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Identification
NameEnoxaparin
Accession NumberDB01225  (APRD00068)
TypeSmall Molecule
GroupsApproved
Description

Enoxaparin is a low molecular weight heparin. Enoxaparin is used to prevent and treat deep vein thrombosis or pulmonary embolism, and is given as a subcutaneous injection. Enoxaparin binds to and accelerates the activity of antithrombin III. By activating antithrombin III, enoxaparin preferentially potentiates the inhibition of coagulation factors Xa and IIa. Factor Xa catalyzes the conversion of prothrombin to thrombin, so enoxaparin’s inhibition of this process results in decreased thrombin and ultimately the prevention of fibrin clot formation. Low molecular weight heparins are less effective at inactivating factor IIa due to their shorter length compared to unfractionated heparin.

Structure
Thumb
Synonyms
SynonymLanguageCode
LMWHNot AvailableNot Available
Low Molecular Weight HeparinNot AvailableNot Available
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Lovenoxinjection40 mg/.4mLintravenous; subcutaneousSanofi Aventis U.S. Llc2008-03-12Not AvailableUs
Lovenoxinjection40 mg/.4mLintravenous; subcutaneousSanofi Aventis U.S. Llc1993-03-29Not AvailableUs
Lovenoxinjection60 mg/.6mLintravenous; subcutaneousSanofi Aventis U.S. Llc2008-04-17Not AvailableUs
Lovenoxinjection60 mg/.6mLintravenous; subcutaneousSanofi Aventis U.S. Llc1993-03-29Not AvailableUs
Lovenoxinjection80 mg/.8mLintravenous; subcutaneousSanofi Aventis U.S. Llc2008-04-21Not AvailableUs
Lovenoxinjection80 mg/.8mLintravenous; subcutaneousSanofi Aventis U.S. Llc1993-03-29Not AvailableUs
Lovenoxinjection100 mg/mLintravenous; subcutaneousSanofi Aventis U.S. Llc2008-04-21Not AvailableUs
Lovenoxinjection100 mg/mLintravenous; subcutaneousSanofi Aventis U.S. Llc1993-03-29Not AvailableUs
Lovenoxinjection30 mg/.3mLintravenous; subcutaneousSanofi Aventis U.S. Llc2008-03-12Not AvailableUs
Lovenoxinjection30 mg/.3mLintravenous; subcutaneousSanofi Aventis U.S. Llc1993-03-29Not AvailableUs
Lovenoxinjection300 mg/3mLintravenous; subcutaneousSanofi Aventis U.S. Llc2008-04-21Not AvailableUs
Lovenoxinjection300 mg/3mLintravenous; subcutaneousSanofi Aventis U.S. Llc1993-03-29Not AvailableUs
Lovenoxinjection120 mg/.8mLintravenous; subcutaneousSanofi Aventis U.S. Llc2008-04-21Not AvailableUs
Lovenoxinjection120 mg/.8mLintravenous; subcutaneousSanofi Aventis U.S. Llc1993-03-29Not AvailableUs
Lovenoxinjection150 mg/mLintravenous; subcutaneousSanofi Aventis U.S. Llc2008-04-21Not AvailableUs
Lovenoxinjection150 mg/mLintravenous; subcutaneousSanofi Aventis U.S. Llc1993-03-29Not AvailableUs
Lovenoxinjection30 mg/.3mLintravenous; subcutaneousSanofi Aventis U.S. Llc1993-03-29Not AvailableUs
Lovenoxinjection40 mg/.4mLintravenous; subcutaneousSanofi Aventis U.S. Llc1993-03-29Not AvailableUs
Lovenoxinjection60 mg/.6mLintravenous; subcutaneousSanofi Aventis U.S. Llc1993-03-29Not AvailableUs
Lovenoxinjection80 mg/.8mLintravenous; subcutaneousSanofi Aventis U.S. Llc1993-03-29Not AvailableUs
Lovenoxinjection100 mg/mLintravenous; subcutaneousSanofi Aventis U.S. Llc1993-03-29Not AvailableUs
Lovenoxinjection120 mg/.8mLintravenous; subcutaneousSanofi Aventis U.S. Llc1993-03-29Not AvailableUs
Lovenoxinjection150 mg/mLintravenous; subcutaneousSanofi Aventis U.S. Llc1993-03-29Not AvailableUs
Lovenoxinjection300 mg/3mLintravenous; subcutaneousSanofi Aventis U.S. Llc1993-03-29Not AvailableUs
Lovenoxinjection80 mg/.8mLintravenous; subcutaneousPhysicians Total Care, Inc.2004-07-28Not AvailableUs
Lovenoxinjection40 mg/.4mLintravenous; subcutaneousPhysicians Total Care, Inc.2005-10-06Not AvailableUs
Lovenoxinjection60 mg/.6mLintravenous; subcutaneousPhysicians Total Care, Inc.2006-05-17Not AvailableUs
Lovenoxinjection100 mg/mLintravenous; subcutaneousPhysicians Total Care, Inc.2007-11-29Not AvailableUs
