Clexane Injection

Clexane (Enoxaparin) can be used to:

  • Treat blood clots that are in your blood
  • Stop blood clots forming in your blood in the following situations: 1. Unstable angina (where not enough blood gets to your heart) or a type of heart attack called NSTEMI. 2. After an operation
Garvan

Pharmacist - M.B.A. (Public Health) D.I.C.

Clexane Injection

Why have I been prescribed Clexane? Clexane (…

Garvan J. Lynch
MBA (Public Health)

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Why have I been prescribed Clexane?

Clexane (Enoxaparin) can be used to:

  • Treat blood clots that are in your blood

Stop blood clots forming in your blood in the following situations:

  • Unstable angina (where not enough blood gets to your heart) or a type of heart attack called NSTEMI
  • After an operation or long periods of bed rest due to illness

Stop blood clots forming in the tubes of your dialysis machine (used for people with kidney problems).

How does it work?

Clexane works in two ways:

  • Stopping existing blood clots from getting any bigger. This helps your body to break them down and stop them causing you harm.
  • Stopping blood clots forming in your blood.

When and how do I take it?

While you are in hospital your doctor or nurse will normally give you Clexane. This is because it needs to be given as an injection.

  • When you go home you may need to continue to use Clexane and give it to yourself (see below instructions on how to do this).
  • Clexane is usually given by injection underneath the skin once a day (subcutaneous).

Instructions on injecting yourself with Clexane:

  • Wash your hands and the area that you will inject with soap and water. Dry them.
  • Sit or lie in a comfortable position so you are relaxed. Make sure you can see the place you are going to inject. A lounge chair, recliner, or bed propped up with pillows is ideal.
  • Choose an area on the right or left side of your stomach. This should be at least 5 centimetres away from your belly button and out towards your sides. Remember: Do not inject yourself within 5 centimetres of your belly button or around existing scars or bruises. Change the place where you inject between the left and right sides of your stomach, depending on the area you were last injected.
  • Carefully pull off the needle cap from the Clexane syringe. Throw away the cap. The syringe is pre-filled and ready to use. Do not press on the plunger before injecting yourself to get rid of air bubbles. This can lead to a loss of the medicine. Once you have removed the cap, do not allow the needle to touch anything. This is to make sure the needle stays clean (sterile).
  • Hold the syringe in the hand you write with (like a pencil) and with your other hand, gently pinch the cleaned area of your abdomen between your forefinger and thumb to make a fold in the skin. Make sure you hold the skin fold throughout the injection.
  • Hold the syringe so that the needle is pointing downwards (vertically at a 90º angle). Insert the full length of the needle into the skin fold.
  • Press down on the plunger with your finger. This will send the medication into the fatty tissue of the stomach. Make sure you hold the skin fold throughout the injection.
  • Remove the needle by pulling it straight out. You can now let go of the skin fold. To avoid bruising, do not rub the injection site after you have injected yourself.
  • Drop the used syringe into the sharps bin provided. Close the container lid tightly and place the container out of reach of children. When the container is full, give it to your doctor or home care nurse for disposal. Do not put it in the household rubbish.

What’s the dose?

Treating blood clots that are in your blood:

  • The usual dose is 1.5mg for every kilogram of your weight, each day
  • Clexane will usually be given for at least 5 days

Stopping blood clots forming in your blood in the following situations:

Unstable angina or NSTEMI type of heart attack:

  • The usual amount is 1mg for every kilogram of weight, every 12 hours
  • Clexane will usually be given for 2 to 8 days. Your doctor will normally ask you to take aspirin as well

After an operation or long periods of bedrest due to illness:
The usual dose is 20mg or 40mg each day. The dose will depend on how likely you are to develop a clot.

  • If you have a low to medium risk of getting a clot, you will be given 20mg of Clexane each day. If you are going to have an operation, your first injection will usually be given 2 hours before your operation.
  • If you have a higher risk of getting a clot, you will be given 40mg each day. If you are going to have an operation, your first injection will usually be given 12 hours before your operation.
  • If you are bedridden due to illness, you will normally be given 40mg of Clexane each day for 6 to 14 days.

Stop blood clots forming in the tubes of your dialysis machine:

  • The usual dose is 1 mg for every kilogram of your weight.
  • Clexane is added to the tube leaving the body (arterial line) at the start of the dialysis session.
  • This amount is usually enough for a 4 hour session. However, your doctor may give you a further dose of 0.5 to 1mg for every kilogram of your weight if necessary.

