【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，用於治療75歲以上老年人VTE、Af、或腎功能不佳 (CrCl<50mL/min) 時須謹慎使用。 ★必確認腎功能：當 Clcr <30mL/min 時頻次應減半 (-> 1 mg/kg SQ QD) #高警訊藥品

抗凝血注射 Anticoagulation
Acute coronary syndromes: Unstable angina, non-ST-elevation myocardial infarction, and ST-elevation myocardial infarction
Venous thromboembolism: Treatment and prophylaxis of pulmonary embolism(PE)

Anticoagulant (Low Molecular Weight Heparin)
Enhance the inhibition rate of clotting proteases by antithrombin III impairing normal hemostasis and inhibition of factor Xa.

Absorption
1. Bioavailability: ~100%
2. Onset of action: 3 to 5 hours
Distribution
1. Vd: 4.3 L (based on anti-factor Xa activity)
2. Protein binding: Does not bind to heparin binding proteins
Metabolism
1. Hepatic, via desulfation and depolymerization
2. Half-life elimination: 2 to 4 times longer than standard heparin
Excretion
1. via Urine: 40% of dose as active and inactive fragments; 10% as active fragments
2. Clearance: Decreased by 30% in patients with CrCl <30 mL/minute

1. Active major bleeding
2. Hypersensitivity to heparin or pork products 3. Thrombocytopenia associated with positive antiplatelet antibody test in vitro induced by enoxaparin

B

Infant can not be ruled out.

Hemorrhagic complications (most frequent, carefully monitor), anemia

Acute coronary syndromes: SubQ
1. <75 y/o: Single IV bolus of 30 mg plus 1 mg/kg every 12 hours
2. ≥75 y/o: 0.75 mg/kg (MAX: 75 mg for the first 2 doses only) every 12 hours
Venous thromboembolism: SubQ
1. DVT and/or PE: 1 mg/kg every 12 hours or 1.5 mg/kg once every 24 hours
2. Venous thromboembolism treatment in patients with active cancer: 1 mg/kg every 12 hours or1.5 mg/kg once daily for a total duration of 3 to 6 months

1. CrCl ≥30 mL/minute: No dose adjustment necessary.
2. CrCl <30 mL/minute: (Treatment)1 mg/kg once daily; (Prophylaxis)30 mg once daily

Unknown (manufacturer's labeling)