Claxo
Generic Name
Enoxaparin Sodium
Manufacturer
Claxo Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| claxo 4000 anti xa injection | ৳ 450.00 | N/A |
Description
Overview of the medicine
Claxo-4000-anti-Xa-injection contains Enoxaparin Sodium, a low molecular weight heparin used to prevent and treat blood clots (deep vein thrombosis and pulmonary embolism) and in certain cardiac conditions.
Uses & Indications
Dosage
Adults
DVT Prophylaxis: 40 mg (4000 anti-Xa IU) subcutaneously once daily. DVT/PE Treatment: 1 mg/kg (100 anti-Xa IU/kg) subcutaneously every 12 hours or 1.5 mg/kg (150 anti-Xa IU/kg) once daily.
Elderly
No dosage adjustment needed for elderly with normal renal function. Monitor renal function in all elderly patients.
Renal_impairment
Severe renal impairment (CrCl <30 mL/min): DVT prophylaxis 20 mg (2000 anti-Xa IU) once daily. DVT/PE treatment 1 mg/kg (100 anti-Xa IU/kg) once daily.
How to Take
Administer by deep subcutaneous injection, alternating injection sites (e.g., anterolateral or posterolateral abdominal wall, or thigh). Do not inject intramuscularly. Do not expel the air bubble from the syringe before injection unless specifically instructed by your doctor.
Mechanism of Action
Enoxaparin acts as an anticoagulant by binding to antithrombin III, which potentiates its inhibition of Factor Xa (primarily) and Factor IIa (thrombin). This prevents the formation and growth of blood clots.
Pharmacokinetics
Onset
Within 3-5 hours after subcutaneous administration (peak anti-Xa activity).
Excretion
Mainly via renal route (approximately 40% as active or inactive fragments).
Half life
Approximately 4-5 hours (anti-Xa activity), allowing for once or twice daily dosing.
Absorption
High bioavailability (approx. 100%) after subcutaneous injection, with peak anti-Xa activity within 3-5 hours.
Metabolism
Primarily hepatic through desulfation and depolymerization into lower molecular weight fragments with reduced biological potency.
Side Effects
Contraindications
- Active major bleeding or conditions predisposing to major bleeding (e.g., active gastric ulcer, hemorrhagic stroke).
- History of Heparin-Induced Thrombocytopenia (HIT) with or without thrombosis with any heparin.
- Hypersensitivity to enoxaparin, heparin, or any components of the product.
Drug Interactions
Oral Anticoagulants (e.g., Warfarin)
Increased risk of bleeding. Bridge therapy requires careful monitoring and appropriate overlap.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
Increased risk of bleeding. Use with caution.
Antiplatelet agents (e.g., Aspirin, Clopidogrel)
Increased risk of bleeding. Close monitoring is recommended.
Other Anticoagulants (e.g., Heparin, Dabigatran)
Increased risk of bleeding. Concomitant use is generally contraindicated or requires extreme caution.
Storage
Store below 25°C. Do not freeze. Protect from light. Keep out of reach of children.
Overdose
Accidental overdose may lead to hemorrhagic complications. The anticoagulant effects can be largely neutralized by the slow intravenous injection of protamine sulfate. The dose of protamine sulfate depends on the dose of enoxaparin administered and the time elapsed since administration.
Pregnancy & Lactation
Pregnancy Category B. Enoxaparin does not cross the placental barrier. Use in pregnancy only if clearly needed. It is unknown if enoxaparin is excreted in human milk, but it is generally considered compatible with breastfeeding due to its high molecular weight and poor oral absorption by the infant.
Side Effects
Contraindications
- Active major bleeding or conditions predisposing to major bleeding (e.g., active gastric ulcer, hemorrhagic stroke).
- History of Heparin-Induced Thrombocytopenia (HIT) with or without thrombosis with any heparin.
- Hypersensitivity to enoxaparin, heparin, or any components of the product.
Drug Interactions
Oral Anticoagulants (e.g., Warfarin)
Increased risk of bleeding. Bridge therapy requires careful monitoring and appropriate overlap.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
Increased risk of bleeding. Use with caution.
Antiplatelet agents (e.g., Aspirin, Clopidogrel)
Increased risk of bleeding. Close monitoring is recommended.
Other Anticoagulants (e.g., Heparin, Dabigatran)
Increased risk of bleeding. Concomitant use is generally contraindicated or requires extreme caution.
Storage
Store below 25°C. Do not freeze. Protect from light. Keep out of reach of children.
Overdose
Accidental overdose may lead to hemorrhagic complications. The anticoagulant effects can be largely neutralized by the slow intravenous injection of protamine sulfate. The dose of protamine sulfate depends on the dose of enoxaparin administered and the time elapsed since administration.
Pregnancy & Lactation
Pregnancy Category B. Enoxaparin does not cross the placental barrier. Use in pregnancy only if clearly needed. It is unknown if enoxaparin is excreted in human milk, but it is generally considered compatible with breastfeeding due to its high molecular weight and poor oral absorption by the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from manufacturing date
Availability
Pharmacies, Hospitals
Approval Status
Approved (e.g., FDA/DGDA)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Enoxaparin has been extensively studied in numerous clinical trials demonstrating its efficacy and safety in various thrombotic conditions. These trials support its use in DVT/PE prophylaxis and treatment, and in acute coronary syndromes.
Lab Monitoring
- Complete Blood Count (CBC) with platelet count, before treatment and regularly thereafter (e.g., daily or every other day initially).
- Renal function (creatinine clearance) in elderly patients or those with known renal impairment.
- Anti-Xa levels (in specific situations, e.g., obesity, renal impairment, pregnancy, or in cases of suspected underdosing/overdosing).
Doctor Notes
- Assess bleeding risk factors before initiating therapy.
- Monitor platelet counts closely, especially during the first few weeks of therapy, to detect Heparin-Induced Thrombocytopenia (HIT).
- Adjust dose in severe renal impairment (CrCl <30 mL/min) and monitor anti-Xa levels in high-risk patients (e.g., morbidly obese, pregnant, renal failure).
Patient Guidelines
- Follow your doctor's instructions precisely regarding dose and administration technique.
- Learn how to properly administer the subcutaneous injection yourself if instructed.
- Report any unusual bleeding, bruising, or severe pain at the injection site immediately to your doctor.
- Inform all healthcare providers, including dentists, that you are taking enoxaparin.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a missed one.
Driving Precautions
Enoxaparin is not known to affect the ability to drive or operate machinery.
Lifestyle Advice
- Avoid activities that may increase your risk of bleeding or injury, such as contact sports.
- Be careful when brushing your teeth, flossing, or shaving to prevent cuts.
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