Lovenox question - what is 1mg/kg SC ???

[worktheday]

How do you figure out a correct dosage for an indication of Lovenox to be administered 1mg/kg SC every 12 hours. Can someone define this formula for me? My lovenox shots come in 100ml/mg tubes (standard). I understand this is based on weight and age but am trying to understand the 1mg/kg SC part?

Any info on this would be of great value right now. Thank you

 

[Protimenow]

I think that the SC is merely an instruction on how to administer the Lovenox (SC = sub cutaneous - under the skin - not into the muscle). If you can get your weight in kilograms, you should be able to figure out how much Lovenox to use -- if you're 50 kg (and I'm only throwing out a number here), then you'd use half a tube (50 ml), subcutaneously.

I haven't used Lovenox, so it would be great if someone who HAD can confirm all this. (You can probably google this and get your answer)

 

[worktheday]

Thanks PTN,

I have Googled it an for the life of me can find a straight foward answer. Although you are right about the SC (sub cutaneous). Im 37 and weigh exactly 200 pounds, which equals 90.7 kg's. but im not sure if that means i should be taking 90 ml?? If anyone has a further answer (yes I know we are not doctors here) I'd appreciate it.

Thank you all!

 

[worktheday]

So as it turns out you were rt PTN about your numbers. Thanks for pointing me in the right direction.

 

[ALCapshaw2]

Lovenox dosing is indeed 1 mg of medication per KiloGram of Body Weight.
1 kg = 2.2 lbs.
SO, 100 mg for a person weighing 220 lbs (and YES, 90 mg for a person weighing 200 lbs).

I was instructed to inject into the Belly Fat around the Belly Button, rotating around the belly button on subsequent injections.

Some members have suggested rubbing an Ice Cube over the Target Area before injecting.

ONE member suggested laying flat, and spreading out the belly fat (as opposed to pinching)
and then laying still for 20 minutes before rising to avoid bruising.

Remember, you can always ask your (or any) PHARMACIST questions about medications, dosing, side-effects, and drug interactions, and it's FREE.

'AL Capshaw'

 

[lance]

A few years ago Lovenox shots were required for surgery while I was off warfarin.
What I do remember for sure is: The needles were pre-packaged for my weight so I needed the whole shot.
THE FOLLOWING IS MOST IMPORTANT TO EXACTLY FOLLOW
There was a clear fluid at one end of the syringe and we reversed the needle until the clear fluid (nitrogen?) floated to the top end of the syringe away from the needle. There is a recess in the syringe that contains the clear fluid and allows all the Lovenox/Enoxaparin to be expelled beneath the skin ensuring the full amount of the drug is given while retaining the clear fluid. Prior to administration DO NOT touch the needle. It is coated in a lubricant allowing easy penetration.
My manager (and I think the enclosed instructions) advised the injections be given in a zig-zag pattern across the stomache while pinching the skin. It might be different now.
The only evidence those shots left was the puncture mark--no bruising at all. The doctors were amazed but we were taught to do it properly
The clear fluid will cause discomfort--a lot if it contacts the point of insertion.
This subject was discussed at length on the old VR and might still be in the archives.

 

[worktheday]

Thanks guys for all the responses. And Thank you AL for your studious dedication to this site. I've been coming here off and on for 6 years and your always a mainstay. Thank you so much!

 

[worktheday]

Follow up question.....Again knowing no one here is a doctor and giving medical advice, but for someone like me who is getting there INR back to a normal range after a few days of it being very low (started at 1.1 about a 6 days ago and up to 1.8 as of yesterday, assuming higher today), I had begun lovenox 90 ml yesterday based on my weight, and am taking it every 12 hrs until my INR is theraputic. My question is how long should i stay on it for, once in a theraputic range (2.5-3.5) and do i need to "taper" off the lovenox or just stop taking, and if so how??

Thanks for the help and wishing you all the best!

Jay

 

[Bina]

Lovenox is indeed 1mg per kg (2.2 lbs) of body weight and is given sub cutaneously; in the belly while laying down
works very well.
Each single shot lasts for 12 hours, and there is no need to taper off, just stop when you are solidly in range.
I would test my INR daily to be sure of when to stop. (Yay--home testing).
Best wishes.

 

[worktheday]

Thanks Bina.

So you dont need to taper down at all? and it doesn't matter how short a period you are on it (within respect i mean, I just started taking the lovenox yesterday and expect to be within normal range within the next 2-3 days so id be coming off of it then). I know this is a different situation, but i thought i remember after my OHS 4 years ago getting out of the hospital and dosing down after 5 days or so (not completely sure though)

 

[KristyW]

Bina's correct, there's no need to taper down. Lovenox is out of your system after 12 hours, which is why we used it prior to surgery as well as when your INR is low. It does not register on your INR check, so just keep taking it until your warfarin/Coumadin gets your INR in range. The Lovenox is there to protect you. Some people are on it only for a day or two, others, like me were on it for 3 weeks after surgery (I should have been on it for another 3 weeks, but I couldn't afford it.)

 

[worktheday]

Thank you all again for your time reading, your replies, and the information. All of this helps. I hope all of you are in good health and spirit!

Jay

 

[normofthenorth]

I'm not quite as convinced as Bina and KristyW that there's no reason to overlap the two anti-coagulants as you first suggested. I'd check with a Doc (or 2) and/or a pharmacist (or 2). My reason for concern is that I've read about Warfarin's multiple and conflicting effects on coagulation, and in the first ~48 days of Warfarin administration, its net effect is to PROMOTE coagulation rather than to RETARD it. (The mechanism for that is a long story!)

