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Lovenox and Heparin

LisaMarie Di Pasquale, Elie M Ferneini
For the oral and maxillofacial surgeon, many patients will be on heparin products during surgery. So far, there is no standardized approach to treating anticoagulated patients during oral and maxillofacial surgical procedures. When a patient is on heparin therapy, heparin may be stopped 4 to 6 hours before surgery and resumed once hemostasis is achieved, usually within 24 hours. If low-molecular-weight heparin is administered, the treatment is generally stopped at least 12 hours before surgery and then resumed in a similar fashion...
November 2016: Oral and Maxillofacial Surgery Clinics of North America
Melissa A Herschman, Frank S Rigelsky, Sandra S Axtell
PURPOSE: A pilot study was conducted to determine whether rivaroxaban (Xarelto, Janssen Pharmaceuticals) resulted in a lower 30-day all-cause readmission rate compared with enoxaparin (Lovenox, Sanofi-Aventis) after total hip arthroplasty (THA) or total knee arthroplasty (TKA) at a community hospital. METHODS: The study was a single-center, retrospective, chart-review investigation involving patients who underwent THA or TKA between May 2013 and May 2014. The study's primary endpoint was the 30-day all-cause readmission rate...
June 2016: P & T: a Peer-reviewed Journal for Formulary Management
Abdelfatah Abou Issa, Richard Simman
Lovenox is a trade name for Enoxaparin. It is a low molecular weight heparin (LMWH) and has other trade names like Clexane and Xaparin. It is an anticoagulant used to prevent and treat venous thromboembolism events (VTE) like deep vein thrombosis or pulmonary embolism, and is given as a subcutaneous injection. General speaking, the most common skin reactions as a result of enoxaparin use are: urticarial, ecchymosis, and even skin necrosis due to vasculitis. These side effects are usually located at the injection site...
December 2013: Journal of the American College of Clinical Wound Specialists
Marco Guerrini, Timothy R Rudd, Lucio Mauri, Eleonora Macchi, Jawed Fareed, Edwin A Yates, Annamaria Naggi, Giangiacomo Torri
The U.S. Food and Drug Administration defines criteria for the equivalence of Enoxaparin with Lovenox, comprising the equivalence of physiochemical properties, heparin source material and mode of depolymerization, disaccharide building blocks, fragment mapping and sequence of oligosaccharide species, biological and biochemical assays, and in vivo pharmacodynamic profile. Chemometric analysis of the NMR spectra, utilizing both (1)H and (1)H-(13)C HSQC NMR experiments, of Lovenox and Enoxaparin, the latter being the generic version of the former, revealed that Lovenox and the four Enoxaparin compounds produced by Sandoz (Enoxaparin and Fibrinox), Winthrop, and Amphastar exhibit dissimilarities in terms of their composition...
August 18, 2015: Analytical Chemistry
Grigoris T Gerotziafas, Aurèlie Rouseau, Elisabeth Mbemba, Amir Khartechi, Patrick Van Dreden, Janine Walenga, Jawed Fareed, Ismail Elalamy
BACKGROUND: The patent protection of low-molecular-weight heparins (LMWHs) expired, so the definition of criteria for the biological similarity between LMWH copies and the original product is a real need. AIM: The present in vitro study compared copies and branded enoxaparin using the specific anti-Xa activity and the calibrated automated thrombogram assay. METHODS: Samples of platelet-poor plasma (PPP) and platelet-rich plasma (PRP) from 15 healthy volunteers were spiked with branded enoxaparin (Lovenox) or its copies (Cutenox, Dilutol, Enoxa, Fibrinox, Loparin, Lupenox, Novex, Noxprin, and Versa)...
November 2015: Clinical and Applied Thrombosis/hemostasis
Vineet Gupta, Naveen Dhawan, Jaya Bahl
A 17-year-old Caucasian male presented with sudden dizziness, ataxia, vertigo, and clumsiness lasting for a couple of hours. He had a subtle trauma during a wrestling match 2 days prior to the presentation. A CT Angiogram (CTA) and MRI showed left vertebral artery dissection (VAD). The patient was treated with anticoagulation with heparin drip in the ICU. The patient was discharged home on the third day on Lovenox-warfarin bridging. This case underscores the importance of considering VAD as a differential diagnosis in patients with sports-related symptoms especially in activities entailing hyperextension or hyperrotation of neck...
