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Hemoxiparin injectable solution is used for the prevention of venous thrombosis and embolism in patients at moderate and high risk undergoing surgical procedures.
Active substance: Enoxaparin sodium – 40 mg
Excipients: Water for injection – up to 0.4 ml
Hemoxiparin is indicated for use in adults.
Prevention of venous thrombosis and embolism in patients undergoing surgical procedures who are at moderate to high risk, particularly during orthopedic and general surgeries, including oncological interventions.
Prevention of venous thrombosis and embolism in bedridden patients with acute medical conditions such as acute or decompensated chronic heart failure (NYHA Class III or IV), respiratory failure, acute infections, or rheumatic diseases associated with an increased risk of venous thromboembolism (see "Special Indications").
Treatment of deep vein thrombosis (DVT) with or without pulmonary embolism (PE), excluding cases requiring thrombolytic therapy or surgical intervention.
Prevention of thrombosis in the extracorporeal circulation system during hemodialysis.
Acute coronary syndrome (ACS):
Treatment of ST segment elevation myocardial infarction (STEMI) in patients undergoing medical treatment or subsequent percutaneous coronary intervention (PCI).
Prevention of Venous Thromboembolism (VTE) in Surgical Patients:
Moderate risk (e.g., abdominal surgery):
Recommended dose: 20 mg once daily subcutaneously. First injection should be given 2 hours before surgery.
High risk (e.g., orthopedic surgery, oncologic surgery, or patients with additional risk factors such as congenital/acquired thrombophilia, malignancy, prolonged immobility over 3 days, obesity, prior DVT, varicose veins of lower limbs, or pregnancy):
Recommended dose: 40 mg once daily subcutaneously. First injection should be administered 12 hours before surgery.
For early preoperative prophylaxis in high-risk patients awaiting delayed orthopedic surgery, the last preoperative injection should be given 12 hours before surgery, and the next dose administered 12 hours after surgery.
Treatment duration: typically 7–10 days. Therapy may be extended as long as thromboembolic risk persists or until the patient is fully ambulatory.
In major orthopedic surgeries, continued treatment with 40 mg once daily for up to 5 weeks may be advisable.
In abdominal or pelvic oncological surgeries, extension of therapy for up to 4 weeks with 40 mg once daily is recommended in high VTE risk patients.
Prevention of VTE in Acutely Ill, Bedridden Medical Patients:
Recommended dose: 40 mg once daily subcutaneously for 6 to 14 days, until full ambulation (max 14 days).
Treatment of Deep Vein Thrombosis (DVT), with or without Pulmonary Embolism (PE):
1.5 mg/kg body weight once daily or 1 mg/kg twice daily, subcutaneously.
For all others (including those with obesity, symptomatic PE, cancer, recurrent VTE, or proximal thrombosis): 1 mg/kg twice daily is recommended.
Treatment duration: typically 10 days. Oral anticoagulants should be started as early as possible, and Hemoxiparin continued until therapeutic anticoagulation is achieved (INR 2.0–3.0).
Prevention of Clot Formation in Extracorporeal Circulation During Hemodialysis:
Recommended average dose: 1 mg/kg body weight.
Administer into the arterial side of the shunt at the beginning of dialysis. One dose usually covers a 2-hour session. For longer sessions, additional 0.5–1 mg/kg can be administered if fibrin rings are observed.
No data available for repeated use during dialysis.
Treatment of Unstable Angina and Non-ST Segment Elevation Myocardial Infarction (NSTEMI):
Dose: 1 mg/kg every 12 hours subcutaneously, along with antiplatelet therapy (e.g., acetylsalicylic acid).
Treatment duration: Minimum of 2 days, continued until clinical stabilization (typically 2–8 days).
Aspirin: Recommended for all patients unless contraindicated (initial 150–300 mg orally, then maintenance 75–325 mg once daily).
Treatment of ST Segment Elevation Myocardial Infarction (STEMI):
Initial: 30 mg IV bolus of enoxaparin sodium, immediately followed by 1 mg/kg subcutaneously.
Then: 1 mg/kg subcutaneously every 12 hours (max 100 mg for the first two injections; for patients >100 kg, the dose should not exceed 100 mg per injection).
Aspirin should be started as early as possible (75–325 mg daily) and continued for at least 30 days unless contraindicated.
Recommended treatment duration: 8 days or until hospital discharge (whichever is longer).
With thrombolytics: Administer enoxaparin between 15 minutes before and 30 minutes after starting thrombolysis.
Patients ≥75 years old: No initial IV bolus.
Patients undergoing PCI:
Store at temperatures not exceeding 25°C.
Do not freeze.
Keep out of reach of children.
