What is the difference between warfarin and lovenox

Compared to heparin, Lovenox has a longer half-life. Meaning, it lasts longer and can be administered once daily. Dosing is more predictable with Lovenox, although patients with a high body weight need more frequent dosing, such as one injection two times daily. In a meta-analysis from the Journal of Thrombosis and Haemostasis , enoxaparin and unfractionated heparin were compared for preventing blood clots in hospitalized patients.

Four clinical trials were included in the meta-analysis and evaluated a total of 3, patients. Results found that, compared to heparin, enoxaparin significantly reduced blood clots without increasing the risk of major bleeding. One caveat to using Lovenox is that its dosage needs to be adjusted in patients with renal failure.

Otherwise, there is an increased risk of bleeding. In clinical practice, unfractionated heparin is preferred for people with kidney impairment. Your doctor will prescribe the best anticoagulant for your condition. The most effective anticoagulant will be determined based on your overall medical history.

Most Medicare and insurance plans will cover Lovenox. However, insurance is more likely to cover generic Lovenox, and they might not cover the full cost. Heparin is usually covered by Medicare and insurance plans. It also tends to be less expensive than Lovenox. Get the pharmacy discount card.

The most common side effect of Lovenox and heparin is injection site reactions. After administering Lovenox or heparin injections, you may experience pain, discomfort, irritation, or swelling around the area of injection.

However, these side effects tend to be mild and go away on their own. Since Lovenox and heparin prevent blood clots, they may cause bleeding side effects. While using Lovenox or heparin, you may experience more frequent bruising. Anticoagulants can also cause severe bleeding. Signs of severe bleeding include heavy bruising and blood in the stool or urine. Seek medical attention if you experience signs of severe bleeding. This may not be a complete list of adverse effects that can occur.

Please refer to your doctor or healthcare provider to learn more. Call your pharmacist for new medicine. You should be sitting or lying down during the injection. Do not inject enoxaparin into a muscle. Your care provider will show you where on your body to inject enoxaparin. Use a different place each time you give an injection. Do not inject into the same place two times in a row. You will need frequent medical tests to help your doctor determine how long to treat you with enoxaparin. If you need surgery or dental work, tell your surgeon or dentist you currently use this medicine.

You may need to stop for a short time. Each single-use prefilled syringe is for one use only. Throw it away after one use, even if there is still medicine left inside. After your first use of an enoxaparin vial bottle , you must use the medicine within 28 days. Throw away the vial after 28 days.

Use a needle and syringe only once and then place them in a puncture-proof "sharps" container. Follow state or local laws about how to dispose of this container. Keep it out of the reach of children and pets.

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. CMS Manual System. Pub Medicare claims processing. Accessed August 29, Data Sources: A PubMed search was completed in Clinical Queries using the key terms outpatient, anticoagulation, warfarin, dabigatran, rivaroxaban, heparin, low-molecular-weight heparin, dalteparin, enoxaparin, patient self-monitor, and INR. The search included meta-analyses, randomized controlled trials, clinical trials, clinical guidelines, and reviews.

Search date: August 10, Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. Winkle College of Pharmacy, and a clinical pharmacist in the outpatient anticoagulation clinic at West Chester Ohio Hospital. Winkle College of Pharmacy, and a clinical pharmacist in the outpatient anticoagulation clinic at West Chester Hospital.

Winkle College of Pharmacy, Eden Ave. Reprints are not available from the authors. Health care expenditures and therapeutic outcomes of a pharmacist-managed anticoagulation service versus usual medical care.

Comparison of two different models of anticoagulation management services with usual medical care. Warfarin maintenance dosing patterns in clinical practice: implications for safer anticoagulation in the elderly population. University of Michigan. Cardiovascular Center. Anticoagulation management service for health professionals. Warfarin dose adjustment. Accessed September 23, Ebell MH. Evidence-based adjustment of warfarin Coumadin doses.

Eliquis apixaban tablets for oral use [prescribing information] Princeton N. Accessed January 23, Pradaxa dabigatran etexilate mesylate capsules for oral use [prescribing information].

Ridgefield, Conn. Xarelto rivaroxaban tablets, for oral use [prescribing information]. Titusville, N. Accessed December 30, Dabigatran versus warfarin in patients with atrial fibrillation [published correction appears in N Engl J Med. Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty. Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty: a double-blind, randomised controlled trial.

Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty. New and emerging anticoagulant therapy for atrial fibrillation and acute coronary syndrome. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. Apixaban versus warfarin in patients with atrial fibrillation. Apixaban in patients with atrial fibrillation. Patient self-testing is a reliable and acceptable alternative to laboratory INR monitoring.

Effect of home testing of international normalized ratio on clinical events [published correction appears in N Engl J Med. Self-monitoring and self-management of oral anticoagulation. Centers for Medicare and Medicaid Services. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.

This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv aafp. Want to use this article elsewhere? Get Permissions. Read the Issue. Sign Up Now. Previous: Diagnosis of Urinary Incontinence. Apr 15, Issue. Updated Guidelines on Outpatient Anticoagulation. This version of the article contains supplemental content.

The American College of Chest Physicians provides recommendations for the use of anticoagulant medications for several indications that are important in the primary care setting. B 2 , 3 In patients with atrial fibrillation and at least one other risk factor for stroke, newer agents rivaroxaban [Xarelto] and dabigatran [Pradaxa] that do not require frequent laboratory monitoring are as effective as warfarin for prevention of stroke or systemic embolism and have comparable risks of major bleeding.

A 11 — 19 Compared with usual clinic-based care, patient self-testing for international normalized ratios, with or without self-dosing of warfarin, is associated with significantly fewer deaths and thromboembolic complications without any increase in bleeding complications for a selected group of motivated patients who have completed appropriate training.

Enlarge Print Table 1. Key Changes in the Ninth Edition of the American College of Chest Physicians Guidelines on Outpatient Management of Anticoagulation Therapy Medication Recommendation Implication for practice Dabigatran Pradaxa Recommended over warfarin Coumadin in patients with nonvalvular atrial fibrillation who do not have severe renal impairment grade 2B Simplification of anticoagulation management: no need for frequent dosage adjustments, INR monitoring Caution: no antidote for reversal LMWH Outpatients with solid tumors, additional risk factors for deep venous thrombosis, and low bleeding risk should receive prophylactic doses of LMWH grade 2B — Vitamin K Revised recommendations for treatment of patients with supratherapeutic INRs who do not have significant bleeding For patients with an INR between 4.

Table 1. Enlarge Print Table 2. Table 2. Enlarge Print Table 3. Table 3. Enlarge Print eTable A. Enlarge Print eTable B. Information from:. Enlarge Print eTable C. Enlarge Print Table 4. John's wort Increased bleeding risk with certain medications e. Table 4. Enlarge Print Table 5. Table 5. Enlarge Print eTable D. Read the full article. Get immediate access, anytime, anywhere.

Choose a single article, issue, or full-access subscription. Earn up to 6 CME credits per issue. Purchase Access: See My Options close. Best Value! To see the full article, log in or purchase access. More in Pubmed Citation Related Articles. Email Alerts Don't miss a single issue. Sign up for the free AFP email table of contents. Navigate this Article. Simplification of anticoagulation management: no need for frequent dosage adjustments, INR monitoring Caution: no antidote for reversal.

Revised recommendations for treatment of patients with supratherapeutic INRs who do not have significant bleeding For patients with an INR between 4.

People taking warfarin must obtain a blood test every weeks to ensure that their blood is thinning to the correct degree without bleeding complications. This test the INR, discussed below may be requested several times a week at the beginning of your treatment to ensure that you are started on the correct dose.

In actuality, Prothrombin time is the test used, and INR is simply a standardized way for medical institutions to report consistent values for Prothrombin times.

The INR ratio is calculated based on comparison of blood tests against a known standard, and your physician will monitor your warfarin levels based on this INR ratio. Generally, an INR of 2. Heparin works faster than warfarin, so it is usually given in situations where an immediate effect is desired. For example, this medication is often given in hospitals to prevent growth of a previously detected blood clot.

This medication is also recommended for pregnant women in whom antiphospholipid antibodies have been discovered, since warfarin can be harmful to an unborn child. However, when taken for long periods of time, this medication might increase the risk of osteoporosis. Usually patients switch to warfarin when long term anticoagulant treatment is recommended.

The two most serious side effects of anticoagulants are bleeding and gangrene necrosis of the skin. Bleeding can occur in any organ or tissue.

Bleeding in the kidneys can cause severe back pain and blood in the urine. Bleeding in the stomach can cause weakness, fainting, black stools, or vomiting of blood.