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Clexane: The Blood Thinner That Can Save Your Life

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Clexane (enoxaparin sodium) is a low-molecular-weight heparin (LMWH). LMWHs are a type of blood thinner that helps to prevent and treat blood clots. Clexane is injected under the skin (subcutaneously).

How does Clexane work?

Clexane works by preventing the blood clotting factors factor Xa and thrombin from working. This helps to prevent and treat blood clots.

Clexane: The Blood Thinner That Can Save Your Life
Clexane: The Blood Thinner That Can Save Your Life

What are the uses of Clexane?

Clexane is used to:

  • Prevent blood clots after surgery or other medical procedures
  • Treat deep vein thrombosis (DVT) and pulmonary embolism (PE)
  • Reduce the risk of stroke and heart attack in people with certain heart conditions
  • Prevent blood clots in people with certain kidney diseases

Who needs Clexane?

  1. Infants and children are given clexane for only two reasons.
    They have had a blood clot and are taking clexane to make sure the blood clot doesn’t grow or break off and travel to another part of the body (e.g. the lungs).
  2. They haven’t had a blood clot yet, but for some reason their doctor thinks they have a bigger risk than other people for getting a blood clot.

Dosage and administration of Clexane

The dosage of Clexane depends on the condition being treated and the patient’s weight. Clexane is usually given once or twice a day.

How to inject Clexane

Clexane is injected under the skin (subcutaneously). The injection site is usually the abdomen or the thigh.

How often to take Clexane

Clexane is usually given once or twice a day. The dosage and frequency of administration depend on the condition being treated and the patient’s weight.

How do I give clexane?

Clexane cannot be taken by mouth, or given through an intravenous drip. It must be given by injection under the skin, twice a day.

We can make these injection a little bit easier for infants and children by using an Insuflon catheter. Insuflons are small devices that are placed into the layer of fat between the skin and muscles. They can stay in place for 7 days. A child can then have their clexane injected into the insuflon, where the body will absorb it. Before inserting an insuflon, we can place some local anaesthetic cream over the site where it will be placed.

This is usually the stomach or the outer side of the thigh. Once the skin has been made numb, the cream is removed. A small needle guides the insuflon into place, and is then removed, leaving a very small plastic tube sitting under the skin.

How do I use Clexane?

How much to use and when to use Clexane

Follow the instructions provided and use Clexane until your doctor tells you to stop.
Your doctor will decide what dose you will receive.
Clexane is usually administered by injection under the skin.

For the prevention of blood clots

The usual dose for moderate risk patients is 20 mg once per day.
The usual dose for high risk patients is 40 mg once per day.

For the treatment of bloods clots in the leg or deep vein

The usual dose is 1 mg per kg of body weight twice per day or 1.5 mg per kg of body weight once per day.
Warfarin is usually started within 3 days of using Clexane.

For patients requiring dialysis

The usual dose is 1 mg per kg of body weight into the tubing of the dialysis machine at the start of the session. Additional doses may be needed.

For patients who have had severe heart attacks

The usual dose is:
30 mg injected into the vein and 1 mg per kg of body weight injected under the skin, then
1 mg per kg of body weight twice per day.

For patients with other types of heart disease

The usual dose is 1 mg per kg of body weight twice per day. Your doctor may change this dose as needed.

How to use Clexane

Clexane may be given by your doctor, nurse, or you.
Clexane is usually given by injection under the skin or into the tubing of a dialysis machine. It can also be given by injection into a vein. This will be done in hospital by a doctor or nurse.

Prefilled syringes

The prefilled syringes are ready to use. The air bubble in syringe should not be expelled.

Graduated Prefilled Syringes

The graduated syringes have markings indicating the volume in the syringe. The volume (mL) or mass (mg) to be injected should be precisely measured according to the dosage recommended by your doctor.

