If your doctor has determined that at-home self-injections are appropriate for you, your doctor, nurse, or pharmacist will provide you with detailed, hands on training on how to give your own injections. You will also be instructed on how often to give your injections. It is very important to use Enoxaparin Sodium Injection exactly as prescribed.
The information below provides general instructions on giving self-injections of Enoxaparin Sodium Injection. Be sure to follow any specific instructions provided by your healthcare professional.
Please have the following materials available prior to beginning your injection:
- Enoxaparin pre-filled syringe
- Alcohol swabs
- Disposal container for sharps
1- Wash and dry hands thoroughly.
2- Check the liquid medicine in the syringe before you give your injection. The liquid in the syringe should look clear, colorless to slightly yellow. If the liquid is cloudy or contains any particles, do not use the syringe and throw it away in the sharps disposal container. Consult your healthcare provider for replacement instructions.
3- Lie in a comfortable position with abdomen in view.
4- Identify the injection site on the left or right side of the abdomen (approximately 3 inches from the belly button). Be sure to alternate injection sites each day and to give injections at the same time every day. Do not inject into muscle and avoid injecting into bruised or scarred skin areas.
5- Clean the injection site with an alcohol swab and let dry completely.
6- Remove the needle shield by pulling it straight off the syringe.
Be careful not to twist off the needle cap as it can damage the needle. Do not expel the air bubble from the syringe.
7- Using your writing hand, hold the syringe like a pencil. Using your other hand, grab the cleansed injection site with your thumb and forefinger to make a fold in the skin. Ensure the whole length of the needle is inserted straight into the skin fold.
Hold the skin fold throughout the injection. Press the plunger of the syringe until the contents are empty.
8- While holding in the plunger rod, remove the syringe from the injection site.
9- With the needle pointed away from yourself and others, activate the safety system by firmly pushing the plunger rod. Activation of the safety system may cause minimal splatter of fluid. The protective sleeve will automatically cover the needle and an audible "click" will be heard to confirm the needle is covered by the shield.
The safety system can only be activated once the syringe has been emptied and removed from the skin. Do not replace the needle shield after injection
10- Immediately dispose of the syringe in the nearest sharps container.
There may be specific laws in your state about how to dispose of needle disposal. Check with your doctor, nurse, pharmacist, or your county or local Department of Municipal Waste for more information.
Enoxaparin sodium injection is a prescription medicine used to:
- Reduce the risk of blood clots that may develop with abdominal, hip, or knee surgery, or as a result of limited movement ability during an acute illness.
- Treat blood clots that may be formed in a deep vein, known as deep vein thrombosis (DVT) that usually occurs in the legs.
Important Safety Information
People who take a blood thinner medicine (anticoagulant) like enoxaparin sodium injection, and have medicine injected into their spinal and epidural area, or have a spinal puncture, have a risk of forming a blood clot that can cause long-term or permanent loss of the ability to move (paralysis). Your risk of developing a spinal or epidural blood clot is higher if:
- A thin tube called an epidural catheter is placed in your back to give you certain medicine.
- You take non-steroidal anti-inflammatory drugs (NSAIDs) or a medicine to prevent blood from clotting.
- You have a history of difficult or repeated epidural or spinal punctures.
- You have a history of problems with your spine or have had surgery on your spine.
If you take enoxaparin sodium injection and receive spinal anesthesia or have a spinal puncture, your doctor should watch you closely for symptoms of spinal or epidural blood clots. Tell your doctor right away if you have back pain, tingling, numbness, muscle weakness (especially in your legs and feet), or loss of control of the bowels or bladder (incontinence).
Do not take enoxaparin sodium injection if you are bleeding; have low platelet counts (thrombocytopenia); or have had an allergic reaction (such as itching, hives, or difficulty breathing) to enoxaparin, heparin, or pork products.
Enoxaparin sodium injection may cause excessive bleeding, which can be serious and, in some cases, life-threatening. People who have recently had certain medical procedures, or have uncontrolled high blood pressure, stomach ulcers, diabetes with vision problems, or kidney problems may have an increased risk of bleeding.
Call your doctor or get medical help right away if you develop any of these signs or symptoms of bleeding:
Unexpected bleeding or bleeding that lasts a long time, such as:
- Nosebleeds that happen often
- Unusual bleeding from gums
- Menstrual bleeding that is heavier than normal, or vaginal bleeding
- Bleeding that is severe or that you cannot control
- Red, pink, or brown urine
- Bright red or black stools (looks like tar)
- Cough up blood or blood clots
- Vomit blood or your vomit looks like "coffee grounds"
- Headaches, feeling dizzy or weak
- Pain, swelling, or new drainage at wound sites
While taking enoxaparin sodium injection you may bruise more easily and it may take longer for bleeding to stop. These may be symptoms of low platelet counts. Tell your doctor right away if you have any bruising, a rash or dark red spots under the skin, or feel unusually tired while taking enoxaparin sodium injection.
Enoxaparin sodium injection may increase your risk of bleeding if used while taking other medicines that may increase your risk of bleeding, such as warfarin, aspirin, ibuprofen and NSAIDs, or clopidogrel and other medicines used to prevent or treat blood clots. Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, such as aspirin or other NSAIDs.
Tell all of your doctors and dentists that you are taking enoxaparin sodium injection. They should talk to the doctor who prescribed enoxaparin sodium injection for you before you have any surgery, medical or dental procedure. In an emergency, have family members tell emergency room staff that you are taking enoxaparin.
Take enoxaparin sodium injection exactly as prescribed by your doctor. Do not stop taking enoxaparin sodium injection without talking to your doctor. Enoxaparin sodium injection should not be substituted with other heparin or blood thinner medicines.
Enoxaparin sodium injection may cause side effects at the site of injection, including mild skin irritation, redness, and bruising. The most common side effects of enoxaparin sodium injection include bleeding, anemia, a drop in platelet counts, increased liver enzymes, diarrhea, and nausea, skin discoloration due to bleeding underneath, fever, swelling, shortness of breath, confusion, and injection site pain.
Tell your doctor if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of enoxaparin sodium injection. For more information, ask your doctor or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at www.fda.gov/medwatch or 1-800-FDA-1088.