Enoxaparin

Identification

Summary

Enoxaparin is a low molecular weight heparin used for the prophylaxis of deep vein thrombosis and ischemic complications of unstable angina and non-Q-wave myocardial infarction.

Brand Names
Lovenox
Generic Name
Enoxaparin
DrugBank Accession Number
DB01225
Background

Enoxaparin is a common low-molecular-weight heparin (LMWH) used in the prevention and management of various thromboembolic disorders. Initially approved by the FDA in 1993, it is administered by a subcutaneous or intravenous injection and marketed by several pharmaceutical companies.10 Enoxaparin markedly reduces the incidence of venous thromboembolism in hospitalized patients when compared to unfractionated heparin, without increasing the risk of serious bleeding.5,7

Type
Small Molecule
Groups
Approved
Synonyms
Not Available

Pharmacology

Indication

Enoxaparin is indicated for the prevention of ischemic complications in unstable angina and in non Q-wave myocardial infarction; it is indicated in conjunction with percutaneous intervention and/or other treatment for the management of acute ST elevation myocardial infarction. 10

Enoxaparin is also indicated in the prophylaxis of DVT in abdominal surgery, hip replacement, knee replacement, or medical patients with severely restricted mobility during acute illness. Additionally, enoxaparin is indicated for the inpatient treatment of DVT with or without pulmonary embolism and the treatment of outpatient DVT without pulmonary embolism.10

Pharmacology
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Associated Conditions
Associated Therapies
Contraindications & Blackbox Warnings
Contraindications
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Pharmacodynamics

This drug has an immediate onset of action.11 Enoxaparin increases Thrombin Time (TT) and activated partial thromboplastin time (aPTT), preventing and reducing thromboembolic complications such as DVT, pulmonary embolism, and ischemic cardiac complications.1 Administered at 1.5 mg/kg subcutaneously in a pharmacodynamic study, enoxaparin led to a higher ratio of anti-Factor Xa to anti-Factor IIa activity (mean ±SD, 14.0±3.1) (based on areas under anti-Factor activity versus time curves) when compared to that of heparin (mean ±SD, 1.22±0.13). Increases in the TT and aPTT were 1.8 times those of the control group.10 Enoxaparin at 1 mg/kg subcutaneously every 12 hours led to aPTT values of 45 seconds or less in most patients. Average aPTT prolongation time on Day 1 was approximately 16% higher than on Day 4 of enoxaparin therapy.10

Caution is advised during treatment with enoxaparin - the risk of hemorrhage and thrombocytopenia is increased. In pregnant women with prosthetic mechanic heart valves, the risk of thromboembolism is increased.10

Mechanism of action

Enoxaparin binds to antithrombin III, a serine protease inhibitor, forming a complex that irreversibly inactivates factor Xa, which is frequently used to monitor anticoagulation in the clinical setting.8 Following factor Xa inactivation, enoxaparin is released and binds to other anti-thrombin molecules. Factor IIa (thrombin) is directly inhibited by enoxaparin, however with less potency than unfractionated heparin (UFH). 6 Due to the cascade of effects resulting from enoxaparin binding, thrombin is unable to convert fibrinogen to fibrin and form a clot, preventing thromboembolic events.

TargetActionsOrganism
AAntithrombin-III
potentiator
Humans
ACoagulation factor X
inhibitor
Humans
UProthrombin
inhibitor
Humans
Absorption

Mean absolute bioavailability of enoxaparin, after 1-2 mg/kg given subcutaneously is approximately 100% in healthy volunteers. The absorption of enoxaparin is proportional to the dose, demonstrating linear absorption. The average maximum plasma anti-Xa activity is reached 3 to 5 hours after a subcutaneous injection.9,12 A 30 mg IV bolus preceding an immediate 1 mg/kg SC every twice a day led to maximum anti-Factor Xa levels of 1.16 IU/mL. Steady-state is reached within 3-4 days9 of treatment with a Cmax of 1.2 IU/mL.12 The AUC under the thrombin generation curve was 305 +/- 48.8

Volume of distribution

The volume of distribution of enoxaparin is approximately 4-5L, similar to normal blood volume.10,12

Protein binding

Enoxaparin binds to antithrombin III.12 The percentage of plasma protein binding for enoxaparin is not readily available in the literature.

