STANDARDIZED ENOXAPARIN (LOVENOX) INPATIENT …

1 STANDARDIZED ENOXAPARIN ( lovenox ) INPATIENT counseling format FOR NURSING AND PHARMACY USE ONLY- NOT TO BE GIVEN TO PATIENTS 1. INDICATION FOR lovenox a. DVT/PE Treatment: You have been prescribed ENOXAPARIN ( lovenox ) to treat a blood clot in your leg/arm/lungs/etc. lovenox is a blood thinner that will help prevent the clot from growing and prevent new clots from forming. b. DVT/PE Prophylaxis: You have been prescribed ENOXAPARIN ( lovenox ) to prevent a blood clot from forming in your leg/arm/lungs/etc while you are in the hospital, recovering from surgery and/or not as mobile as before.

2 C. If patient is also taking warfarin: You have been prescribed ENOXAPARIN ( lovenox ) to prevent blood clots from forming until your warfarin begins to work. Once your physician determines your warfarin is working fully, you will not have to use the lovenox . 2. MONITORING a. We will monitor your blood while you are in the hospital, but minimal monitoring will be needed once you are discharged. 3. HOW TO USE THE MEDICATION a. If you feel comfortable injecting yourself, you can give yourself your own doses. If you do not feel comfortable, have a family member/friend help give you the injection.

3 B. Try to give lovenox and the same time(s) every day. If you forget a dose, take it as soon as you remember. If it is close to the next dose time, skip the dose. Do not double dose! c. To give lovenox , follow the steps below: 1. Whoever administers the dose should wash and dry their hands thoroughly. 2. lovenox is available in a pre-filled syringe. Your dose will be determined by your physician. If your dose is less than the total amount in the syringe, you will need to waste the extra amount from the syringe into a sink or trash can BEFORE giving yourself the dose (nurses and pharmacists: please see the lovenox Dose Rounding and Renal Dosing Protocol for the appropriate volume to waste from the syringe).

4 3. Lie down and find a target area on either the right or left side of your stomach (at least 2 inches from your belly button) or your love handles. Try to use a different side of your body for each dose. Clean the target area with an alcohol wipe and let it dry. If you don t let it dry, the injection may burn/sting. 4. Remove the cap on the lovenox syringe and throw it into the sharps container (red) given to you by WakeMed. 5. Hold the syringe like a pencil in your writing hand. Use your other hand to pinch the skin in your target area between your thumb and your forefinger (pointing finger).

5 Gently push the entire needle into your skin at a 90- degree angle. Press the plunger down all of the way. This will inject all of the drug into your skin. You only need to press the plunger down once to get the full dose. 6. Remove the needle at the same angle that it was inserted (straight in, straight out), then release the pinch of skin. 7. Point the needle down and away from you and press the plunger down fully again to activate the safety covering. Place the entire syringe in a sharps container. When the container is full or you are done taking lovenox , take the container to your physician.

6 Do not throw it in the regular trash! 8. To minimize bruising and pain, do not rub the injection site after completion of the injection. 4. DRUG INTERACTIONS a. Over-the-counter medications: before taking any medication, you should ask your pharmacist or physician if it safe to take it while you re on ENOXAPARIN ( lovenox ). 1. Avoid taking pain relievers such as Aleve (naproxen), Advil/Motrin (ibuprofen) or Excedrin because they can make you more likely to bleed when you re on lovenox . You can take Tylenol (acetaminophen) instead but follow the directions on the box to make sure you don t take more than the recommended amount.

7 2. Avoid all herbal medications because many of them can interact with lovenox and make you more likely to bleed. b. Prescription medications: Always tell all of your physicians that you are on lovenox . 5. ADVERSE EVENTS a. Common: bleeding gums when you brush your teeth or floss, small nose bleeds, menstrual bleeding that is a bit heavier than usual, easy bruising, bruising around injection sites, more bleeding than normal after a small cut. b. Call your physician immediately and/or call 911 if any of the following occur, or if you have any unusual symptom: 1.

8 If you have signs and symptoms of a clot. These can include: severe shortness of breath, unusual swelling of one leg or arm, one leg or arm that is a different color than the other, pain in one leg or arm, inability to move one or both sides of your body, facial drooping, difficulty speaking, dizziness, blurred vision, or sudden severe headaches. 2. If you have signs and symptoms of serious bleeding. These can include: red, dark or coffee colored urine or bowel movements, coughing or vomiting bright red blood, severe headache or stomachache, a cut or nosebleed that will not stop bleeding within 10 minutes or bruising for unknown reasons.

9 3. Since you have a higher chance to bleed, the following situations put you at risk: a serious fall or hit to the head or a car accident. 6. WAYS TO PROTECT YOURSELF WHILE TAKING lovenox a. Be careful when using knives or scissors b. Use an electric razor to shave, as you are less likely to cut yourself c. Use a soft toothbrush d. Use waxed dental floss e. Wear shoes or non-skid socks or slippers in your house to avoid falls