Clexane Overdosage

Oral ingestion of Clexane (no reported cases) should lead to no serious consequences, taking into account the very low gastric and intestinal absorption of Clexane. This may be checked by carrying on a plasma assay of the anti-Xa activity.
Accidental overdosage after IV, extracorporeal or SC administration of massive doses of enoxaparin sodium may lead to bleeding complications. Neutralization can be obtained by slow IV injection of protamine; however, the anti-Xa activity of enoxaparin sodium is never completely neutralized (maximum about 60%). Protamine 1 mg can be used to neutralize the anticoagulant effect of about enoxaparin sodium 1 mg, if enoxaparin sodium was administered in the previous 8 hrs. An infusion of 0.5-mg protamine per 1 mg of enoxaparin sodium may be administered >8 hrs previous to the protamine administration, or if it has been determined that a 2nd dose of protamine is required. After 12 hrs of the enoxaparin sodium injection, protamine administration may not be required.