A Morbidly Obese Man is Diagnosed with PE. Can I use Lovenox? EBM Q&A

Question:

A 25 yo morbidly obese man is admitted with PE. His weight is 516 lbs. He is on heparin IV but he hates the IV infusion. You are planning to switch him to Lovenox and start Coumadin. Is this OK?


Answer:

No. Lovenox (enoxaparin) was not studied in patients with weight more than 150 kg or less than 45 kg. This is the reason why the maximal recommended dose of enoxaparin is 150 mg sc q 12 hr. Patients who weigh more than 150 kg should be treated with IV heparin until fully anticoagulated with warfarin.

References:
Enoxaparin Clinical Pearl - CCF MedEd
Anticoagulation in special patient populations: Are special dosing considerations required? - CCJM
Arixtra is the New Contender for the LMWH Throne
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