Enoxaparin

Enoxaparin is commonly called Clexane

Enoxaparin is commonly called Clexane. Easy-to-read medicine information about Clexane – what it is, how to use Clexane safely and possible side effects.

Type of medicine Also called
  • Anticoagulant (also called 'blood thinner')
  • Belongs to a group of medicines known as low molecular weight heparins
  • Clexane®
  • Clexane Forte®

What is Clexane?

Clexane is an anticoagulant or 'blood thinner' which is used to treat and prevent blood clots that can block blood vessels. Clexane helps to reduce the risk of blood clots in your blood by stopping them from forming. If blood clots have already formed, Clexane can be used to reduce the size of existing blood clots by breaking them down. 

Clexane is often prescribed after operations (surgeries) such as hip or knee surgery, or abdominal surgery when your risk of getting blood clots is increased. Clexane is also used if a blood clot has already formed in the heart (heart attack), leg (deep vein thrombosis)  or lung (pulmonary embolism).

Clexane is given as an injection, under the skin. It comes as a pre-filled syringe, which means the syringe comes filled with the medicine in it. It is ready for use.

Dose

  • The dose of Clexane is different for different people, depending on its use and on your body weight and how well your kidneys are working. 
  • Your doctor will work out the best dose for you. 
  • Let your doctor know if you have stomach ulcers or ulcerative colitis or diabetes, or if you have had a stroke or recent eye or brain surgery.
  • Inject Clexane exactly as your doctor or nurse has told you. The pharmacy label will tell you how much Clexane to use, how often to use it and any special instructions. Your doctor, nurse or pharmacist will show you how to use it properly.
  • It is important to let health professionals know that you are taking Clexane such as your dentist, your pharmacist, your podiatrist, or your nurse.

How to use Clexane

How to inject Clexane at home

Clexane is given as an injection, just under the skin (called subcutaneous injection). If you are unsure about how to inject Clexane, ask your doctor, nurse or pharmacist to show you. The following is a guide. 

  • Wash and dry your hands.
  • Prepare the exact dose. Your healthcare provider will teach you how to measure your dose. You may need to use all of the syringe, OR discard some first. 
  • You may notice an air bubble in the syringe. This is supposed to be there. Do not try to remove it.
  • Change injection sites each time to stop the skin from hardening.
How to inject Clexane  
  • Clexane is injected into the abdomen (tummy area), on the right or left side of your stomach – about 5 cm away from your belly button.
  • Inject on a different side (left or right side) each time you use Clexane. Avoid areas of skin that are scarred or bruised.
  • Do not inject Clexane into the muscle, as this can cause a painful bruise. 
  • Sit or lie down so you can see your tummy.
  • Your skin needs to be clean and dry.
  • Remove the needle cap by pulling it straight off the syringe.
  • Hold the syringe like a pencil in your writing hand.
  • With your other hand, pinch an inch of the clean skin to make a fold in the skin.
  • Put the full length of the needle straight down at a 90-degree angle into the top of the fold of skin. Continue to hold the skin fold throughout the injection.
  • Press the plunger with your thumb until the syringe is empty. 
  • Pull the needle straight out and release the skin fold.
  • To prevent bruising, do not rub the injection site.
Images Sanofi 2014

Other handy tips

  • Inject your Clexane dose at the same time each day.   
  • If you miss a dose, inject it as soon as you remember, if it is on the same day. If it is the next day, skip the missed dose and inject your normal dose. Do not double the dose. Contact your doctor if you miss 2 or more doses in a row.
  • Keep your Clexane syringes at room temperature; do not put them in the fridge or freezer.
  • Keep used syringes in a hard plastic container (such as an empty detergent bottle) with a lid. You can take the container to your local pharmacy to be disposed of safely. Do not reuse syringes.

Possible side effects

Like all medicines, Clexane can cause side effects, although not everyone gets them. 

Increased risk of bleeding

Clexane increases your risk of bleeding. You might bleed or bruise more easily while you are taking Clexane.

Injuries or falls

Be careful when shaving, clipping fingernails, brushing and flossing your teeth or playing sports. Do not get any new tattoos or piercings while you are taking Clexane, or any deep-tissue massage; these things may cause bruising and bleeding. Minor bleeding should usually stop on its own. If you have a fall or hurt your head or body, get medical attention immediately, even if you feel okay.

Signs of severe bleeding

If you have any of the following signs of bleeding, contact your doctor immediately or ring Healthline for free 24hr health advice 0800 611 116:

  • becoming pale, very weak and tired, or short of breath
  • any bleeding from the gums, cuts or nosebleeds that won’t stop
  • blood in the stools (poo) – black, tarry stools
  • blood in the urine (wee) – pink, red or brown-coloured urine
  • heavy periods (menstrual bleeding)
  • coughing up blood or vomit that looks like coffee grounds.

Interactions

Clexane should not be taken with some other medications and herbal supplements, so always check with your doctor or pharmacist before starting Clexane or before starting any new medicines. Also, check with your pharmacist before taking:

  • over-the-counter anti-inflammatories such as diclofenac (e.g. Voltaren Rapid), ibuprofen (e.g. Nurofen), naproxen (e.g. Naprogesic)
  • herbal extracts such as garlic, ginkgo or ginseng.

Taking these together with Clexane may increase your risk of bleeding and should be avoided. 

Learn more

Medsafe Consumer Information (NZ): Clexane 
New Zealand Formulary Patient Information: Enoxaparin

References

  1. Low molecular weight heparin use in primary care BPAC, November 2009
  2. Enoxaparin Institute of Safe Medication Practice (ISMP)
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 14 May 2019