Metabolism

Enoxaparin is mainly metabolized by the liver via desulfation and/or depolymerization to lower and less potent molecular weight metabolites.10,12

Route of elimination

Enoxaparin is mainly excreted by the kidneys.4 Renal clearance of active fragments represents about 10% of the administered dose and total renal excretion of active and non-active fragments 40% of the dose.12

Half-life

The half-life of enoxaparin is about 4 hours after a single dose administered subcutaneously and about 7 hours after several doses.12 One source mentions a half-life ranging from 1 hour to 4.5 hours.9

Clearance

The mean clearance of enoxaparin is 0.74 L/h after a 1.5 mg/kg intravenous infusion over 6 hours12; clearance of enoxaparin is significantly decreased in patients with severe renal impairment.2

Adverse Effects
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Toxicity

The oral LD50 for enoxaparin in mice is >5000 mg/kg; the subcutaneous LD50 of enoxaparin in mice is >2500 mg/kg.13 Accidental overdose after the administration of enoxaparin may cause hemorrhage. Enoxaparin administered by injection is mainly neutralized by gradual intravenous injection of a 1% protamine sulfate solution. The dose of protamine sulfate should be equal to the dose of enoxaparin administered: 1 mg protamine sulfate for 1 mg enoxaparin, of enoxaparin was administered in the previous 8 hours. If a minimum of 12 hours has passed since the last enoxaparin dose, protamine may not be necessary; it is important to avoid an overdose with protamine, as fatal reactions may occur.10

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbciximabThe risk or severity of bleeding can be increased when Abciximab is combined with Enoxaparin.
AcebutololThe risk or severity of hyperkalemia can be increased when Acebutolol is combined with Enoxaparin.
AceclofenacThe risk or severity of bleeding and hemorrhage can be increased when Aceclofenac is combined with Enoxaparin.
AcemetacinThe risk or severity of bleeding and hemorrhage can be increased when Acemetacin is combined with Enoxaparin.
AcenocoumarolThe risk or severity of bleeding can be increased when Enoxaparin is combined with Acenocoumarol.
Acetylsalicylic acidAcetylsalicylic acid may increase the anticoagulant activities of Enoxaparin.
Albutrepenonacog alfaThe therapeutic efficacy of Albutrepenonacog alfa can be decreased when used in combination with Enoxaparin.
AlclofenacThe risk or severity of bleeding and hemorrhage can be increased when Alclofenac is combined with Enoxaparin.
AldesleukinThe risk or severity of bleeding can be increased when Enoxaparin is combined with Aldesleukin.
AlemtuzumabThe risk or severity of bleeding can be increased when Enoxaparin is combined with Alemtuzumab.
Interactions
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Food Interactions
  • Avoid herbs and supplements with anticoagulant/antiplatelet activity. Examples include garlic, ginger, bilberry, danshen, piracetam, and ginkgo biloba.

