Lovenox dosage question and dilemma

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rosalinda
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Re : Lovenox dosage question and dilemma

Postby rosalinda » Fri Aug 13, 638945 10:31 pm

With my second pregnancy (that ended is miscarriage at 9wks) I started Lovenox at 6wks, with no clotting disorders. My peri said she could not see a reason to prescribe it, but if it made me feel more comfortable (like I was doing everything I possibly could) then she would prescribe it. So she did. I took 30mg twice a day for a total of 60mg.

With my third pregnancy, I opted not to do the Lovenox, and instead my peri suggested LDA twice a day. Which I did, and delivered at 36wks, 3 days for low fluid & high BP's (I'm chronic).

jmom08
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Re : Lovenox dosage question and dilemma

Postby jmom08 » Tue Aug 03, 638945 6:55 pm

I was on one shot of prefilled lovenox each day until the end, when I was switched to heparin. I bruised quite a bit while on the lovenox. Good luck with finding answers!!

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Re : Lovenox dosage question and dilemma

Postby angieb » Fri Jul 23, 638945 6:18 pm

Well, she does want me to take 30 mg 2x daily. (She did also give me a script for heparin which would have also been 2x daily, in case my insurance didn't cover the lovenox because we weren't sure they would, but they did.) (The lovenox website actually mentions in some cases they recommend 30 mg every 12 hours.)

Thanks for the tip, Jamie! I still haven't totally decided what I'm going to do yet aside from just taking one full shot tonight.

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jamie w
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Re : Lovenox dosage question and dilemma

Postby jamie w » Fri Jul 23, 638945 12:27 pm

Lovenox is not always dosed every 24 hrs. Many of our hospital patients are dosed twice daily. If a patient is going to surgery we only hold a dose 12 hrs prior to surgery. It usually depends on if you are doing the dose for prophylaxis or for an already formed clot. You can squirt out some of the med to make the right dose but be sure you hold it so that you do not squirt out the air bubble. The air bubble needs to actually be injected at the end of the dose. We have some patients who are on 70 mg but it only comes in 60 & 80 so we will squirt out 10 from the 80 and then they get 70mg.

alsgirl2002
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Re : Lovenox dosage question and dilemma

Postby alsgirl2002 » Fri Jul 23, 638945 10:25 am

I'm not sure why she's having you dose 2x per day. Lovenox stays in your system for 24hrs. They usually have you do heparin twice daily because it is in your system for only 12 hrs. Make sure you discuss this as well.

angieb
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Re : Lovenox dosage question and dilemma

Postby angieb » Fri Jul 23, 638945 7:45 am

Thanks Heather!

After looking into lovenox even more, I know she wanted me to do 2 shots every 12 hours for sure, and it seems that 30 mg is the lowest dose the prefilled come in, and so perhaps that's why.

I'm going to hold off until I get the actual meds later today when they are in at the pharmacy, just to make sure I'm not misunderstanding (maybe she wants me to do 15 mg 2x a day and 30 mg a day total?, or 20 2x a day, etc.) I'm not so sure that the pharmacist wasn't just talking about my syringes and not the actual dose she wants me to take. I know probably not, but I couldn't read the RX so I'll hold off on calling till then at least. (And just do the one 30 mg shot tonight). I don't think she'll have a problem with having me scale it back if I say I'm not comfortable with the higher dose,as she made them optional from the start, I'm just not sure if I should be uncomfortable with it or not.

Oh, how I miss the days when I just listened to what doctors told me and did what they said without researching it for myself, too. I know that's not always the best thing, but life sure was a lot more simple then!

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heather j
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Re : Lovenox dosage question and dilemma

Postby heather j » Fri Jul 23, 638945 5:28 am

40 mg is the prophylactic dosage for lovenox, but I know we've had at least a few people who take more than that. Joni (leftcoastgirl) is one of those people - I think she's also on 60. Like you, I'd definitely want to talk to others who've been rxed that dosage. Also, if you've not already done so, I'd be inclined to call or email the prescribing doctor and ask her why she's recommending 60 as opposed to the more typical 40mg. I completely understand about not wanting to thin your blood too much, and I think that's a valid concern with any amount of an anticoagulant.

angieb
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Lovenox dosage question and dilemma

Postby angieb » Fri Jul 23, 638945 2:08 am

I don't have a clotting disorder that they have found, though I pretty strongly suspect that I have one somewhere. (Have always bruised very easily, my mom had issues with blood vessels rupturing when she was on birth control.)

I met with 2 different MFM's at 2 different hospitals/practices pre-conception. One recommended LDA+ lovenox, because I had HELLP so early and Olivia was extremely IUGR and had reverse blood flow at 23 wks. (They really didn't find clots in the placenta but a lot of infracts.) She feels that for me, the benefits outweigh the risks. (And my ob agrees with that.) But, it was an option she wanted me to consider, not that I *had* to do them. The other MFM said they won't do them, that they don't do anything without research to support it (I don't really understand how they do anything pe related since the research on everything is so mixed.) She thought we could just do nothing and things should be fine next time, and even said as long as it's just a singleton she'd "sleep easily through my pregnancy." Needless to say, I picked the first MFM, and my gut tells me to do the lovenox. I've been versed in the risks and feel relatively comfortable about it.

However, I just found out when the pharmacist called that I'm going to be doing 2 shots 30 mg each, so 60 mg a day. I knew that my MFM was going to have me do 2 shots 12 hours apart, I didn't realize what the "normal" dose seems to be and how mine compared, or how much she had planned for me to take.

From my hours of research (at least I've taken a break from researching all things miscarriage), it seems like most people even with known clotting disorders are on 1 shot 40 mg a day. Is that just because it's what the shots are pre-filled at? Is 60 mg a day a huge difference in terms of this stuff? What dose are/were you on? I'm considering doing a week of 20/20 or 25/25 to let my body adjust and then bump it up to the 30/30 maybe...Gah! I really like this doctor, and I know she knows more about this than I do, but I also do not want to OD on Lovenox.


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