Enoxaparin Dose Adjustment
Treatment
| Weight (KG) | Treatment of ACS, DVT, PE | ||
| CrCl > 30 ml/min | CrCl ≤ 30 ml/min | ||
| (1 mg/kg/dose) | (1.5 mg/kg/dose) | ||
| Less than 36 | Contact Physician | Contact Physician | Contact Physician |
| 36-45.9 | 60 mg SC once daily | ||
| 36-49.9 | 40 mg SC BID | 40 mg SC once daily | |
| 46-60.9 | 80 mg SC once daily | ||
| 50-69.9 | 60 mg SC BID | 60 mg SC once daily | |
| 61 to 70.9 | 100 mg SC once daily | ||
| 70-89.9 | 80 mg SC BID | 80 mg SC once daily | |
| 71 to 90.9 | 120 mg SC once daily | ||
| 90-109.9 | 100 mg SC BID | 100 mg SC once daily | |
| 91 to 110.9 | 150 mg SC once daily | ||
| 110-129.9 | 120 mg SC BID | 120 mg SC once daily | |
| 111 and above | Use BID dosing | ||
| 130-159.9 | 150 mg SC BID (120 mg + 30 mg) ** use two separate syringes | 150 mg SC once daily (120 mg + 30 mg) ** use two separate syringes | |
Prophylaxis
| DVT Prophylaxis | |
| CrCl | Dose |
| Standard Prophylactic Dose | 40 mg SC QD |
|
30 mg SC QD |
| CrCl < 10 ml/min | Heparin 5000 units SC Q12H or Q8H |
| Patients > 100 kg | 40 mg SC Q12H |