Enoxaparin

• Increased tendency to bleed i.e. time taken for bleeding to stop may be prolonged
Be careful when handling sharp objects such as knives. Avoid situations where you may get cut or knocked, or other activities which may increase your chance of bleeding.
• ​Pain and redness at the injection site

Inform your doctor if any of the following occurs:

• Headache, dizziness or weakness
• Unusual bleeding or if bleeding from a cut ​takes a long time to stop
• Unusual bruising or appearance of large, dark, purple/red patches on the skin
• Pink or brown urine
• Black sticky stools
• Allergic reaction e.g. rash, itch, swelling and breathing difficulty

• Inform your doctor or pharmacist if you are taking any other medication which may increase bleeding risks e.g. warfarin, NSAIDs, anti-platelets.
• Inform your doctor if you suspect or intend for pregnancy.
• Inform all healthcare professionals whom you seek treatment from, including dentists, that you are receiving Enoxaparin.

It is given as a subcutaneous (into the fat tissues under the skin) injection. You may be required to inject once or twice daily. Follow the dosage schedule instructed by your doctor and inject at the same time each day.

Instructions for Injection

1. Wash your hands with soap and water and dry with a clean towel/napkin.
2. Identify the area on the body to inject. This is usually about 2 fingers’ spacing to the left or the right of the belly button where more fatty tissues can be found.
3. Use an alcohol swab to clean the area to be injected. Swab 2-3 times in one direction to ensure that you do not bring the dirt back to where you have swabbed. Allow to dry.
4. Peel the packaging open and take out the syringe.
5. Check the syringe for any particles or discoloration. Do not use if present.
6. Remove the rubber cap by pulling it straight off the syringe. Do not touch the areas covered by the rubber cap with your hands as these areas need to remain clean. Do not pump out the air bubble in the syringe.
7. Depending on the dose prescribed, you may need to discard some contents of the syringe before injecting. If required, follow the markings on the syringe and expel fluid until you get the prescribed dose.
8. Ensure that you are sitting or lying down before injecting.
9. Use your master hand to hold the syringe. If you are administering the injection yourself, grasp the syringe using your thumb and middle finder and leave the index finger free to press the plunger.
10. Using the other hand, pinch the skin around the area to be injected. Do not touch the area you intend to inject and which you have already swabbed. Keep the skin pinched throughout the injection.
11. Insert the needle at a 90 or 45 degrees (for really thin patients) angle. Insert the entire needle.
12. Slowly press the plunger until all the fluid in the syringe has been expelled.
13. While still pinching the flesh, withdraw the needle.
14. Release the area you were previously pinching. Apply firm pressure over the site of injection for 3-5 minutes to avoid bruising. Do not rub the area which you had just injected as this may increase bruising in the area.
15. Dispose the syringe in a hard, puncture-proof container. Do not attempt to re-cap the needle using the rubber cover. Do not throw the exposed needle directly into the dustbin or leave it lying about.
16. Remember to alternate the site of injection. This is to prevent scarring which will make it harder to inject the area and also affect how the medication is released into your body.

If you miss a dose of Enoxaparin, inject it as soon as you remember. If it is too near the next dose, skip the missed dose and go back to your usual dosing times. Do not double dose.

If you overdose on this medication, inform your doctor immediately.

​Be careful to hold the syringe securely. Do not point the needle at anyone when uncapped.

Refer to point 15 of Instructions for Injection.