Abstract
Enoxaparin is a low-molecular-weight heparin (LMWH) that differs substantially from unfractionated heparin (UFH) in its pharmacodynamic and pharmacokinetic properties. Some of the pharmacodynamic features of enoxaparin that distinguish it from UFH are a higher ratio of anti-Xa to anti-IIa activity, more consistent release of tissue factor pathway inhibitor, weaker interactions with platelets and less inhibition of bone formation. Enoxaparin has a higher and more consistent bioavailability after subcutaneous administration than UFH, a longer plasma half-life and is less strongly bound to plasma proteins. These properties mean that enoxaparin provides a more reliable anticoagulant effect without the need for laboratory monitoring, and also offers the convenience of once-daily administration. Clinical studies have confirmed that these pharmacological advantages translate into improved outcomes. There are important pharmacokinetic and pharmacodynamic differences between enoxaparin, other LMWHs and UFH, and therefore these molecules cannot be regarded as interchangeable.
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Acknowledgements
The expert advice of Dr Dominick Argenti of Johnson and Johnson, Titusville, NJ, USA is gratefully acknowledged. We also acknowledge the expert assistance of Dr Mandy Wong and Dr Jacqueline Mason in the preparation of this manuscript. There were no sources of funding or conflicts of interest directly relevant to the content of this review.
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Fareed, J., Hoppensteadt, D., Walenga, J. et al. Pharmacodynamic and Pharmacokinetic Properties of Enoxaparin. Clin Pharmacokinet 42, 1043–1057 (2003). https://doi.org/10.2165/00003088-200342120-00003
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DOI: https://doi.org/10.2165/00003088-200342120-00003