for thromboprophylaxis and treatment-dose enoxaparin. Studies in pediatric and pregnant patients were excluded.

Data synthesis: Optimal enoxaparin dosing strategies for VTE prophylaxis and treatment for patients at extremes of weight have not yet been elucidated by clinical trials; however, data suggest that standard dosing regimens may not be appropriate in these patients. Relevance to Patient Care and Clinical Practice: This review provides a thorough discussion on both thromboprophylaxis and treatment of VTE with enoxaparin in low- and high-body-weight patients. It includes dosing recommendations to guide clinicians caring for these patient populations.

Conclusions: Patients at extremes of weight require special consideration to determine appropriate enoxaparin doses. Specifically, low-body-weight patients may benefit from 30 mg subcutaneously daily for VTE prophylaxis, and standard weight-based dosing for VTE treatment. Conversely, in patients with BMIs ≥40 kg/m2, 40 mg subcutaneously twice daily is recommended, with consideration for higher doses in patients with BMIs ≥50 kg/m2.

Keywords: dosing; drug monitoring; internal medicine; low-molecular-weight heparins; obesity; prophylaxis.

Publication types

  • Review

MeSH terms

  • Anticoagulants / administration & dosage*
  • Body Weight
  • Enoxaparin / administration & dosage*
  • Fibrinolytic Agents / administration & dosage*
  • Humans
  • Venous Thromboembolism / drug therapy*
  • Venous Thromboembolism / prevention & control

Substances

  • Anticoagulants
  • Enoxaparin
  • Fibrinolytic Agents