Lovenoxinjection120 mg/.8mLintravenous; subcutaneousPhysicians Total Care, Inc.2007-12-04Not AvailableUs
Lovenoxinjection30 mg/.3mLintravenous; subcutaneousCardinal Health1993-03-29Not AvailableUs
Lovenoxinjection40 mg/.4mLintravenous; subcutaneousCardinal Health1993-03-29Not AvailableUs
Lovenoxinjection60 mg/.6mLintravenous; subcutaneousCardinal Health1993-03-29Not AvailableUs
Lovenoxinjection80 mg/.8mLintravenous; subcutaneousCardinal Health1993-03-29Not AvailableUs
Lovenoxinjection100 mg/mLintravenous; subcutaneousCardinal Health1993-03-29Not AvailableUs
Lovenoxinjection60 mg/.6mLintravenous; subcutaneousCardinal Health1993-03-29Not AvailableUs
Lovenoxinjection80 mg/.8mLintravenous; subcutaneousCardinal Health1993-03-29Not AvailableUs
Lovenoxinjection100 mg/mLintravenous; subcutaneousCardinal Health1993-03-29Not AvailableUs
Lovenoxinjection40 mg/.4mLintravenous; subcutaneousCardinal Health1993-03-29Not AvailableUs
Lovenoxinjection30 mg/.3mLintravenous; subcutaneousCardinal Health1993-03-29Not AvailableUs
Generic Prescription ProductsNot Available
Over the Counter ProductsNot Available
International Brands
NameCompany
ClexaneNot Available
Lovenox HPNot Available
Brand mixturesNot Available
SaltsNot Available
Categories
CAS number9005-49-6
WeightNot Available
Chemical FormulaC26H42N2O37S5
InChI KeyHTTJABKRGRZYRN-UHFFFAOYSA-N
InChINot Available
IUPAC NameNot Available
SMILESNot Available
Taxonomy
ClassificationNot classified
Pharmacology
IndicationFor the prophylaxis of deep vein thrombosis, which may lead to pulmonary embolism, and also for the prophylaxis of ischemic complications of unstable angina and non-Q-wave myocardial infarction, when concurrently administered with aspirin.
PharmacodynamicsEnoxaparin is a highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from 3800 to 5000 daltons. Enoxaparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Enoxaparin is a well known and commonly used anticoagulant which has antithrombotic properties. Enoxaparin inhibits reactions that lead to the clotting of blood and the formation of fibrin clots both in vitro and in vivo. Enoxaparin acts at multiple sites in the normal coagulation system. Small amounts of enoxaparin in combination with antithrombin III (enoxaparin cofactor) can inhibit thrombosis by inactivating activated Factor X and inhibiting the conversion of prothrombin to thrombin. Once active thrombosis has developed, larger amounts of enoxaparin can inhibit further coagulation by inactivating thrombin and preventing the conversion of fibrinogen to fibrin. Enoxaparin also prevents the formation of a stable fibrin clot by inhibiting the activation of the fibrin stabilizing factor. Its use should be avoided in patients with a creatinine clearance less than 20mL/min. In these patients, unfractionated heparin should only be used. As for monitoring, active partial thromboplastin time (aPTT) will only increase at high doses of low molecular weight heparins (LMWH). Therefore, monitoring aPTT is not recommended. However, anti-Xa activity can be measured to monitor the efficacy of the LMWH.
Mechanism of actionThe mechanism of action of enoxaparin is antithrombin-dependent. It acts mainly by accelerating the rate of the neutralization of certain activated coagulation factors by antithrombin, but other mechanisms may also be involved. The antithrombotic effect of enoxaparin is well correlated to the inhibition of factor Xa. Enoxaparin interacts with Antithrombin III, Prothrombin and Factor X. Enoxaparin binds to and accelerates the activity of antithrombin III. By activating antithrombin III, enoxaparin preferentially potentiates the inhibition of coagulation factors Xa and IIa.
AbsorptionMean absolute bioavailability of enoxaparin, after 1.5 mg/kg given subcutaneously, based on anti-Factor Xa activity is approximately 100% in healthy volunteers.
Volume of distribution
  • 4.3 L
Protein binding80% bound-albumin
Metabolism