Products

Products
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Product Ingredients
IngredientUNIICASInChI Key
Enoxaparin sodium8NZ41MIK1O679809-58-6Not applicable
Product Images
International/Other Brands
Clexane
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
InclunoxSolution40 mg / 0.4 mLIntravenous; SubcutaneousSandoz Canada Incorporated2021-05-04Not applicableCanada flag
InclunoxSolution80 mg / 0.8 mLIntravenous; SubcutaneousSandoz Canada Incorporated2021-05-04Not applicableCanada flag
InclunoxSolution30 mg / 0.3 mLIntravenous; SubcutaneousSandoz Canada Incorporated2021-06-21Not applicableCanada flag
InclunoxSolution60 mg / 0.6 mLIntravenous; SubcutaneousSandoz Canada Incorporated2021-05-04Not applicableCanada flag
InclunoxSolution100 mg / 1 mLIntravenous; SubcutaneousSandoz Canada Incorporated2021-05-04Not applicableCanada flag
Inclunox HpSolution150 mg / 1 mLIntravenous; SubcutaneousSandoz Canada Incorporated2021-05-04Not applicableCanada flag
Inclunox HpSolution120 mg / 0.8 mLIntravenous; SubcutaneousSandoz Canada Incorporated2021-05-04Not applicableCanada flag
InhixaInjection, solution40 mg/0.4mLTechdow Pharma Netherlands B.V.2021-01-12Not applicableEU flag
InhixaInjection, solution40 mg/0.4mLTechdow Pharma Netherlands B.V.2021-01-12Not applicableEU flag
InhixaInjection, solution60 mg/0.6mLTechdow Pharma Netherlands B.V.2021-01-12Not applicableEU flag
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Enoxaparin sodiumInjection120 mg/0.8mLSubcutaneousWinthrop U.S.2011-10-03Not applicableUS flag
Enoxaparin SodiumInjection100 mg/1mLSubcutaneousAmphastar Pharmaceuticals, Inc.2011-09-19Not applicableUS flag
Enoxaparin SodiumInjection100 mg/1mLSubcutaneousAmphastar Pharmaceuticals, Inc.2011-09-19Not applicableUS flag
Enoxaparin SodiumInjection100 mg/1mLSubcutaneousSandoz Inc2010-07-23Not applicableUS flag
Enoxaparin SodiumInjection100 mg/1mLSubcutaneousNorthStar Rx LLC2019-12-01Not applicableUS flag
Enoxaparin SodiumInjection80 mg/0.8mLSubcutaneousApotex Corp.2019-01-31Not applicableUS flag
Enoxaparin SodiumInjection, solution30 mg/0.3mLIntravenous; SubcutaneousTeva Parenteral Medicines, Inc.2014-12-19Not applicableUS flag
Enoxaparin SodiumInjection, solution30 mg/0.3mLIntravenous; SubcutaneousItalfarmaco SpA2021-04-01Not applicableUS flag
Enoxaparin sodiumInjection80 mg/0.8mLSubcutaneousWinthrop U.S.2011-10-03Not applicableUS flag
Enoxaparin SodiumInjection150 mg/1mLSubcutaneousAmphastar Pharmaceuticals, Inc.2011-09-19Not applicableUS flag

Categories

ATC Codes
B01AB05 — Enoxaparin
Drug Categories
Classification
Not classified
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
E47C0NF7LV
CAS number
9005-49-6

References

Synthesis Reference

Jorgen I. Nielsen, "Process of using light absorption to control enzymatic depolymerization of heparin to produce low molecular weight heparin." U.S. Patent US5106734, issued May, 1981.

