Noxadium 4000/Noxadium 6000 Drug Interactions

Unless really needed, agents which may enhance the risk of hemorrhage should be discontinued prior to initiation of Enoxaparin therapy. These agents include medications such as: anticoagulants, platelet inhibitors including acetylsalicylic acid, salicylates, NSAIDS (including ketorolac, tromethamine), dipyridamole, or sulfinpyrazone. If co-administration, conduct close clinical and laboratory monitoring.
Heparin-induced thrombocytopenia: Enoxaparin should be used with extreme caution in patients with a history of heparin-induced thrombocytopenia.
Hemorrhage: Enoxaparin, like other anticoagulants, should be used with extreme caution in conditions with increased risk of hemorrhage, such as bacterial endocarditis, congenital or acquired bleeding disorders, active ulcerative and angiodysplastic gastrointestinal disease, hemorrhagic stroke, or shortly after brain, spinal, or ophthalmological surgery, or in patients treated concomitantly with platelet inhibitors. Cases of epidural or spinal hematomas have been reported with the associated use of Enoxaparin and spinal/epidural anesthesia or spinal puncture resulting in long-term or permanent paralysis. The risk of these events is higher with the use of post-operative indwelling epidural catheters or by the concomitant use of additional drugs affecting homeostasis such as NSAIDS.
Major hemorrhages including retroperitoneal and intracranial bleeding have been reported. Some of these cases have been fatal.
Bleeding can occur at any site during therapy with Enoxaparin. An unexplained fall in hematocrit or blood pressure should lead to a search for a bleeding site.
Low-weight patients: An increase in exposure of Enoxaparin with sodium with prophylactic dosages (non-weight adjusted) has been observed in low weight (<45 kg) and low-weight men (<57 kg), which may lead to a higher risk of bleeding. Therefore, careful clinical monitoring is advised. Patients should be observed carefully for signs and symptoms of bleeding.
Use in Pregnancy: Enoxaparin is not predicated to increase the risk of development and abnormalities.
Enoxaparin does not cross the placenta, based on human and animal studies, and shows no evidence of teratogenic effects of fetoxicity.
Since there are no adequate and well-controlled studies in pregnant women, Enoxaparin should be used during pregnancy only if clearly needed. Pregnant women should be apprised of the potential hazard to the fetus and the mother if Enoxaparin is administered during pregnancy.