It is considered appropriate to use enoxaparin for:

1. Prevention of postoperative deep vein thrombosis or pulmonary embolism, in:

following hospitalization.

Hip or Knee Replacement Surgery: 30 mg subcutaneously twice a day to begin within 24 hours of surgery and to continue 10-14 days- reasons for longer therapy should be documented

Hip replacement surgery: 40 mg once a day SC given 12 hours prior to surgery to continue for 21 days.

Abdominal Surgery: 40mg once a day SC, initial dose given 2 hours prior to surgery (usual duration 7-10 days.

Unstable angina and Non-Q Wave Myocardial Infarction: 1mg/kg SQ q 12 h - no more than 150mg q 12 hr. until stabilized or discharged. (Avoid enoxaparin for 6-8 hours prior and post vascular access sheath removal.)

Treatment of DVT: 1mg/kg every 12 hours SQ (or 1.5mg daily) until INR from warfarin = 2-3.

1. Pre-operative coagulation values if medical history indicates

2. Renal Function if age or medical history indicates

3. Complete blood counts, including platelet count and stool occult blood tests initially and periodicaly during therapy lasting > 5 days.

5. Consider Anti Factor Xa in patients with significant renal impairment(<30ml/ml) or if abnormal coagulation parameters or bleeding occurs

6. Signs and symptoms of neurologic impairment in patients given epidural/spinal anesthesia or spinal puncture

Patient does not develop a deep vein thrombus or pulmonary embolism

Patient experiences resolution of DVT without incident.

Patient does not experience an adverse event with enoxaparin.