Undergoes desulfation and polymerization via the liver

Route of eliminationEnoxaparin sodium is primarily metabolized in the liver by desulfation and/or depolymerization to lower molecular weight species with much reduced biological potency. Renal clearance of active fragments represents about 10% of the administered dose and total renal excretion of active and non-active fragments 40% of the dose.
Half life4.5 hours
ClearanceNot Available
ToxicityMouse, median lethal dose greater than 5000 mg/kg. Another side effect is heparin induced thrombocytopenia (HIT syndrome). HIT is caused by an immunological reaction that makes platelets form clots within the blood vessels, thereby using up coagulation factors.
Affected organisms
  • Humans and other mammals
PathwaysNot Available
SNP Mediated EffectsNot Available
SNP Mediated Adverse Drug ReactionsNot Available
ADMET
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption-0.9215
Blood Brain Barrier-0.8366
Caco-2 permeable-0.6496
P-glycoprotein substrateNon-substrate0.698
P-glycoprotein inhibitor INon-inhibitor0.5818
P-glycoprotein inhibitor IINon-inhibitor0.9771
Renal organic cation transporterNon-inhibitor0.9454
CYP450 2C9 substrateNon-substrate0.6694
CYP450 2D6 substrateNon-substrate0.8196
CYP450 3A4 substrateNon-substrate0.5842
CYP450 1A2 substrateNon-inhibitor0.8157
CYP450 2C9 substrateNon-inhibitor0.771
CYP450 2D6 substrateNon-inhibitor0.8869
CYP450 2C19 substrateNon-inhibitor0.7655
CYP450 3A4 substrateNon-inhibitor0.9194
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.9232
Ames testNon AMES toxic0.5957
CarcinogenicityNon-carcinogens0.694
BiodegradationNot ready biodegradable0.851
Rat acute toxicity2.3846 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9589
hERG inhibition (predictor II)Non-inhibitor0.7157
Pharmacoeconomics
ManufacturersNot Available
Packagers
Dosage forms
FormRouteStrength
Injectionintravenous; subcutaneous100 mg/mL
Injectionintravenous; subcutaneous120 mg/.8mL
Injectionintravenous; subcutaneous150 mg/mL
Injectionintravenous; subcutaneous30 mg/.3mL
Injectionintravenous; subcutaneous300 mg/3mL
Injectionintravenous; subcutaneous40 mg/.4mL
Injectionintravenous; subcutaneous60 mg/.6mL
Injectionintravenous; subcutaneous80 mg/.8mL
Prices
Unit descriptionCostUnit
Lovenox 300 mg/3ml Solution 3ml Vial281.47USD vial
Lovenox 150 mg/ml Solution 1ml Syringe140.94USD syringe
Lovenox 100 mg/ml Solution 1ml Syringe93.93USD syringe
Lovenox 80 mg/0.8ml Solution 0.8ml Syringe75.14USD syringe
Lovenox 60 mg/0.6ml Solution 0.6ml Syringe56.36USD syringe
Lovenox 40 mg/0.4ml Solution 0.4ml Syringe37.53USD syringe
Lovenox Hp (0.8Ml/1Ml Syringe) 150 mg/ml Syringe34.63USD syringe
Lovenox 30 mg/0.3ml Solution 0.3ml Syringe28.15USD syringe
Lovenox (0.4 - 1 Ml Syringe) 100 mg/ml Syringe23.09USD syringe
Lovenox 100 mg/ml23.09USD syringe
Lovenox (0.3 Ml Syringe) 30 mg/syr Syringe6.97USD syringe
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
CountryPatent NumberApprovedExpires (estimated)
Canada20454332002-07-302011-06-25
United States53896181995-02-142012-02-14
Properties
StateSolid
Experimental Properties
PropertyValueSource
water solubility> 200 mg/mLNot Available
logP-13.2Not Available
Predicted PropertiesNot Available
Spectra
Mass Spec (NIST)Not Available
SpectraNot Available
References
Synthesis Reference

Jorgen I. Nielsen, “Process of using light absorption to control enzymatic depolymerization of heparin to produce low molecular weight heparin.” U.S. Patent US5106734, issued May, 1981.