2015: Case Reports in Neurological Medicine
Jad Bou Monsef, Friedrich Boettner
BACKGROUND: The steady rise in demand for total hip arthroplasty constitutes a significant and increasing burden on health care resources. The biggest contributors to the total cost of hip replacement procedures other than the price of the implant are hospital stay and postoperative rehabilitation. Blood management is one of the most adjustable factors that can impact length of stay and cost-efficiency while improving patient safety. QUESTIONS/PURPOSES: The primary purpose of this retrospective study was to assess the potential impact of blood management interventions on length of hospital stay after primary unilateral total hip arthroplasty...
July 2014: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Ali Farooqui, Bradley Hiser, Stephen L Barnes, N Scott Litofsky
OBJECT: Patients with traumatic brain injury (TBI) are at risk for development of thromboembolic disease. The use of chemoprophylaxis in this patient group has not fully been characterized. The authors hypothesize that early chemoprophylaxis in patients with TBI is safe and efficacious. METHODS: In May 2009, a protocol was instituted for patients with TBI where chemoprophylaxis for thromboembolic disease (either 30 mg of Lovenox twice daily or 5000 U of heparin 3 times a day) was initiated 24 hours after an intracranial hemorrhage (ICH) was demonstrated as stable on head CT image...
December 2013: Journal of Neurosurgery
Lisa Black
BACKGROUND: Subcutaneous injection into an elevated skin fold poses a risk of "bilateral exposure" injury whereby the needle pierces the opposite side of a skin fold and subsequently enters the tissue of the health care worker (HCW). METHODS: Retrospective review was conducted examining the Exposure Prevention Information Network (EPINet) needlestick surveillance data. Data from 2,402 injuries occurring during subcutaneous injection were included for analysis. Descriptive data, statistical comparisons, and a logistic regression model reporting relative risk are provided...
September 2013: American Journal of Infection Control
Michael Byrne, Marc Zumberg
The reversal of low-molecular-weight heparins, particularly at supratherapeutic levels, remains challenging. The paucity of literature available to guide the treatment of these patients makes their management difficult for primary care providers, surgeons, and subspecialists alike. We report the case of a 34-year-old woman, who intentionally overdosed on enoxaparin (Lovenox) in a suicide attempt. Her initial antifactor Xa activity level was 8.3 IU/ml, the highest level reported in the literature to date. She was initially managed conservatively, however, within 24 h of admission she developed evidence of acute blood loss...
December 2012: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Jeanine M Walenga, Walter P Jeske, Debra Hoppensteadt, Josephine Cunanan, Hussein Khan, Vicki Escalante, Jawed Fareed, Mamdouh Bakhos
Enoxaparin, a complex, biologically derived low-molecular-weight heparin, is approved for a range of clinical indications. This study was carried out to compare the potency profile and pharmacodynamic responses of branded enoxaparin (Lovenox; Sanofi, US) with a generic enoxaparin (enoxaparin sodium injection, USP). Five batches of each product were tested. Although the average molecular weight, anti-factor Xa, and anti-factor IIa potencies were similar for the two products, differences were observed in the in vitro thrombin generation and kinetics of clot formation (P = ...
June 2013: Clinical and Applied Thrombosis/hemostasis
Howard I Pryor, Adam Singleton, Elissa Lin, Paul Lin, Khashayar Vaziri
BACKGROUND: In the morbidly obese population that undergoes bariatric surgery, venous thromboembolism (VTE) is the leading cause of morbidity and mortality. Certain factors place a patient at higher risk for VTE. No consensus exists on VTE screening or prophylaxis for the high-risk patient. This report describes the results of a survey on VTE screening and prophylaxis patterns in high-risk bariatric surgery. METHODS: Members of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) were queried on factors that identified bariatric patients as high risk for VTE and on routine screening and prophylaxis practices...
March 2013: Surgical Endoscopy
C Loira-Pastoriza, A Sapin-Minet, R Diab, J L Grossiord, P Maincent
A commercial suspension of nanoparticles (Eudragit RS 30D) was used to manufacture a gel for topical application. Gels were prepared by mixing a polycationic polymer (Eudragit(®) RS 30D) and a low molecular weight heparin (LMWH), an antithrombotic agent. Gels formed spontaneously at a ratio of 1:1 as a result of electrostatic interactions between the polyanionic drug and the polycationic polymer. Different types of heparin were used: Bemiparin, Enoxaparin (Lovenox), Nadroparin (Fraxiparin) and Tinzaparin (Innohep)...
