Lovenox IV

my gut feeling (and confirmed by my various drug guides, CPS) is DON'T GIVE IT and call your hospital pharmacy! all the literature i've seen says it's for sc use only...

Lovenox IV

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Is anyone giving Lovenox IV, we have just had an MD order it and have not given it by this route and the MD could not give us much evidence other than other hospitals are giving it IV as a bolus when starting anticoagulant therapy. Thanks

Haven't heard of IV Lovenox yet. I agree to check with the Pharmacy. (He can always do the IV bolus with good ol' unfractionated heparin)

Just had this discussion on another thread. It's routinely ordered at my hospital on our ACS orders. There was a disagreement on how soon after the IV bolus to give the SC dose. I got some really good information from the drug company. Giving it IV has not been approved by the FDA, so that' why you won't find anything published on it. I will e-mail you the stuff I got, if you want.

Just had this discussion on another thread. It's routinely ordered at my hospital on our ACS orders. There was a disagreement on how soon after the IV bolus to give the SC dose. I got some really good information from the drug company. Giving it IV has not been approved by the FDA, so that' why you won't find anything published on it. I will e-mail you the stuff I got, if you want.

I posted, stayed curious, and found this site from Vancouver. Since that's outside of the US, then the FDA wouldn't have jurisdiction, right?

http://www.vhpharmsci.com/pdtm/Monographs/enoxaparin.htm

Interesting though...I'm going to question a few of my cardiologists & pharmacists to get their thoughts...

Very interesting information on that site. Even with all the info the drug co sent me, there was not info on side effects specific to IV use of Lovenox. Probably because it hasn't been studied. I have given it many times, and never experienced a problem. Before I wrote the company, I spoke to 2 of our pharmacists, and 2 ER docs, and non of them knew anything. Which I think is really interesting, since the ACS protocols call for IMMEDIATE dosing in pts strongly suspected of thrombolytic events. You would think ER docs would be interested in learning more about it. Granted, I only talked to 2.

Without FDA approval for that route, you could be held accountable for giving it in another route if any problem occurred. You also must have approval from your hospital's Pharmacy and Therapeutics Committee to administer it via another route. Just because drug company says that it is okay, it must come from your facility before you can do it and be covered.

Actually, we have an ACS protocol, written by the hospital, that has the order for IV Lovenox. I've never given it IV without an order, or with just a verbal order. I wrote the drug co for information mostly because I could not find any information anywhere on how soon after the IV bolus to give the 1st SC injection. I work nights and the pharmacist didn't know. It is always given immediately after the IV dose in ER, and that is the way I have given it. We had some nurses who were giving it up to 12 hours or more after. Which I found out from the company is not the intended or recommended time frame.

I have seen it being used IV recently in out cath lab of all places...(which makes it a much longer wait for that line pull...)

I have only seen it once or twice and at the time was very surprised by it...I haven't seen the doctor who ordered it yet so I could ask him about it...