Clexane (Enoxaparin)

[Rafael]

please enlighten us what was the outcome?

not sure about clexane, but some products(injections) can be emptied in a cup and given orally as an off license drug.

[Moosa]

From a doctor's point of view, I can confirm that prophylactic clexane is very commonly used in patients who have reduced mobility, the most common dose being 40mg s/c od, although 20mg is more likely in the case of frail elderly patients. You might also see "CLEXANE + TEDS" written on the drug chart, which reminds nurses to ensure the patient is wearing TED stockings, which also reduce incidence of DVT.

It's very rare for doctors to prescribe IV heparin nowadays, because it's a headache to ensure levels in the bloods, for instance it often involves the night medics having to take a patient's blood at 4am to measure APTT ratio. A practical example when iv heparin would be clinically indicated is: patient has confirmed pulmonary embolus, and suspected GI bleed. In this case, heparin would have a big advantage over enoxaparin, because you could stop the heparin with immediate effect if the patient becomes haemodynamically unstable.

Dabigatrin is a direct thrombin inhibitor, I've only seen one patient on it, he was taking it as part of a clinical trial. I don't think it's licensed in the UK yet, it's certainly not in common use in the UK. Currently there's not really a good oral alternative for warfarin, which is a great shame because of course warfarin is a hugely problematic drug with all the issues surrounding P450 inhibition/potentiation by a whole list of medications including alcohol.

[Nik]

I believe dabigatran etexilate (Pradaxa) is licensed in UK. Rivaroxaban is the other rival anticoag on the market.

[starhammad]

Enoxaparan is nothing....& Heparin and related compounds can't be taken orally, as they are amino acids and destroyed by gastric acids.
Regards,

[jennimay]

What would be the result of taking rivaroxaban and having subcut clexane?

[Nik]

Just going back to the q regarding administering rivaroxaban and enoxaparin together, I can't imagine a situation whereby both would be needed. Enoxaparin acts via inhibition of the action of factor Xa, and rivaroxaban is a direct factor Xa inhibitor. So both together would probably increase the risk of bleeding.