lovenox while on heparin drip

[tojal1989]

A patient with heparin drip was admitted to my floor. The doctor ordered lovenox (enoxaparin) SQ also. Is it safe to administer it while on heparin drip???

I didnt until I contacted the doc, considering there wasnt a heparin protocol ordered for the patient in the first place. Doc was hard to get a hold of, and it was the end of my shift so had to hand-off the problem to the next nurse... hate doing that.

[DemonWings]

Lovenox takes a little time to start working, so in the mean time we use heparin drips as needed and it is safe as long as you monitor the appropriate coags, if the coags are out of whack then contact the doctor for further orders, remember coags can sometimes be 2 times higher then the normal range for the desired effect.

sorry if this posts twice, I clicked something and my reply disappeared

[agldragonRN]

i posted a similar question last year and got helpful info.

here is the link: https://allnurses.com/general-nursing-discussion/heparin-lovenox-together-633469.html

[MunoRN, RN]

Heparin and Lovenox should not be given together except in very rare cases where there are no other options. I know I've seen multiple ISMP reports on this in the past (bleeding deaths, acute CVA's, etc) but my admittedly lazy google search produced only this: http://www.ismp.org/hazardalerts/HeparinAlert.asp

[shortstuff_RN]

Pharmacy usually will do heparin and coumadin dosing. What was the patient receiving heparin for? DVT/PE? Heparin is started for immediate anticoagulation and if the patient will need to be on long term anticoagulation, lovenox can be used (usually it's one dose) before the heparin is discontinued and coumadin is started, and the until therapetic PT/INR is achieved.

[KelRN215, BSN, RN]

At my facility if a patient is on a heparin drip, the 1st dose of lovenox is given while the drip is still running and then the drip is turned off 2 hours later. At least that's how we did it with my last patient who was on a heparin drip.