April 15, 2012: International Journal of Pharmaceutics
Walter Jeske, Evangelos Litinas, Hussein Khan, Debra Hoppensteadt, Jawed Fareed
Pharmacodynamic behavior of branded and biosimilar enoxaparin was compared in a crossover study in primates. Blood samples collected at baseline and at 1, 4, 6, and 28 hours post-subcutaneous administration of Lovenox or Fibrinox were evaluated using clot-based and amidolytic assays. Anti-Xa levels following Fibrinox and Lovenox administration were not different. Anti-IIa levels were significantly higher in Lovenox-treated animals 1 to 6 hours post-administration. Higher drug levels were measured by Heptest in Fibrinox-treated animals from 4 to 6 hours...
June 2012: Clinical and Applied Thrombosis/hemostasis
Marise Gomes, Eduardo Ramacciotti, Alexandre Cruz Henriques, Gilson Roberto Araujo, Luiz Arnaldo Szultan, Fausto Miranda, Indermohan Thethi
INTRODUCTION: Several generic low-molecular-weight heparins (LMWHs) have recently become available worldwide, including the United States. Companies have filed for regulatory approval of generic versions in many countries, based only on compound biochemical characteristics or its immunogenicity. METHODS: Prospective study to evaluate the comparative effect of 2 enoxaparins (Sanofi-Aventis branded enoxaparin [SAe] vs eurofarma-enoxaparin [Ee], a generic version) as prophylaxis for venous thromboembolism (VTE) following major abdominal surgery...
November 2011: Clinical and Applied Thrombosis/hemostasis
Randall N Willard, Antonio E Muñiz, Francis Chuidian
Enoxaparin (Lovenox) is a low–molecular weight heparin used to prevent deep venous thrombosis in patients undergoing total hip or knee arthroplasty. Anticoagulation in a patient after trauma may be dangerous and lead to significant hemorrhage. An elderly man fell and sustained a concussion and a hip fracture. His initial computed tomographic scan of the head was normal. He received enoxaparin perioperatively and developed a delayed extensive subdural hematoma. Although enoxaparin has been shown to be an effective and a safe drug for venous thromboembolism prophylaxis in orthopedic surgeries and trauma, severe bleeding may rarely occur, especially in the setting of head trauma...
July 2012: American Journal of Emergency Medicine
Kuldeep Singh, Erica R Podolsky, Scott Um, Salim Saba, Irfan Saeed, Lakshmi Aggarwal, Melody Zaya, Andres Castellanos
BACKGROUND: One of the most concerning and potentially fatal complications of gastric bypass surgery is pulmonary embolism (PE) with published rates exceeding 1%. Although this procedure has been proven effective in reducing the morbidity and mortality of obesity and associated health care costs, it is elective and risk must be minimized. No dosing guidelines exist for pharmacologic prophylaxis in obese patients who are already at increased risk for these events. Although the current ASMBS and Chest guidelines recommend preoperative pharmacologic prophylaxis against thromboembolic events, no standard dosing protocols exist for the obese population...
January 2012: Obesity Surgery
Frederick A Ofosu
The Food and Drug Administration (FDA) approved on July 23, 2010, the abbreviated new drug application (ANDA) by Sandoz Inc for a generic enoxaparin (Lovenox) as the FDA is satisfied with the active ingredient ''sameness'' and the interchangeability of Lovenox with this generic version. Regulatory authorities that consider low-molecular-weight heparins (LMWHs) as drugs approve generic LMWHs via an ANDA pathway, whereas EMEA views them as biological medicines and will therefore regulate copies of LMWHs via a biosimilar pathway because only similar copies can be manufactured...
February 2011: Clinical and Applied Thrombosis/hemostasis
F Loisel, J Pauchot, N Gasse, T Meresse, S Rochet, Y Tropet, L Obert
Antithrombotic agents are not routinely used in microsurgery for finger replantation. A prospective monocentric study of 13 cases of replantation at hand level is reported with local irrigation of anastomosis with urokinase and low-molecular-weight heparin. Thirteen consecutive patients have been included and treated in the first six hours by three senior surgeons in microsurgery. The injuries consisted in one devascularisation of hand, two complete amputations of hand, four ring fingers and six complete amputations of finger...
October 2010: Chirurgie de la Main
Vikram Sood, Cathy Luke, Erin Miller, Mayo Mitsuya, Gilbert R Upchurch, Thomas W Wakefield, Dan D Myers, Peter K Henke
BACKGROUND: Venous thrombus resolution sets up an early intense inflammatory reaction, from which vein wall damage results. Tissue response to injury includes matrix metalloproteinase (MMP) activation and extracellular matrix protein turnover. This study sought to determine the effect of exogenous MMP inhibition and its potential attenuation of early vein wall injury. METHODS: Rats received treatment beginning 24 hr after a stasis venous thrombosis by near occlusive ligation and until harvest at day 7...
February 2010: Annals of Vascular Surgery
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