US5106734
General References
  1. Iqbal Z, Cohen M: Enoxaparin: a pharmacologic and clinical review. Expert Opin Pharmacother. 2011 May;12(7):1157-70. doi: 10.1517/14656566.2011.570261. Epub 2011 Apr 7. [Article]
  2. Sanderink GJ, Guimart CG, Ozoux ML, Jariwala NU, Shukla UA, Boutouyrie BX: Pharmacokinetics and pharmacodynamics of the prophylactic dose of enoxaparin once daily over 4 days in patients with renal impairment. Thromb Res. 2002 Feb 1;105(3):225-31. doi: 10.1016/s0049-3848(02)00031-2. [Article]
  3. Azizi M, Veyssier-Belot C, Alhenc-Gelas M, Chatellier G, Billaud-Mesguish E, Fiessinger JN, Aiach M: Comparison of biological activities of two low molecular weight heparins in 10 healthy volunteers. Br J Clin Pharmacol. 1995 Dec;40(6):577-84. [Article]
  4. Bruno R, Baille P, Retout S, Vivier N, Veyrat-Follet C, Sanderink GJ, Becker R, Antman EM: Population pharmacokinetics and pharmacodynamics of enoxaparin in unstable angina and non-ST-segment elevation myocardial infarction. Br J Clin Pharmacol. 2003 Oct;56(4):407-14. doi: 10.1046/j.1365-2125.2003.01904.x. [Article]
  5. Laporte S, Liotier J, Bertoletti L, Kleber FX, Pineo GF, Chapelle C, Moulin N, Mismetti P: Individual patient data meta-analysis of enoxaparin vs. unfractionated heparin for venous thromboembolism prevention in medical patients. J Thromb Haemost. 2011 Mar;9(3):464-72. doi: 10.1111/j.1538-7836.2011.04182.x. [Article]
  6. Nutescu EA, Burnett A, Fanikos J, Spinler S, Wittkowsky A: Pharmacology of anticoagulants used in the treatment of venous thromboembolism. J Thromb Thrombolysis. 2016 Jan;41(1):15-31. doi: 10.1007/s11239-015-1314-3. [Article]
  7. Hofmann T: Clinical application of enoxaparin. Expert Rev Cardiovasc Ther. 2004 May;2(3):321-37. doi: 10.1586/14779072.2.3.321. [Article]
  8. Wei MY, Ward SM: The Anti-Factor Xa Range For Low Molecular Weight Heparin Thromboprophylaxis. Hematol Rep. 2015 Nov 23;7(4):5844. doi: 10.4081/hr.2015.5844. eCollection 2015 Nov 23. [Article]
  9. Dawes J: Comparison of the pharmacokinetics of enoxaparin (Clexane) and unfractionated heparin. Acta Chir Scand Suppl. 1990;556:68-74. [Article]
  10. FDA Approved Drug Products: Lovenox (enoxaparin sodium injection), for subcutaneous and intravenous use [Link]
  11. NIH StatPearls: Enoxaparin [Link]
  12. Medsafe NZ Datasheet: CLEXANE AND CLEXANE FORTE (enoxaparin sodium) for injection [Link]
  13. Pfizer: Enoxaparin sodium MSDS [Link]
Human Metabolome Database
HMDB14551
KEGG Drug
D07510
PubChem Substance
46507450
ChemSpider
751
RxNav
67108
ChEMBL
CHEMBL1201685
Therapeutic Targets Database
DAP000616
PharmGKB
PA449463
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Enoxaparin_sodium

