Low molecular weight heparin Eniksum: indications, instructions, testimonials

Eniksum belongs to the group of direct anticoagulants, the main active ingredient of which is sodium enoxaparin, which in its chemical composition is a low molecular weight heparin.

The drug is enoxaparin sodium in a dose of 20 mg to 100 mg.

Produced in syringes of 0.2 ml, 0.3 ml, 0.4 ml, 0.6 ml 0.8 ml, 1.0 ml. Packed in 2 syringes in the outline package and 5 such cell packs in a cardboard box.

Pharmacological profile

General pharmacological properties of the drug:

• high activity to factor Xa;
• low activity to factor IIa of blood coagulation.

The properties of decreasing blood coagulation are manifested with antithrombin III.In addition to the ability to prevent thrombosis, the drug also exhibits anti-inflammatory properties. These qualities were determined in animal and human studies. It manifests itself in the suppression of such a factor of blood coagulation, as VIIa.

When prescribing for prophylactic purposes, it can be observed:

• active component of the drug makes changes in APTT;
• does not affect thrombogenesis;
• does not affect the amount of binding of fibrinogen to platelet receptors.

Structural formula of sodium enoxaparin

The pharmacokinetic characteristics of the drug appear in a linear relationship. With a single subcutaneous administration of the drug at a dose of 1 milligram per kilogram of patient weight, the maximum concentration in the blood is 0.49 IU / ml.

When assessing the concentration of the drug after the administration of subcutaneously, the results were obtained about 100% of its bioavailability.

The process of drug metabolism occurs in the liver. At the same time, in the process of desulphation or depolymerization, substances with a low molecular weight structure that have low biological activity are formed.

The excretion of active fragments occurs by the kidneys and amounts to no more than 10%, and the total number of all fragments does not exceed 40% of the entire administered dose of the drug.

Indications and contraindications for the use of

Eniksum is used in such cases:

• during surgical operations to prevent the development of blood clots and emboli in the veins;
• in the treatment of deep vein thrombosis, in which there is the possibility of developing pulmonary embolism;
• therapy in conjunction with Aspirin myocardial infarction and unstable angina;
• if necessary percutaneous coronary intervention.

The main contraindications to the prescription of this medication are:

• allergic reactions to the main components of the drug;
• profuse bleeding of various etiologies;
• presence of artificial valves in the heart of pregnant women;
• children under 18 years.

There are conditions in which there is a high likelihood of bleeding, therefore the use of Enixum in these cases should be done with extreme caution:

• the patient has hemostasis and severe vasculitis;
• presence in the anamnesis of erosive-ulcerative lesions in the digestive tract;
• ischemic stroke, which occurred recently;
• diabetes mellitus in severe form;
• surgical intervention of a neurological or ophthalmological nature;
• anesthesia: spinal, epidural;
• need for spinal puncture;
• bacterial endocarditis in acute or subacute form;
• presence of an intrauterine device;
• polytrauma or large open wounds;
• combined administration of drugs that have properties to influence hemostasis.

To date, there is no necessary data on the use of the drug for the treatment of patients with tuberculosis and in the conduct of radiation therapy.

Application features for different conditions of

Eniksum should be administered subcutaneously. Intramuscular use of the drug is prohibited. The injection is done lying alternately in the left and right side of the abdomen. The syringe with the medicine is ready for use, it is enough just to remove the protection from the needle.

Based on the fact that the drug is used to stop various diseases, then for each situation there is a scheme of therapy, dosages and duration of treatment:

1. Prevention of the formation of thrombi and emboli during operations .With a moderate risk of thrombotic conditions, 20 mg of the drug are used two hours before the surgery, and with a high risk of 40 mg once every 24 hours. The duration of therapy is from 7 to 10 days.
2. Deep venous thrombosis .The course of treatment with the drug is 1.5 mg / kg once every 24 hours for 10 days.
3. Prevention of thrombus formation in patients who are not moving should be injected at a dose of 40 mg once every 24 hours. The duration of therapy is 7-14 days.
4. With myocardial infarction with ascent, the segment of the ST .It is necessary to introduce the patient initially 30 mg and after 15 minutes 1 mg / kg of patient's body weight.
5. When performing percutaneous coronary intervention .To perform this procedure, you need to enter the dose of the drug once for 8 hours before the beginning of manipulation.
6. To prevent the formation of thrombi in the extracorporeal circulatory system during hemodialysis .The required dose of the drug is calculated 1 mg / kg of the patient's weight and administered once.

