Coxpar
Generic Name
Enoxaparin Sodium
Manufacturer
A reputable pharmaceutical company
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| coxpar 40 mg injection | ৳ 200.00 | N/A |
Description
Overview of the medicine
Coxpar 40 mg Injection contains Enoxaparin Sodium, a low molecular weight heparin used to prevent and treat various thromboembolic disorders such as deep vein thrombosis and pulmonary embolism.
Uses & Indications
Dosage
Adults
VTE Prophylaxis: 40 mg subcutaneously once daily. DVT Treatment: 1 mg/kg subcutaneously every 12 hours or 1.5 mg/kg once daily.
Elderly
No dosage adjustment necessary unless severe renal impairment is present. Monitor for bleeding complications.
Renal_impairment
Severe renal impairment (CrCl < 30 mL/min): VTE Prophylaxis: 30 mg subcutaneously once daily. DVT Treatment: 1 mg/kg subcutaneously once daily.
How to Take
Administer by deep subcutaneous injection, preferably into the anterolateral or posterolateral abdominal wall, or outer thigh. Do not inject intramuscularly. Do not expel the air bubble from the syringe before injection.
Mechanism of Action
Enoxaparin works by selectively inhibiting Factor Xa and, to a lesser extent, Factor IIa (thrombin), thereby preventing clot formation. It potentiates the anticoagulant effect of antithrombin III.
Pharmacokinetics
Onset
Peak anti-Xa activity achieved within 3-5 hours.
Excretion
Renal excretion of active and inactive fragments.
Half life
Approximately 4.5 to 7 hours after a single subcutaneous dose, extending in renal impairment.
Absorption
High bioavailability (approx. 100%) after subcutaneous administration.
Metabolism
Primarily metabolized in the liver by desulfation and depolymerization into less active or inactive fragments.
Side Effects
Contraindications
- Active major bleeding or conditions with a high risk of uncontrolled hemorrhage
- History of heparin-induced thrombocytopenia (HIT) with or without thrombosis
- Hypersensitivity to enoxaparin, heparin, or pork products
- Patients undergoing spinal or epidural anesthesia or spinal puncture who are receiving therapeutic anticoagulation
Drug Interactions
Dextran
Increased risk of bleeding.
Oral Anticoagulants (e.g., Warfarin)
Monitor INR closely when co-administering to ensure proper transition and avoid over-anticoagulation.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
Increased risk of bleeding. Use with caution.
Antiplatelet agents (e.g., Aspirin, Clopidogrel, Ticagrelor)
Increased risk of bleeding. Close monitoring required.
Storage
Store at room temperature (20°C to 25°C or 68°F to 77°F). Protect from light. Do not freeze. Keep out of reach of children.
Overdose
Overdose symptoms include hemorrhagic complications. The anticoagulant effects can be largely neutralized by the slow intravenous administration of protamine sulfate. Dose of protamine depends on the enoxaparin dose and time since administration.
Pregnancy & Lactation
Pregnancy Category B. Use in pregnancy only if clearly needed after careful risk-benefit assessment. Enoxaparin does not cross the placenta. Exercise caution when administered to a nursing woman, as it is unknown if enoxaparin is excreted in human milk.
Side Effects
Contraindications
- Active major bleeding or conditions with a high risk of uncontrolled hemorrhage
- History of heparin-induced thrombocytopenia (HIT) with or without thrombosis
- Hypersensitivity to enoxaparin, heparin, or pork products
- Patients undergoing spinal or epidural anesthesia or spinal puncture who are receiving therapeutic anticoagulation
Drug Interactions
Dextran
Increased risk of bleeding.
Oral Anticoagulants (e.g., Warfarin)
Monitor INR closely when co-administering to ensure proper transition and avoid over-anticoagulation.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
Increased risk of bleeding. Use with caution.
Antiplatelet agents (e.g., Aspirin, Clopidogrel, Ticagrelor)
Increased risk of bleeding. Close monitoring required.
Storage
Store at room temperature (20°C to 25°C or 68°F to 77°F). Protect from light. Do not freeze. Keep out of reach of children.
Overdose
Overdose symptoms include hemorrhagic complications. The anticoagulant effects can be largely neutralized by the slow intravenous administration of protamine sulfate. Dose of protamine depends on the enoxaparin dose and time since administration.
Pregnancy & Lactation
Pregnancy Category B. Use in pregnancy only if clearly needed after careful risk-benefit assessment. Enoxaparin does not cross the placenta. Exercise caution when administered to a nursing woman, as it is unknown if enoxaparin is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date when stored correctly. Refer to the specific product packaging for exact expiry date.
Availability
Pharmacies, Hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generic available, original patent expired
WHO Essential Medicine
YesClinical Trials
Enoxaparin has been extensively studied in numerous randomized controlled clinical trials across various indications, demonstrating efficacy and safety in the prevention and treatment of venous thromboembolism and acute coronary syndromes.
Lab Monitoring
- Complete Blood Count (CBC) including platelet count regularly (baseline and during treatment)
- Renal function tests (e.g., creatinine clearance) before and during treatment, especially in elderly or renally impaired patients
- Anti-Factor Xa levels (in specific patient populations such as obesity, renal impairment, pregnancy, or very low body weight)
Doctor Notes
- Careful monitoring for signs of bleeding (clinical and laboratory) is crucial during treatment.
- Assess renal function (CrCl) prior to initiation and periodically during therapy, adjusting dose for severe renal impairment.
- Avoid intramuscular injection due to the significant risk of hematoma formation.
- Consider anti-Factor Xa level monitoring in specific populations (e.g., morbidly obese, very low weight, pregnant patients, renal insufficiency).
Patient Guidelines
- Report any signs of unusual bleeding or bruising immediately to your doctor or nurse.
- Do not take other blood-thinning medications (e.g., aspirin, NSAIDs) without consulting your doctor.
- Inform all healthcare providers (including dentists) about your use of Coxpar injection before any procedures or surgeries.
- Follow the administration instructions carefully for subcutaneous injection, rotating injection sites.
Missed Dose Advice
If a dose is missed, administer it as soon as possible. If it's almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Coxpar 40 mg Injection is not known to affect the ability to drive or operate machinery. However, if you experience dizziness or visual disturbances, avoid such activities.
Lifestyle Advice
- Avoid activities that may increase the risk of bleeding or injury.
- Maintain regular follow-up appointments with your doctor to monitor your condition and treatment.
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