Saturday June 26, 2010
Nomogram for Enoxaparin Treatment



Anti Factor Xa level: less than 0.35 u/ml
Hold Next Dose?: No
Dose Change?: increase by 25%
Repeat Anti Factor Xa level?: 4 hours post next dose


Anti Factor Xa level: 0.35 to 0.69 u/ml
Hold Next Dose?: No
Dose Change?: increase by 15%
Repeat Anti Factor Xa level?: 4 hours post next dose


Anti Factor Xa level: 0.7 to 1.1 u/ml
Hold Next Dose?: No
Dose Change?: 0
Repeat Anti Factor Xa level?: 1 x per week at 4 hours post dose

Anti Factor Xa level: 1.1 to 1.5 u/ml
Hold Next Dose?: No
Dose Change?: decrease by 20%
Repeat Anti Factor Xa level?: 4 hours post next dose


Anti Factor Xa level: 1.6 to 2.0 u/ml
Hold next dose?: No
Dose Change?: decrease by 30%
Repeat Anti Factor Xa level?: 4 hours post next dose


Anti Factor Xa level: more than 2.0 u/ml
For these patients, all further doses should be held, and the anti factor Xa level measured q 12 hours until the anti factor Xa level is less than 0.5 u/ml. Enoxaparin can then be restarted at a dose 40% less than was originally prescribed.

The above nomogram assumes that there is no bleeding.