WHAT IS THIS MEDICINE?
Clexane 40mg is the most commonly used prophylactic dose of
enoxaparin for patients at high risk of venous thromboembolism (VTE). It is
used before and after major orthopaedic surgery, abdominal surgery, cancer
surgery, and in acutely ill medical patients with immobility.
2. HOW TO TAKE THIS MEDICINE
Administer 40mg subcutaneously once daily. For elective hip
or knee surgery, begin 12 hours before surgery OR 12–24 hours after surgery
depending on local protocol. Continue for 10–35 days, depending on the
procedure. Inject into the anterolateral or posterolateral abdominal wall. Do
not inject into the muscle.
3. POSSIBLE SIDE EFFECTS
Common side effects include the following. Contact your
doctor or pharmacist if any side effect worries you.
|
Side Effect |
Frequency |
What To Do |
|
Injection site haematoma |
Very common |
Rotate sites; avoid rubbing |
|
Bleeding |
Common |
Apply pressure; seek help if severe |
|
Thrombocytopenia |
Uncommon |
Blood counts monitored; report bruising |
|
Elevated ALT/AST |
Very common |
Usually asymptomatic and reversible |
|
Anaemia |
Common |
Report fatigue; monitor haemoglobin |
|
HIT (immune-mediated) |
Rare |
Stop immediately; specialist review needed |
|
Hyperkalaemia |
Rare |
Monitor potassium, especially in diabetics |
|
⚠ IMPORTANT WARNING |
|
Use with extreme caution in patients with
mechanical prosthetic heart valves — enoxaparin has not been adequately
studied in this setting and thromboembolism may occur. A specialist
haematologist or cardiologist should be involved. |
4. WHO SHOULD NOT TAKE THIS MEDICINE
Contraindicated in active haemorrhage, recent haemorrhagic
stroke, severe thrombocytopenia, known HIT, and allergy to enoxaparin or pork
products. Reduce dose or avoid in severe renal impairment (CrCl <30ml/min).
5. DRUG INTERACTIONS
Concurrent use with other anticoagulants, antiplatelet agents
(aspirin, clopidogrel, dipyridamole), NSAIDs, or SSRIs increases bleeding risk.
Dextran solutions interact with enoxaparin. Ketorolac is specifically
contraindicated with enoxaparin.
6. HOW TO STORE
Store below 25°C. Do not freeze. Single-use pre-filled
syringes. Protect from light.
7. PRESCRIPTION STATUS
Prescription Only Medicine (POM). Requires a physician's
prescription and monitoring.
|
💚 PATIENT TIP |
|
Orthopaedic surgery patients: continue your
Clexane injections for the full prescribed duration even after discharge.
Stopping early significantly increases the risk of post-operative DVT and
pulmonary embolism. |
8. PHARMACIST'S NOTE
The 40mg dose is the standard high-risk prophylactic dose and
is distinct from therapeutic (treatment) doses. Clarify the indication with the prescriber if the dose seems low for treatment purposes. Ensure patients with
renal impairment have dose-adjusted prescriptions.
9. FREQUENTLY ASKED QUESTIONS
|
FREQUENTLY ASKED QUESTIONS |
|
Q: What is Clexane 40mg
used for? A: It prevents deep vein thrombosis and
pulmonary embolism in high-risk patients, especially after hip replacement,
knee replacement, abdominal surgery, and in hospitalised medical patients. |
|
Q: How long will I need
to inject it? A: Typically 10–14 days after general surgery.
After major orthopaedic surgery (hip/knee), up to 35 days of extended
prophylaxis may be recommended. |
|
Q: Will I need blood
tests? A: For standard prophylaxis, anti-Xa levels are
not routinely needed. Platelet counts are checked before treatment and
periodically thereafter to watch for HIT. |
|
Q: What are signs of an
allergic reaction? A: Rash, itching, difficulty breathing, or
swelling of the face — stop the injection and seek immediate medical help. |