VTE Prophylaxis

SC: (Adults) Knee replacement surgery–30 mg q 12 hr starting 12–24 hr after surgery for 7–10 days; Hip replacement–30 mg q 12 hr starting 12–24 hr postop or 40 mg once daily starting 12 hr before surgery (either dose may be continued for 7–14 days; continued prophylaxis with 40 mg once daily may be continued for up to 3 wk); Abdominal surgery–40 mg once daily starting 2 hr before surgery and then continued for 7–12 days or until ambulatory (up to 14 days); Medical patients with acute illness–40 mg once daily for 6–14 days.

SC: (Infants and Children ≥2 mo –18 yr): 0.5 mg/kg/dose every 12 hr.

SC: (Infants 1–2 mo): 0.75 mg/kg/dose every 12 hr.

Treatment of DVT/PE

SC: (Adults) Outpatient–1 mg/kg every 12 hr. Warfarin should be started within 72 hr; enoxaparin may be continued for a minimum of 5 days and until therapeutic anticoagulation with warfarin is achieved (INR >2 for 2 consecutive days); Inpatient–1 mg/kg every 12 hr or 1.5 mg/kg every 24 hr. Warfarin should be started within 72 hr; enoxaparin may be continued for a minimum of 5 days or until therapeutic anticoagulation with warfarin is achieved (INR >2 for two consecutive days).

SC: (Infants and Children ≥2 mo –18 yr): 1 mg/kg/dose every 12 hr.

SC: (Infants 1–2 mo): 1.5 mg/kg/dose every 12 hr.

Unstable Angina/Non–ST-Segment-Elevation MI

SC: (Adults) 1 mg/kg q 12 hr for 2–8 days (with aspirin).

ST-Segment-Elevation MI

IV: SC: (Adults <75 yr): Administer single IV bolus of 30 mg plus 1 mg/kg subcut dose (maximum of 100 mg for first 2 doses only), followed by 1 mg/kg subcut q 12 hr. The usual duration of treatment is 2–8 days. In patients undergoing percutaneous coronary intervention, if last subcut dose was <8 hr before balloon inflation, no additional dosing needed; if last subcut dose was ≥8 hr before balloon inflation, administer single IV bolus of 0.3 mg/kg.

SC: (Adults ≥75 yr): 0.75 mg/kg every 12 hr (no IV bolus needed) (maximum of 75 mg for first 2 doses only; no initial bolus). The usual duration of treatment is 2–8 days.

Renal Impairment
SC: (Adults CCr <30 mL/min): VTE prophylaxis for abdominal or knee/hip replacement surgery–30 mg once daily. Treatment of DVT/PE–1 mg/kg once daily. Unstable angina/non-ST-segment-elevation MI–1 mg/kg once daily. Acute ST-segment-elevation MI (patients <75 yr)–Single IV bolus of 30 mg plus 1 mg/kg subcut dose, followed by 1 mg/kg subcut once daily. Acute ST-segment-elevation MI (patients ≥75 yr)–1 mg/kg once daily (no initial bolus).