Lovenox Sub Q...but where!?!

[chenoaspirit, ASN, RN]

I have been told several different things. My manager and a CN told me that Lovenox is only to be given in the flank area or abdomen. Thats how Ive always done it. Well, a new graduate nurse was talking about it and she said anywhere as long as its SubQ, which makes sense and Ive always thought "why does it matter". It kinda made me feel "stupid"! I emailed the company that manufactures the drug, but their response didnt say. Anyone know for sure?!

[RNMom2010]

I was instructed to inject my Lovenox no closer than 2 inches to the umbilicus and to alternate sides each injection. My pham instructor advised us that that is the best route for this SubQ. I have never heard of it being done at any other site.

[jnette, ASN, EMT-I]

Think "Love Handles" when administering Lovenox.

The preferable site to inject, and rotate sites.

I've never heard of it being administered "just anywhere as long as it's SQ."

Lovenox=Lovehandles. :)

[pirap]

When I working Med/Surg just early last year the trauma docs said it was OK to give SC upper legs. Our patient had a lot of abdominal trauma..but if ok for that why not SC anywhere else??

[glasgow3]

The Lovenox maker's web site is quite specific as to the correct administration technique in order to obtain the desired effect. And no, they do NOT recommend just any SQ site.

[MayisontheWay]

Per the package insert:

http://products.sanofi-aventis.us/lovenox/lovenox.html#Boxed%20Warning

Subcutaneous Injection Technique: Patients should be lying down and Lovenox administered by deep SC injection. To avoid the loss of drug when using the 30 and 40 mg prefilled syringes, do not expel the air bubble from the syringe before the injection. Administration should be alternated between the left and right anterolateral and left and right posterolateral abdominal wall. The whole length of the needle should be introduced into a skin fold held between the thumb and forefinger; the skin fold should be held throughout the injection. To minimize bruising, do not rub the injection site after completion of the injection.

May

[imanedrn]

Per the package insert:

http://products.sanofi-aventis.us/lovenox/lovenox.html#Boxed%20Warning

Subcutaneous Injection Technique: Patients should be lying down and Lovenox administered by deep SC injection. To avoid the loss of drug when using the 30 and 40 mg prefilled syringes, do not expel the air bubble from the syringe before the injection. Administration should be alternated between the left and right anterolateral and left and right posterolateral abdominal wall. The whole length of the needle should be introduced into a skin fold held between the thumb and forefinger; the skin fold should be held throughout the injection. To minimize bruising, do not rub the injection site after completion of the injection.

May

While I was still in school, I had an emaciated (Crohn's) patient. He had almost no abdominal fat to pinch. My preceptor told me that the manufacturer did an in-service and stated the above information. Abdomen only. (I believe the reasons have to do with its maximum effects, though I don't remember precisely.) In any case, she told me to pinch as much skin as I could and insert at an angle (as we've learned for SQ with any thin person), but that -- regardless -- it should always be given in the abdomen.

Hope that helps!

[NRSKarenRN, BSN, RN]

Check out the advice in our Med Savvy forum and continue discussion there---over 14,000 views and 63 responses since 2002 so hot topic: Lovenox(enoxaparin) SQ

[SteveNNP, MSN, NP]

I remember always giving it on the abdomen when I worked adults. Here in NICU, we insert an insuflon SQ catheter into the dorsal thigh SQ tissue, so we can give daily doses without repeatedly sticking the infant. (Insuflon catheters are like plastic IV catheters that are inseted SQ, the needle is retracted, and it's taped in place, almost like an insulin pump SQ site.....)