Enoxaparin sodium, sold under the brand name Lovenox among others, is an anticoagulant medication (blood thinner). It is used to treat and prevent deep vein thrombosis (DVT) and pulmonary embolism (PE) including during pregnancy and following certain types of surgery. It is also used in those with acute coronary syndrome (ACS) and heart attacks. It is given by injection just under the skin or into a vein. It is also used during hemodialysis.Common side effects include bleeding, fever, and swelling of the legs. Bleeding may be serious especially in those who are undergoing a spinal tap. Use during pregnancy appears to be safe for the baby. Enoxaparin is in the low molecular weight heparin family of medications.Enoxaparin was first made in 1981 and approved for medical use in 1993. It is on the World Health Organizations List of Essential Medicines. Enoxaparin is sold under several brand names and is available as a generic medication. Enoxaparin is made from heparin. In 2017, it was the 299th most commonly prescribed medication in the United States, with more than one million prescriptions. Medical uses
Treatment of unstable angina (UA) and non-Q-wave myocardial infarction (NQMI), administered concurrently with aspirin
DVT and pulmonary embolism prophylaxis in bed-ridden patients
DVT prophylaxis in knee replacement surgery
DVT prophylaxis in hip replacement surgery
DVT prophylaxis in abdominal surgery
Treatment of DVT with or without pulmonary embolism
Treatment of DVT inpatient, with ST-segment elevation myocardial infarction (STEMI)
Bridging treatment for those with INR below therapeutic range

Monitoring
Enoxaparin has predictable absorption, bioavailability, and distribution therefore monitoring is not typically done.
However, there are instances where monitoring may be beneficial for special populations, for example individuals with kidney insufficiency or those that are obese. In this case, anti-Xa units can be measured and dosing adjusted accordingly. Reversal agent
Protamine sulfate is less effective at reversing enoxaparin compared to heparin, with a maximum neutralization of approximately 60% of the anti-factor Xa effect. Pregnancy
Enoxaparin is a FDA pregnancy category B drug which means enoxaparin is not expected to cause harm to an unborn baby when used during pregnancy. This statement is based on reproductive studies involving pregnant rats and rabbits. No birth defects or toxic effects to an unborn fetus due to enoxaparin were observed during these animals studies. However a humans response to enoxaparin might be different from that of a small animal, therefore enoxaparin should be used during pregnancy only if there is a definite need. Enoxaparin does not cross the placenta therefore it is unlikely an unborn baby would be exposed to it. Some fetal deaths have been reported by women who used enoxaparin during pregnancy, but it is unclear if enoxaparin caused these deaths. Pregnant woman on enoxaparin should be monitored on a regular basis for bleeding and/or "excessive anticoagulation" especially when the delivery date is approaching. The risk of hemorrhage is higher during delivery if the person is still using enoxaparin and this could endanger the life of the baby and/or the mother. The multiple-dose vials of the brand name enoxaparin (Lovenox) contain 15 mg benzyl alcohol per 1 mL as a preservative.