Sunday December 18, 2005
Enoxaparin (Lovenox) dose in obesity

There is no standard guidelines so far available for Lovenox dose in obesity (particularly beyond 150 kg). Best way is to manage it through anti-factor Xa levels (The target therapeutic range is 0.6-1.0 IU/ml - draw 4 hours after 3rd dose). But many hospitals don't have anti-factor Xa levels available or turn around time is too long. One crude way is to dose per "adjusted body weight".

ABW = IBW + 0.4 [TBW – IBW]

ABW = Adjusted body weight
IBW = Ideal body weight
TBW = Total body weight

* Obesity is defined as a BMI >30kg/m2

Reference: Click to get abstract/article
1. Drug Use Criteria for Low Molecular Weight Heparins and Fondaparinux - Source visn21.med.va.gov