Lovenox Drug Interactions

Certain drugs or therapeutic classes may promote the occurrence of hyperkalemia: potassium salts, potassium-sparing diuretics, conversion enzyme inhibitors, angiotensin II inhibitors, non-steroidal anti-inflammatory drugs, heparins (low molecular weight and unfractionated heparin), ciclosporin and tacrolimus, trimethoprim.
Occurrence of hyperkalemia may depend on possible related risk factors.
This risk is potentiated when the above-mentioned drugs are co-administered.
Inadvisable combinations: Acetylsalicylic acid at analgesic, antipyretic and anti-inflammatory doses (and, by extrapolation, other salicylates): Increased risk of hemorrhage (salicylic-induced platelet function inhibition and gastroduodenal mucosal damage).
Use a non-salicylate antipyretic analgesic (such as paracetamol).
NSAIDs (systemic use): Increased risk of hemorrhage (NSAID-induced platelet function inhibition and gastroduodenal mucosal damage).
If co-administration cannot be avoided, close clinical monitoring is required.
Dextran 40 (parenteral use): Increased risk of hemorrhage (inhibition of platelet function by dextran 40). Adjust heparin dosage so that the coagulation test performed as a measure of hypocoagulability does not exceed 1.5 times the control value during co administration and after discontinuation of dextran 40.
Ticlodipine: Increased risk of hemorrhage (inhibition of platelet function by ticlopidine).
Combinations requiring precautions for use: Corticoids (glucocorticoids) (except for hydrocortisone used as replacement therapy in Addison's disesase) (systemic use and, in certain cases local uses, i.e. intramuscular, intraarticular or cutaneous use of rectal washout).
Heparin-related increase in the risk of haemorrhage specific to corticoid therapy (gastric mucosa, vascular fragility), at high doses or during prolonged treatment lasting more than ten days. If the combination cannot be avoided clinical monitoring must be intensified.
Oral anticoagulants: Potentiation of the anticoagulant effect.
When heparin is replaced by an oral anticoagulant, clinical monitoring must be intensified.
Combinations to take into consideration: Platelet aggregation inhibitors (other than acetylsalicylic acid as analgesic, antipyretic and anti-inflammatory doses; NSAIDs): abciximab, acetylsalicylic acid at antiaggregant doses in cardiological and neurological indications, baraprost, clopidogrel, eptifibatide, iloprost, ticlopidine and tirofiban.
Increased risk of hemorrhage.
2000/4000 anti-Xa IU: Patients under 65 years of age: Combinations to take into consideration: Combined use of drugs which variably affect hemostasis potentiate the risk of bleeding. Therefore, regardless of the age of the patients, co-administration of LMWH at preventive doses with the following drugs must be taken into consideration by means of continued clinical monitoring and possible laboratory tests: oral anticoagulants, platelet aggregation inhibitors (abciximab, NSAIDs, acetylsalicylic acid at any dose, clopidogrel, eptifibatide, iloprost, ticloprost, ticlopidine, tirofiban) and thrombolytic agents.