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4Active Not RecruitingTreatmentAcute Coronary Syndrome (ACS) / Myocardial Infarction / Myocardial Ischemia / Unstable Angina Pectoris1
4CompletedPreventionAcute Coronary Syndrome (ACS)1
4CompletedPreventionAcute Ischemic Stroke (AIS)1
4CompletedPreventionAnticoagulants / BMI >30 kg/m2 / Thrombosis, Venous1
4CompletedPreventionAntiphospholipid Syndrome / Recurrent Miscarriages1
4CompletedPreventionDeep Vein Thrombosis / Pulmonary Embolism / Venous Thromboembolism Diseases1
4CompletedPreventionDeteriorating renal function / Venous Thromboembolism1
4CompletedPreventionEnoxaparin / Placental Insufficiency1
4CompletedPreventionFracture of Neck of Femur / Necrosis of Femoral Head / Osteoarthritis in the Hip Joint1
4CompletedPreventionInflammation1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
  • Cardinal Health
  • Lake Erie Medical and Surgical Supply
  • Neuman Distributors Inc.
  • Physicians Total Care Inc.
  • Sanofi-Aventis Inc.
Dosage Forms
FormRouteStrength
SolutionIntravenous; Subcutaneous100 mg
SolutionIntravenous; Subcutaneous300 mg
Injection, solutionParenteral10.000 IE
Injection, solutionParenteral100 MG/1ML
Injection, solutionParenteral10000 IE/1ML
Injection, solutionParenteral20 MG/0.2ML
Injection, solutionParenteral2000 IE/0.2ML
Injection, solutionParenteral4.000 IE
SolutionIntra-arterial; Intravenous; Subcutaneous40 mg
Injection, solutionParenteral4000 IE/0.4ML
Injection, solutionParenteral4000 I.E./0.4ML
Injection, solutionParenteral40 MG/0.4ML
Injection, solutionParenteral4000 IE
Injection, solutionParenteral6.000 IE
InjectionSubcutaneous
Injection, solutionParenteral6000 I.E./0.6ML
Injection, solutionParenteral60 MG/0.6ML
Injection, solutionParenteral6000 IE
Injection, solutionParenteral6000 IE/0.6ML
Injection, solutionParenteral60 MG
Injection, solutionParenteral8.000 IE
Injection, solutionParenteral8000 I.E./0.8ML
Injection, solutionParenteral80 MG/0.8ML
Injection, solutionParenteral8000 IE/0.8ML
Injection, solutionParenteral80 MG
SolutionIntra-arterial; Intravenous; Subcutaneous80 mg
SolutionSubcutaneous100 mg
SolutionIntra-arterial; Intravenous; Subcutaneous20 mg
SolutionIntra-arterial; Intravenous; Subcutaneous60 mg
Injection, solutionIntravenous; Parenteral
Injection, solutionSubcutaneous
SolutionIntra-arterial; Intravenous; Subcutaneous100 mg
Injection, solutionParenteral
Injection, solutionParenteral10000 IE
Injection, solutionParenteral2000 IE
Injection, solutionParenteral8000 IE
Injection, solution100 mg/1ml
InjectionIntravenous; Subcutaneous300 mg/3mL
InjectionSubcutaneous100 mg/1mL
InjectionSubcutaneous120 mg/0.8mL
InjectionSubcutaneous150 mg/1mL
InjectionSubcutaneous30 mg/0.3mL
InjectionSubcutaneous300 mg/3mL
InjectionSubcutaneous40 mg/0.4mL
InjectionSubcutaneous60 mg/0.6mL
InjectionSubcutaneous80 mg/0.8mL
Injection, solutionIntravenous; Subcutaneous100 mg/1mL
Injection, solutionIntravenous; Subcutaneous120 mg/0.8mL
Injection, solutionIntravenous; Subcutaneous150 mg/1mL
Injection, solutionIntravenous; Subcutaneous30 mg/0.3mL
Injection, solutionIntravenous; Subcutaneous40 mg/0.4mL
Injection, solutionIntravenous; Subcutaneous60 mg/0.6mL
Injection, solutionIntravenous; Subcutaneous80 mg/0.8mL
Solution100 mg/1ml
SolutionSubcutaneous
SolutionIntravenous; Subcutaneous20 mg