US5106734
General ReferenceNot Available
External Links
ATC CodesB01AB05
AHFS Codes
  • 20:12.04.16
  • 92:00.00
PDB EntriesNot Available
FDA labelDownload (1.44 MB)
MSDSNot Available
Interactions
Drug Interactions
Drug
ApixabanDue to pharmacodynamic interaction, a 50-60% increase in anti-Factor Xa activity may be observed with concomitant therapy.
Drotrecogin alfaCombination should be used with caution after weighing advantages and disadvantages. Low molecular weight heparins such as enoxaparin may increase the adverse effects of drotrecogin. Monitor for bleeding if used concomitantly.
Ginkgo bilobaAdditive anticoagulant/antiplatelet effects may increase bleed risk. Concomitant therapy should be avoided.
TreprostinilThe prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the anticoagulant, Exoxaparin. Monitor for increased bleeding during concomitant thearpy.
Food Interactions
  • Avoid danshen, dong quai, evening primrose oil, gingko, policosanol, willow bark

Targets

1. Antithrombin-III

Kind: protein

Organism: Human

Pharmacological action: yes

Actions: potentiator

Components

Name UniProt ID Details
Antithrombin-III P01008 Details

References:

  1. Peng K, Wang C, Pang BS, Yang YH: [Effects of thrombolysis and anticoagulation on the functions of vascular endothelial cells and coagulation and fibrinolysis in patients with pulmonary thromboembolism] Zhonghua Jie He He Hu Xi Za Zhi. 2005 Sep;28(9):596-9. Pubmed
  2. Lee S, Gibson CM: Enoxaparin in acute coronary syndromes. Expert Rev Cardiovasc Ther. 2007 May;5(3):387-99. Pubmed
  3. Bisio A, Vecchietti D, Citterio L, Guerrini M, Raman R, Bertini S, Eisele G, Naggi A, Sasisekharan R, Torri G: Structural features of low-molecular-weight heparins affecting their affinity to antithrombin. Thromb Haemost. 2009 Nov;102(5):865-73. Pubmed

2. Coagulation factor X

Kind: protein

Organism: Human

Pharmacological action: yes

Actions: inhibitor

Components

Name UniProt ID Details
Coagulation factor X P00742 Details

References:

  1. Graff J, Picard-Willems B, Harder S: Monitoring effects of direct FXa-inhibitors with a new one-step prothrombinase-induced clotting time (PiCT) assay: comparative in vitro investigation with heparin, enoxaparin, fondaparinux and DX 9065a. Int J Clin Pharmacol Ther. 2007 Apr;45(4):237-43. Pubmed
  2. Berges A, Laporte S, Epinat M, Zufferey P, Alamartine E, Tranchand B, Decousus H, Mismetti P: Anti-factor Xa activity of enoxaparin administered at prophylactic dosage to patients over 75 years old. Br J Clin Pharmacol. 2007 Oct;64(4):428-38. Epub 2007 May 17. Pubmed
  3. Sanchez-Pena P, Hulot JS, Urien S, Ankri A, Collet JP, Choussat R, Lechat P, Montalescot G: Anti-factor Xa kinetics after intravenous enoxaparin in patients undergoing percutaneous coronary intervention: a population model analysis. Br J Clin Pharmacol. 2005 Oct;60(4):364-73. Pubmed
  4. Dalmora SL, Junior LB, Schmidt CA, Vaccari SF, Oliveira PR, Codevilla CF: Validation of the anti-factor Xa assay for the potency assessment of enoxaparin in pharmaceutical formulations. J AOAC Int. 2004 Nov-Dec;87(6):1305-8. Pubmed
  5. Paige JT, Gouda BP, Gaitor-Stampley V, Scalia PG, Klainer TE, Raum WJ, Martin LF: No correlation between anti-factor Xa levels, low-molecular-weight heparin, and bleeding after gastric bypass. Surg Obes Relat Dis. 2007 Jul-Aug;3(4):469-75. Epub 2007 Jun 12. Pubmed

Enzymes

1. Myeloperoxidase

Kind: protein

Organism: Human

Pharmacological action: unknown

Actions: Other

Components

Name UniProt ID Details
Myeloperoxidase P05164 Details

References:

  1. Rudolph TK, Rudolph V, Witte A, Klinke A, Szoecs K, Lau D, Heitzer T, Meinertz T, Baldus S: Liberation of vessel adherent myeloperoxidase by enoxaparin improves endothelial function. Int J Cardiol. 2010 Apr 1;140(1):42-7. Epub 2008 Dec 2. Pubmed

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Drug created on June 13, 2005 07:24 / Updated on June 05, 2014 12:17