the package insert of the medicine Clexane. Therapeutic class of Anticoagulants. Active principles Enoxaparin.
Prophylaxis of DVT and recurrence; prophylaxis of pulmonary thromboembolism and prevention of clotting in the cpb circuit was during hemodialysis.
Use injectable – adult Use
When should I not use?
Hypersensitivity to enoxaparin or to any component of the product; bacterial endocarditis acute with or without a prosthesis; severe changes of hemostasis; lesions organic susceptible of bleeding; thrombocytopenia in patients who present test of aggregation positive in vitro in the presence of enoxaparin; ulcer gastro-duodenal active; cerebral vascular accident (recent), except if there is, embolization and systemic; and association with antiplatelet drugs (ticlopidine, salicylates, dipyridamole), and nonsteroidal anti-asteroids.
How to use?
For the prophylaxis of DVT/PE: Use for 7 to l0 days.
Under moderate risk: 20 mg (0.2 ml) – dose subcutaneous single daily, beginning 2 hours before surgery.
Under high risk: 40 mg (0.4 ml) in a dose of subcutaneous single daily, beginning 12 hours before surgery.
In the surgical cases, in case the anesthesia for the surgical act is by blocking the spinal, Clexane should be started 1 hour after the puncture to lock the anesthetic has been performed.
The use of the catheter for blocking the continuous counter-indicates the start of prophylaxis until their withdrawal.
Haemodialysis: 1 mg/kg (in access arterial), and, if there is a need, more 0.5 to 1 mg/kg; if there is bleeding risk, use 0.75 mg/kg (vascular access double) or 0.75 mg/kg (vascular access simple).
What are the evils that can cause me?
haemorrhagic Manifestations, thrombocytopenia, ecchymosis at the site of the injections, allergic manifestations and elevation of transaminases.
can Rarely occur hematoma intra-spinal after puncture diagnostic/anesthesia, fever, nausea, anemia hipocrômica, oedema.
Warnings and Precautions
what should I know before using?
do Not mix Clexane with other infusions; one should not administer by intramuscular injection; it is not should administer on haemorrhagic diathesis.
Clexane in pregnancy, during the first quarter, it should not be administered, nor in the breastfeeding mother.
it is Recommended caution in hepatic insufficiency, arterial hypertension uncontrolled and a history of ulcer pastroduodenal.
In the elderly and in renal insufficiency, the elimination of enoxaparin is delayed.
During the use of enoxaparin is required to platelet count at least once a week; in the case of plaquetopenia, suspend the use of the medicine.
you Must have caution in the use that precedes anesthesia via spinal.
Deseconselha-if the concomitant use with: acetylsalicylic acid, nonsteroidal anti-asteroids, tidopidina and heparin; one must exercise caution during concomitant use with: oral anticoagulants, glucocorticoids and Dextran 40.
what to do if someone use a larger amount than is recommended?
If there are no haemorrhagic manifestations, activity, anti-lla of enoxaparin may be neutralised by the administration slow intravenous of protamine (sulfate or hydrochloride).
The dose of protamine should equal the dose of enoxaparin.
The neutralization of the activated anti-Xa is a maximum of 60%, allowing the persistence of the activity risk factors.