SolutionHemodialysis; Intravenous; Subcutaneous80 mg
SolutionSubcutaneous20 mg
SolutionSubcutaneous60 mg
SolutionIntravenous; Subcutaneous40 mg
SolutionSubcutaneous80 mg
SolutionHemodialysis; Intravenous; Subcutaneous60 mg
SolutionIntravenous; Subcutaneous60 mg
SolutionIntravenous; Subcutaneous80 mg
Injection, solutionParenteral10000 IU
Injection, solutionParenteral2000 IU
Injection, solutionParenteral4000 IU
Injection, solutionParenteral6000 IU
Injection, solutionParenteral8000 IU
SolutionIntravenous; Subcutaneous100 mg / 1 mL
SolutionIntravenous; Subcutaneous150 mg / 1 mL
Injection, solution1000 mg/10mL
Injection, solution120 mg/0.8mL
Injection, solution150 mg/1mL
Injection, solution20 mg/0.2mL
Injection, solution300 mg/3mL
Injection, solution40 mg/0.4mL
Injection, solution500 mg/5mL
Injection, solution60 mg/0.6mL
Injection, solution80 mg/0.8mL
Injection, solutionEpidural; Intravenous bolus; Subcutaneous
Injection, solutionExtracorporeal; Parenteral
Injection, solutionParenteral; Subcutaneous
Injection, solutionParenteral100 mg/ml
Injection, solutionParenteral100 MG
Injection, solutionParenteral40 MG
Injection
InjectionIntravenous; Subcutaneous100 mg/1mL
InjectionIntravenous; Subcutaneous120 mg/0.8mL
InjectionIntravenous; Subcutaneous30 mg/0.3mL
InjectionIntravenous; Subcutaneous40 mg/0.4mL
InjectionIntravenous; Subcutaneous60 mg/0.6mL
InjectionIntravenous; Subcutaneous80 mg/0.8mL
SolutionSubcutaneous100 mg / mL
SolutionSubcutaneous30 mg / 0.3 mL
SolutionSubcutaneous40 mg / 0.4 mL
SolutionSubcutaneous60 mg / 0.6 mL
SolutionSubcutaneous80 mg / 0.8 mL
Injection, solution
Injection, solutionParenteral10000 IU/mL
Injection, solutionParenteral100 MG/1.0ML
Injection, solutionParenteral2000 IU/0.2mL
Injection, solutionParenteral20 MG
Injection, solutionParenteral4000 IU/0.4mL
Injection, solutionParenteral6000 IU/0.6mL
Injection, solutionParenteral8000 IU/0.8mL
SolutionSubcutaneous120 mg / 0.8 mL
SolutionSubcutaneous150 mg / mL
SolutionSubcutaneous90 mg / 0.6 mL
SolutionIntravenous; Subcutaneous100 mg / mL
SolutionIntravenous; Subcutaneous20 mg / 0.2 mL
SolutionIntravenous; Subcutaneous30 mg / 0.3 mL
SolutionIntravenous; Subcutaneous40 mg / 0.4 mL
SolutionIntravenous; Subcutaneous60 mg / 0.6 mL
SolutionIntravenous; Subcutaneous80 mg / 0.8 mL
SolutionIntravenous; Subcutaneous120 mg / 0.8 mL
SolutionIntravenous; Subcutaneous150 mg / mL
SolutionSubcutaneous40 mg
SolutionSubcutaneous
SolutionIntravenous; Subcutaneous300 mg / 3 mL
Injection, solutionIntraluminal; Intravenous; Subcutaneous
Prices
Unit descriptionCostUnit
Lovenox 300 mg/3ml Solution 3ml Vial281.47USD vial
Lovenox 150 mg/ml Solution 1ml Syringe140.94USD syringe
Lovenox 100 mg/ml Solution 1ml Syringe93.93USD syringe
Lovenox 80 mg/0.8ml Solution 0.8ml Syringe75.14USD syringe
Lovenox 60 mg/0.6ml Solution 0.6ml Syringe56.36USD syringe
Lovenox 40 mg/0.4ml Solution 0.4ml Syringe37.53USD syringe
Lovenox Hp (0.8Ml/1Ml Syringe) 150 mg/ml Syringe34.63USD syringe
Lovenox 30 mg/0.3ml Solution 0.3ml Syringe28.15USD syringe
Lovenox (0.4 - 1 Ml Syringe) 100 mg/ml Syringe23.09USD syringe
Lovenox 100 mg/ml23.09USD syringe
Lovenox (0.3 Ml Syringe) 30 mg/syr Syringe6.97USD syringe
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)Region
US5389618No1995-02-142012-02-14US flag
CA2045433No2002-07-302011-06-25Canada flag