Injection Technique

The recommended site for injection is the stomach area. A different injection site should be used for each injection.
The needle on the prefilled syringe is covered in a silicon coating. Do not wipe the needle or allow the solution to crystallise on the needle as this will damage the coating.
Gently fold the skin using a thumb and finger. Hold the fold of the skin for the duration of the injection.
Introduce the whole length of the needle vertically into the thickness of the skin fold and inject Clexane.
Do not rub the injection site after administration.
Clexane is for single use only. Use only once and discard after use.

If you use too much Clexane

If you think that you have used too much Clexane or have been given too much Clexane, you may need urgent medical attention.

Monitoring Clexane Therapy

The amount of clexane needed by a child is based on how much they weigh. A blood test is taken a few days after starting clexane to work out how a child’s body is responding to the medication. This test is called an anti-Factor Ten-A (anti-Xa) test. Once a child’s anti-Xa level is in the right range, we usually don’t need to do blood tests more often than once every two to four weeks.

Side effects of Clexane

The most common side effects of Clexane are:

  • Bleeding
  • Bruising
  • Hair loss
  • Thrombocytopenia (low platelet count)

Serious side effects of Clexane are rare, but can include:

  • Severe bleeding
  • Allergic reactions
  • Anaphylaxis

Precautions and warnings

What should I know before I use Clexane?

Do not use if you have ever had an allergic reaction to Clexane, heparin or any medicine derived from heparin, or any of the ingredients listed at the end of the CMI. Do not take Clexane if you have or have had major bleeding disorders, injury to the brain, stomach or bowel problems, or bacterial infections of the heart.
Talk to your doctor if you have any other medical conditions, take any other medicines, or are pregnant or plan to become pregnant or are breastfeeding.

Clexane should be used with caution in people with:

  • Bleeding disorders
  • Kidney disease
  • Liver disease
  • Stomach ulcers
  • Pregnant or breastfeeding women

Drug interactions

Clexane can interact with other medications, including:

  • Aspirin
  • Warfarin
  • Clopidogrel
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Antiplatelet medications

Special populations

Clexane should be used with caution in pregnant or breastfeeding women, and in people with kidney disease or liver disease.

Alternatives to Clexane

Other LMWHs that are similar to Clexane include:

  • Dalteparin (Fragmin)
  • Fondaparinux (Arixtra)
  • Tinzaparin (Innohep)

Frequent Asked Questions about Clexane

What is the difference between Clexane and other anticoagulants?

There are several different types of anticoagulants, including LMWHs, unfractionated heparin, warfarin, and direct oral anticoagulants (DOACs). LMWHs are a newer type of anticoagulant that is easier to use and has fewer side effects than some of the older types of anticoagulants.

How long should I take Clexane for?

The length of time you need to take Clexane depends on the condition being treated. For example, if you are taking Clexane to prevent blood clots after surgery, you may only need to take it for a few days or weeks. If you are taking Clexane to treat DVT or PE, you may need to take it for several months.

What is the difference between Clexane and other anticoagulants?

There are several different types of anticoagulants, including low-molecular-weight heparins (LMWHs), unfractionated heparin, warfarin, and direct oral anticoagulants (DOACs). LMWHs are a newer type of anticoagulant that is easier to use and has fewer side effects than some of the older types of anticoagulants.

Can I take Clexane while pregnant or breastfeeding?

Clexane can be used safely in pregnant and breastfeeding women. It is important to talk to your doctor about the risks and benefits of taking Clexane while pregnant or breastfeeding.

What should I do if I miss a dose of Clexane?

If you miss a dose of Clexane, inject it as soon as you remember. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not inject a double dose to catch up.

What are the signs and symptoms of a blood clot?

The signs and symptoms of a blood clot can vary depending on the location of the clot. Some common signs and symptoms of a blood clot include:

  • Pain
  • Swelling
  • Redness
  • Warmth
  • Numbness
  • Weakness

If you experience any of these signs or symptoms, seek medical attention immediately.

Conclusion

Clexane is a safe and effective anticoagulant that is used to prevent and treat blood clots. It is important to talk to your doctor about the risks and benefits of taking Clexane before you start taking it.

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