Enoxaparin (LMWH)

Pregnancy & gynaecology-specific. Every dose row is source-referenced; verify against institutional protocols.

Enoxaparin (LMWH)EMERGENCY KITLow molecular weight heparin

Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.

Enoxaparin (LMWH): indication-specific regimens
Indication	Dose	Route	Frequency	Duration / preparation	Maximum	Monitoring / cautions
Confirmed or strongly suspected acute VTE in pregnancy unless anticoagulation is contraindicated RCOGchecked	1 mg/kg using booking/early-pregnancy weight	Subcutaneous	Every 12 hours	For the remainder of pregnancy and at least 6 weeks postpartum; at least 3 months total anticoagulation · Use a graduated prefilled syringe of the correct mg strength; inject SC, not IM. Do not interchange mg, mL and anti-Xa units Renal / hepatic: CrCl <30 mL/min: specialist regimen; consider IV unfractionated heparin when rapid reversal is needed	Weight-based therapeutic dose; renal dysfunction changes the regimen, not an arbitrary fixed maximum	Monitor Baseline CBC/platelets, renal/liver function and bleeding risk; clinical response Routine anti-Xa monitoring is not needed for most women; consider extremes of weight, renal impairment or recurrent VTE Stop therapeutic LMWH at least 24 h before planned neuraxial procedures; anaesthetic staff must prescribe postpartum restart using puncture time, catheter removal and haemostasis Contraindications / cautions Active major bleeding, heparin-induced thrombocytopenia or imminent urgent surgery without an anticoagulation plan
Risk-assessed obstetric thromboprophylaxis; standard-weight example, NOT VTE treatment RCOGchecked	40 mg for a woman weighing 50–90 kg; other weight bands require the RCOG weight table	Subcutaneous	Once daily	According to the documented risk assessment: commonly 10 days after birth or 6 weeks for high risk; antenatal use when indicated · 40 mg/0.4 mL prefilled product: use the prescribed syringe SC. Confirm its actual concentration; do not give IM Renal / hepatic: Reduced renal function requires a different dose/agent; do not reuse a standard prophylactic syringe without review	40 mg/day applies ONLY to this standard-weight prophylactic row; renal impairment and weight extremes require adjustment	Monitor Reassess VTE and bleeding risk after birth, surgery, admission or clinical change At least 12 h between prophylactic LMWH and neuraxial placement; postpartum restart needs an anaesthetic plan, adequate haemostasis and consideration of time since puncture/catheter removal Contraindications / cautions Active bleeding, HIT or neuraxial timing contraindication

Pregnancy safety

Preferred anticoagulant in pregnancy

Lactation

Compatible

RCOGcheckedIN REVIEW