Properties

State
Solid
Experimental Properties
PropertyValueSource
water solubility50 g/Lhttps://imgcdn.mckesson.com/CumulusWeb/Click_and_learn/SDS_SANOFI_LOVENOX.pdf
logP-1.7https://hmdb.ca/metabolites/HMDB0014551
logS-2https://hmdb.ca/metabolites/HMDB0014551
pKa-2.8https://hmdb.ca/metabolites/HMDB0014551
Predicted Properties
Not Available
Predicted ADMET Features
PropertyValueProbability
Human Intestinal Absorption-0.9215
Blood Brain Barrier-0.8366
Caco-2 permeable-0.6496
P-glycoprotein substrateNon-substrate0.698
P-glycoprotein inhibitor INon-inhibitor0.5818
P-glycoprotein inhibitor IINon-inhibitor0.9771
Renal organic cation transporterNon-inhibitor0.9454
CYP450 2C9 substrateNon-substrate0.6694
CYP450 2D6 substrateNon-substrate0.8196
CYP450 3A4 substrateNon-substrate0.5842
CYP450 1A2 substrateNon-inhibitor0.8157
CYP450 2C9 inhibitorNon-inhibitor0.771
CYP450 2D6 inhibitorNon-inhibitor0.8869
CYP450 2C19 inhibitorNon-inhibitor0.7655
CYP450 3A4 inhibitorNon-inhibitor0.9194
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.9232
Ames testNon AMES toxic0.5957
CarcinogenicityNon-carcinogens0.694
BiodegradationNot ready biodegradable0.851
Rat acute toxicity2.3846 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9589
hERG inhibition (predictor II)Non-inhibitor0.7157
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
Not Available

Targets

Drugtargets
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Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Potentiator
General Function
Serine-type endopeptidase inhibitor activity
Specific Function
Most important serine protease inhibitor in plasma that regulates the blood coagulation cascade. AT-III inhibits thrombin, matriptase-3/TMPRSS7, as well as factors IXa, Xa and XIa. Its inhibitory a...
Gene Name
SERPINC1
Uniprot ID
P01008
Uniprot Name
Antithrombin-III
Molecular Weight
52601.935 Da
References
  1. Peng K, Wang C, Pang BS, Yang YH: [Effects of thrombolysis and anticoagulation on the functions of vascular endothelial cells and coagulation and fibrinolysis in patients with pulmonary thromboembolism]. Zhonghua Jie He He Hu Xi Za Zhi. 2005 Sep;28(9):596-9. [Article]
  2. Lee S, Gibson CM: Enoxaparin in acute coronary syndromes. Expert Rev Cardiovasc Ther. 2007 May;5(3):387-99. [Article]
  3. Bisio A, Vecchietti D, Citterio L, Guerrini M, Raman R, Bertini S, Eisele G, Naggi A, Sasisekharan R, Torri G: Structural features of low-molecular-weight heparins affecting their affinity to antithrombin. Thromb Haemost. 2009 Nov;102(5):865-73. doi: 10.1160/TH09-02-0081. [Article]
  4. NIH StatPearls: Enoxaparin [Link]
Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Inhibitor
Curator comments
The effects of enoxaparin on factor X occur due to downstream effects after binding to antithrombin III.
General Function
Serine-type endopeptidase activity
Specific Function
Factor Xa is a vitamin K-dependent glycoprotein that converts prothrombin to thrombin in the presence of factor Va, calcium and phospholipid during blood clotting.
Gene Name
F10
Uniprot ID
P00742
Uniprot Name
Coagulation factor X
Molecular Weight
54731.255 Da
References
  1. Graff J, Picard-Willems B, Harder S: Monitoring effects of direct FXa-inhibitors with a new one-step prothrombinase-induced clotting time (PiCT) assay: comparative in vitro investigation with heparin, enoxaparin, fondaparinux and DX 9065a. Int J Clin Pharmacol Ther. 2007 Apr;45(4):237-43. [Article]
  2. Berges A, Laporte S, Epinat M, Zufferey P, Alamartine E, Tranchand B, Decousus H, Mismetti P: Anti-factor Xa activity of enoxaparin administered at prophylactic dosage to patients over 75 years old. Br J Clin Pharmacol. 2007 Oct;64(4):428-38. Epub 2007 May 17. [Article]
  3. Sanchez-Pena P, Hulot JS, Urien S, Ankri A, Collet JP, Choussat R, Lechat P, Montalescot G: Anti-factor Xa kinetics after intravenous enoxaparin in patients undergoing percutaneous coronary intervention: a population model analysis. Br J Clin Pharmacol. 2005 Oct;60(4):364-73. [Article]
  4. Dalmora SL, Junior LB, Schmidt CA, Vaccari SF, Oliveira PR, Codevilla CF: Validation of the anti-factor Xa assay for the potency assessment of enoxaparin in pharmaceutical formulations. J AOAC Int. 2004 Nov-Dec;87(6):1305-8. [Article]
  5. Paige JT, Gouda BP, Gaitor-Stampley V, Scalia PG, Klainer TE, Raum WJ, Martin LF: No correlation between anti-factor Xa levels, low-molecular-weight heparin, and bleeding after gastric bypass. Surg Obes Relat Dis. 2007 Jul-Aug;3(4):469-75. Epub 2007 Jun 12. [Article]
  6. NIH StatPearls: Enoxaparin [Link]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Thrombospondin receptor activity
Specific Function
Thrombin, which cleaves bonds after Arg and Lys, converts fibrinogen to fibrin and activates factors V, VII, VIII, XIII, and, in complex with thrombomodulin, protein C. Functions in blood homeostas...
Gene Name
F2
Uniprot ID
P00734
Uniprot Name
Prothrombin
Molecular Weight
70036.295 Da
References
  1. Nutescu EA, Burnett A, Fanikos J, Spinler S, Wittkowsky A: Pharmacology of anticoagulants used in the treatment of venous thromboembolism. J Thromb Thrombolysis. 2016 Jan;41(1):15-31. doi: 10.1007/s11239-015-1314-3. [Article]
  2. Gikakis N, Rao AK, Miyamoto S, Gorman JH 3rd, Khan MM, Anderson HL, Hack CE, Sun L, Niewiarowski S, Colman RW, Edmunds LH Jr: Enoxaparin suppresses thrombin formation and activity during cardiopulmonary bypass in baboons. J Thorac Cardiovasc Surg. 1998 Dec;116(6):1043-51. doi: 10.1016/s0022-5223(98)70057-1. [Article]
  3. FDA Approved Drug Products: Lovenox (enoxaparin sodium injection), for subcutaneous and intravenous use [Link]