A video clip on how to stab Kleksan, injections of Eniksum are put similarly:

Cases of overdose and side effects of

With the administration of subcutaneous high doses of the drug, there is the possibility of developing hemorrhagic complications. With oral administration of this drug, absorption of the drug almost does not occur and the possibility of an overdose is unlikely.

Antidote: Protamine sulfate. With the help of this drug, the previously introduced Eniksum is neutralized. Before you enter the antidote you need to make sure the correct ratio of risk and benefit due to the possible development of anaphylactic shock.

Protamine sulfate is able to inactivate Eniksum in a 1: 1 ratio, provided that sodium enoxaparin was administered no longer than 8 hours ago.

For repeated administration, the dose is calculated as 0.5 mg of the antidote per 1 mg of the injected drug.

If enoxaparin sodium was administered 12 hours earlier than a decision was made to administer an antidote, the administration of protamine sulfate is no longer appropriate.

During the use of this drug, the following complications may develop:

• bleeding of different etiologies;
• is a neuroxic hematoma that can cause neurologic disorders;
• possible development of thrombocytosis and thrombocytopenia;
• allergic reactions to the main components of the drug;
• at the injection site can form solid inflammatory nodules-infiltrates, they disappear after a couple of days, without having to cancel the use of the drug;
• increases the activity of hepatic transaminases;
• increase in the concentration of potassium in the blood;
• with prolonged therapy there is an increased risk of osteoporosis.

Special patients and conditions

To date, there is insufficient evidence of the possibility of developing teratogenic or fetotoxic properties of the drug during its use in pregnancy, for this reason, the appointment of Enixum in this period is not recommended. Exception are cases where the benefits for women are much higher than the risk for the future of the child.

This medication is not used during pregnancy in women who have prosthetic heart valves. If the doctor decided to prescribe enoxaparin sodium during lactation, then breastfeeding should be temporarily stopped.

Due to the lack of research on the safety of the drug in childhood, its use for children under 18 years is prohibited.

If the patient has no abnormalities in the functioning of the kidneys, then the elderly patients do not need to reduce the dose of the drug.

If you have a history of severe dysfunction in the kidneys, you need to reduce the dose of the drug and conduct a study of the clearance of creatinine.

When appointing Eniksum, patients with liver diseases should be cautious because of the lack of data on the effect of the drug on a person during this period.

Precautions should be observed when using the drug to treat patients who have the following medical history:

• chronic heart failure;
• cirrhosis;
• hypovolaemia.

During drug treatment it is necessary to refrain from driving a car or working with other mechanisms, because during clinical studies it was revealed that enaproxen sodium provokes headache, dizziness, drowsiness.

Interaction with other drugs

When using Eniksum, it is worth paying attention to the following possible drug interactions:

• is not allowed to inject the drug in one syringe with other drugs;
• it is not recommended to administer the drug and other heparins of a low molecular weight structure in turn, this is due to their different pharmacokinetic properties and biological activity;
• when combined with salicylates, non-steroidal anti-inflammatory drugs, Ticlopidine, thrombolytics increases the possibility of bleeding.

Actual view of

It will be useful to study the opinions of doctors and patients who have received or are taking Enixum at the moment.

Conditions for the purchase and storage of

The preparation does not require special storage conditions, it is sufficient not to exceed the temperature of 25 degrees Celsius and not to freeze syringes with the drug.

Shelf life 2 years from the date of manufacture. After the end of this time, use the drug is prohibited. Leave from pharmacies occurs only upon presentation of a prescription from a doctor.

The price of the drug depends on the amount of the main active substance, and is at the level of 1500-3200 rubles per package, and the following analogues of Eniksum can be purchased at the pharmacy:

• Anfiber;
• Clexan;
• Hemapaksan.