4.6 Dosing 4.6.1 Therapeutic anticoagulation Dose according to actual body weight (rounded down to the nearest 10 kg) and renal function as detailed in Tables D and E (see also the Medication Dosing Calculator available via desktop icon (Maximum dose = 145mg) b. CrCl 15-30 → Heparin drip recommended. Ensure the weight is clearly documented on the front of the Inpatient Medical Chart and in the medical notes. Appropriate timing of enoxaparin dosing in relation to catheter placement or removal. 2. Dosing in patients outside of normal weight ranges: a. A lower dose of enoxaparin may be reasonable in low‐weight patients for VTE prophylaxis. Low body weight In low-weight women (< 45 kg) and low-weight men (< 57 kg), an increase in enoxaparin exposure has been observed within the prophylactic dosage ranges (non-weight adjusted), which may … There appears to be no safety concerns with reduced enoxaparin dosing in low‐weight patients. There is no need to dose cap in obesity. No significant correlations between aFXa level and body mass index or body weight were found. See Appendix 1 for dose banding. At SSM Health St. Mary’s Hospital-St. Louis (SM-SL), the policy states for treatment of VTE the dose of enoxaparin should be 1 mg/kg based on actual body weight … Body weight No dosage adjustments are recommended in obesity or low body weight. Used to reduce the risk of further blood clots that may lead to pulmonary emboli (blood clots in the lungs) in people with acute deep vein thrombosis (DVT) (a … Use a maximum dose of 145mg subcutaneously Q12h for patients who weight 145kg. These studies have found that a reduced dose may be appropriate for treatment of VTE in patients with a BMI > 40 kg/m2. 1 Prescribing 1.1 Calculate the dose according to indication and renal function using actual body weight (table 1). 1mg/kg subcutaneously Q24 may be considered with extreme caution and attending consultation. The mean weight was approximately 44 kg. Use lower dosage for low body weight patients. However individualised dosing based on Xa levels is even better, although at this time are not justified in most renal failure or obese patients. enoxaparin are based on actual body weight. The calculator does warn that some patients with eGFRs between 40 and 30 will not need the dose of enoxaparin recommended, although most will. Objective: The aim of this study is to evaluate the impact of enoxaparin dosing on major and minor bleeding events in low body weight patients. patients. Upsides. Conclusion. b. The patient must be weighed. **Extremes of actual body weight and VTE prophylaxis: <50kg – use 20mg enoxaparin once daily 100-150kg – use 80mg enoxaparin once daily >150kg – use 120mg enoxaparin once daily ǂActual body weight should be used for dose calculation. Enoxaparin belongs to the class of medicines known as low molecular weight heparins (LMWH). The maximum dose of enoxaparin should be 150 mg SC Q 12 h. For a patient receiving a dose of enoxaparin of 130 mg to 150 mg (i.e., patient weight 130 kg to 150 kg or greater), the low molecular weight heparin assay may be a useful monitoring tool. 4. Methods: This was a retrospective cohort study of patients weighing less than 45 kg receiving subcutaneous (SC) enoxaparin for VTE prevention. * Dose adjustment may be needed depending on when last dose of prophylactic LMWH was administered. Booking Weight Enoxaparin Dose Booking Weight Enoxaparin dose <50kg 50–90kg 91–130kg 131–170kg >170kg 20mg OD 40mg OD 60mg daily* 80mg daily* 0.6 mg/kg/day* *may be given in two divided doses 1mg/kg TWICE DAILY antenatal (1mg/kg TWICE DAILY or 1.5mg/kg ONCE DAILY postnatal) WEIGHT DOSE <50kg 50–69kg 70–89kg 90–109kg 110–125kg
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