Enzymes

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Other
Curator comments
In vitro studies demonstrate that enoxaparin leads to the liberation of myeloperoxidase from the vascular wall, increasing plasma myeloperoxidase levels.
General Function
Peroxidase activity
Specific Function
Part of the host defense system of polymorphonuclear leukocytes. It is responsible for microbicidal activity against a wide range of organisms. In the stimulated PMN, MPO catalyzes the production o...
Gene Name
MPO
Uniprot ID
P05164
Uniprot Name
Myeloperoxidase
Molecular Weight
83867.71 Da
References
  1. Rudolph TK, Rudolph V, Witte A, Klinke A, Szoecs K, Lau D, Heitzer T, Meinertz T, Baldus S: Liberation of vessel adherent myeloperoxidase by enoxaparin improves endothelial function. Int J Cardiol. 2010 Apr 1;140(1):42-7. doi: 10.1016/j.ijcard.2008.10.035. Epub 2008 Dec 2. [Article]
  2. Baldus S, Eiserich JP, Mani A, Castro L, Figueroa M, Chumley P, Ma W, Tousson A, White CR, Bullard DC, Brennan ML, Lusis AJ, Moore KP, Freeman BA: Endothelial transcytosis of myeloperoxidase confers specificity to vascular ECM proteins as targets of tyrosine nitration. J Clin Invest. 2001 Dec;108(12):1759-70. doi: 10.1172/JCI12617. [Article]
  3. Gozdzikiewicz J, Borawski J, Koc-Zorawska E, Mysliwiec M: Effects of enoxaparin on myeloperoxidase release during hemodialysis. Hemodial Int. 2014 Oct;18(4):819-24. doi: 10.1111/hdi.12177. Epub 2014 May 19. [Article]

Drug created on June 13, 2005 13:24 / Updated on July 23, 2021 16:03