But it's very possible (likely?) that the INR measurement captures all of those effects, so once your INR is solidly in the therapeutic range, you don't need any Lovenox, exactly as Bina and KristyW have said.

(Your first measured INR at 1.1 is basically starting ACT from scratch.)

 

[Jkm7]

Lovenox is by prescription. Didn't whichever doctor prescribed it for you educate as to use and dosage? Didn't the pharmacy where you purchased it offer 'education' regarding this medication? It amazes me these professionals would arrange for you to have these syringes filled with a serious medication and leave you with so many questions. I'd be furious if that were my doctor and/or pharmacist. I expect more from those who take care of my health.


Sorry for the anger but I think we need to expect more from health professionals than to leave any of us so 'in the dark' about something so important.

What would have happened to you were it not for the very kind, sharing, informed members who have experience and knowledge and willingly helped? What would you have done?

 

[Bina]

I'm not quite as convinced as Bina and KristyW that there's no reason to overlap the two anti-coagulants as you first suggested. I'd check with a Doc (or 2) and/or a pharmacist (or 2). My reason for concern is that I've read about Warfarin's multiple and conflicting effects on coagulation, and in the first ~48 days of Warfarin administration, its net effect is to PROMOTE coagulation rather than to RETARD it. (The mechanism for that is a long story!)

But it's very possible (likely?) that the INR measurement captures all of those effects, so once your INR is solidly in the therapeutic range, you don't need any Lovenox, exactly as Bina and KristyW have said.

(Your first measured INR at 1.1 is basically starting ACT from scratch.)

Norm,
I never said not to OVERLAP..... of course the Lovenox and starting of Coumadin have to overlap.
My response was that there is no need to TAPER down once the Coumadin has the INR solidly in range.

 

[worktheday]

Thanks for all the responses guys and gals.

JKM, I didnt make it clear, the lovenox that i have is a from when i had a procedure post AVR, a few years ago. It wasnt that I wasnt instructed correctly, it was just that it had been a long time since use (the lovenox is not expired also, expires in '13) and I couldnt remember the exact directions on my own. With the holiday weekend, the only person I could get a hold of was a pharmacist in fact, and after explaining my situation, they werent willing to give me any advice "not knowing my full medical history", which i can somewhat understand. Covering there own behinds.

I just dont know why after getting out of the hospital last monday, and being on hepparin for 3 days, they just started back on coumidin and had me tested on tuesday, when my INR was 1.1, and the issue of putting me on lovenox never arose. I had forgotten about the intermitent therapy using lovenox while getting INR back to normal range. Although this is a new Cardio for me, everyone raves over him and my first impressions were really positive. I have another appointment tomorrow afternoon to see him, and this issue will be brought up needless to say. Maybe there is another reason.

eperately my INR is up to 2.3 as of earlier today. Expecting 2.5-2.6 by tomorrow. The low end of my theraputic 2.5-3.5 range, which I'm glad to be getting back to without incident.

Thanks again for your responses and as always, any more responses are welcome!

Thanks,

Jay

 

[Jkm7]

Thanks for explaining, Jay. That does change the circumstance.

The most important is you seem to be close to your range and are now probably adequately protected. I was worried about you being at risk and it seemed your caretakers weren't taking very good care of you. Happy to hear the situation was not what appeared.

I do agree a conversation with your cardio re: why he didn't prescribe lovenox when you left the hospital would be a good idea.

Again, happy to hear you are very close to your range.
Wishing you all the best.

 

[ALCapshaw2]

Thanks for all the responses guys and gals.

JKM, I didnt make it clear, the lovenox that i have is a from when i had a procedure post AVR, a few years ago. It wasnt that I wasnt instructed correctly, it was just that it had been a long time since use (the lovenox is not expired also, expires in '13) and I couldnt remember the exact directions on my own. With the holiday weekend, the only person I could get a hold of was a pharmacist in fact, and after explaining my situation, they werent willing to give me any advice "not knowing my full medical history", which i can somewhat understand. Covering there own behinds.

I just dont know why after getting out of the hospital last monday, and being on hepparin for 3 days, they just started back on coumidin and had me tested on tuesday, when my INR was 1.1, and the issue of putting me on lovenox never arose. I had forgotten about the intermitent therapy using lovenox while getting INR back to normal range. Although this is a new Cardio for me, everyone raves over him and my first impressions were really positive. I have another appointment tomorrow afternoon to see him, and this issue will be brought up needless to say. Maybe there is another reason.

eperately my INR is up to 2.3 as of earlier today. Expecting 2.5-2.6 by tomorrow. The low end of my theraputic 2.5-3.5 range, which I'm glad to be getting back to without incident.

Thanks again for your responses and as always, any more responses are welcome!

Thanks,

Jay

Good Grief !

Your description sounds like Gross Negligence on the part of the Hospital for releasing you with NO anticoagulation protection. I suggest you contact whoever is manageing your Coumadin plus your Primary Care Physician and Cardiologist about this abysmal care provided by this hospital. You may want to ask if this should be reported to your State Medical Officials.

I expect your Doctors will not be thrilled about you using Lovenox without Doctor's orders.

This may get 'messy' (and nasty)...

 

[Jkm7]

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