Enoxar Overdosage

2000 IU/0.2 mL and 6000 IU/0.6 mL soln for inj: Accidental overdosage following administration of Enoxaparin may lead to hemorrhagic complications.
Injected Enoxaparin may be largely neutralized by the slow I.V. injection of protamine sulfate (1% solution).
The dose of protamine sulfate should be administrated to neutralize 1 mg of Enoxaparin, if Enoxaparin Sodium was administered in the protamine administration, or if it has been determined that a second dose of protamine is required. The second infusion of 0.5 mg protamine sulfate per 1 mg of Enoxaparin may be administered if a PTT measured 2 to 4 hours after the first infusion remains prolonged.
After 12 hours of the Enoxaparin sodium injection, protamine administration may not be required. However, even with higher doses of protamine, the PTT may remain more prolonged than under normal conditions found following administration of heparin. In all cases, the anti-Factor Xa activity is never completely neutralized (maximum about 60%).
4000 IU/0.4 mL soln for inj: Signs and symptoms: Accidental overdose with enoxaparin sodium after IV, extracorporeal or SC administration may lead to hemorrhagic complications. Following oral administration of even large doses, it is unlikely that enoxaparin sodium will be absorbed.
Management: The anticoagulant effects can be largely neutralized by the slow IV injection of protamine. The dose of protamine depends on the dose of enoxaparin sodium injected; 1 mg protamine neutralizes the anticoagulant effect of 100 IU (1 mg) of enoxaparin sodium, if enoxaparin sodium was administered in the previous 8 hours. An infusion of 0.5 mg protamine per 100 IU (1 mg) of enoxaparin sodium may be administered if enoxaparin sodium was administered greater than 8 hours previous to the protamine administration, or if it has been determined that a second dose of protamine is required. After 12 hours of the enoxaparin sodium injection, protamine administration may not be required. However, even with high doses of protamine, the anti-Xa activity of enoxaparin sodium is never completely neutralized (maximum about 60%).