Could it interact with other tablets?

Please tell your doctor, pharmacist or nurse if you are taking or have recently taken any other medicines. This includes medicines you buy without a prescription, including herbal medicines. This is because Clexane can affect the way some other medicines work. Also some medicines can affect the way Clexane works.
In particular, do not have this medicine and tell your doctor if: You are using the medicine called heparin to treat blood clots.

Tell your doctor if you are taking any of the following medicines:

  • Warfarin - used for thinning the blood
  • Aspirin, dipyridamole, clopidogrel or other medicines used to stop blood clots forming
  • Dextran injection - used as a blood replacer
  • Ibuprofen, diclofenac, ketorolac or other medicines - used to treat pain and swelling in arthritis and other illnesses
  • Prednisolone, dexamethasone or other medicines - used to treat asthma, rheumatoid arthritis and other conditions
  • Water tablets (diuretics) such as spironolactone, triamterene or amiloride. These may increase the levels of potassium in your blood when taken with Clexane. Your doctor may change one of your medicines or take regular blood tests to check that taking these medicines with Clexane is not causing you any harm.

Operations and anaesthetics:

  • If you are going to have a spinal puncture or an operation where an epidural or spinal anaesthetic is used, tell your doctor that you are using Clexane.

What are the possible risks or side-effects?

Like all medicines, Clexane can cause side-effects, although not everybody gets them.

Tell a nurse or doctor straight away if you notice any of the following side-effects:

  • If you have an allergic reaction. The signs may include: a rash, swallowing or breathing problems, swelling of your lips, face, throat or tongue.
  • If you have had a spinal puncture or a spinal anaesthetic and notice tingling, numbness and muscular weakness, particularly in the lower part of your body. Also if you lose control over your bladder or bowel (so you cannot control when you go to the toilet).
  • Sudden severe headache. This could be a sign of bleeding in the brain.
  • Bleeding a lot from a wound.
  • A feeling of tenderness and swelling in your stomach. You may have bleeding inside your stomach.
  • A painful rash of dark red spots under the skin which do not go away when you put pressure on them. You may also notice pink patches on your skin. These are more likely to appear in the area you have been injected with Clexane.

Tell a nurse or doctor as soon as possible if you notice any of the following side-effects:

  • If you have a mechanical heart valve, treatment with Clexane might not be sufficient to prevent blood clots. You may notice that that you have difficulty breathing, tiredness or difficulty exercising, chest pain, numbness, feeling sick or loss of consciousness. This could be due to a blood clot on the heart valve.
  • You bruise more easily than usual. This could be because of a blood problem (thrombocytopenia).
  • You have pain, swelling or irritation in the area you have been injected with Clexane. This normally gets better after a few days.

Other side effects that you should discuss with your doctor if you are concerned about them:

  • Changes in the results of blood tests done to check how your liver is working. These usually go back to normal after you stop having Clexane.
  • Changes in the potassium levels in your blood. This is more likely to happen in people with kidney problems or diabetes. Your doctor will be able to check this by carrying out a blood test.

Can I drink alcohol while taking it?

  • There are no known interactions between alcohol and Clexane.
  • Always ask your pharmacist/doctor however as other tablets you are taking may have a bearing on whether you can drink alcohol or not.

What if I’m pregnant/breastfeeding?

  • Talk to your doctor before you use this medicine if you are pregnant, might become pregnant, or think you may be pregnant. You should not use this medicine if you are pregnant and have a mechanical heart valve as you may be at increased risk of developing blood clots. Your doctor should discuss this with you.
  • You should not breast-feed whilst using Clexane. If you are planning to breast-feed, talk to your doctor, pharmacist or nurse.


If you have any more questions please ask your Pharmacist.

Remember to keep all medicines out of reach of children
Please Note:
We have made every effort to ensure that the content of this information sheet is correct at time of publish, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.

References:

http://www.drugs.com/sfx/clexane-side-effects.html

https://www.hpra.ie/img/uploaded/swedocuments/2142382.PPA1328_064_001.8adfadba-a6a7-4de7-85aa-f793e93a70ed.000001pil.140430.pdf

http://www.netdoctor.co.uk/medicines/heart-and-blood/a6416/clexane-enoxaparin/

https://www.medicines.org.uk/emc/medicine/24345

https://en.wikipedia.org/wiki/Enoxaparin_sodium


 

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