1. (1) patients with liver insufficiency; (2) patients with uncontrolled hypertension; (3) patients with a history of gastrointestinal ulcer. (4) lactating women.
2. Enoxaparin sodium should not be mixed with other injections or intravenous fluids.
3. The ideal site for injection is the subcutaneous tissue in the center of the anterior or dorsal abdominal wall when the patient is in bed, and the injection should be carried out alternately on the left and right sides. Do not push or pull the injection piston before injection to avoid the dosage is not allowed or hematoma occurs at the injection site.
Excessive injection may cause bleeding. Can be neutralized with protamine. Protamine 1 mg can be neutralized by heparin sodium 1 mg anticoagulant factor Ⅱ a role. High dose protamine can't all and anticoagulant factors Ⅹ a (up to 60%), but still can maintain its effect in anti thrombosis.
5. Enoxaparin sodium is not suitable for intramuscular injection. The use of enoxaparin during intrathecal/epidural anesthesia can cause prolonged or permanent spinal bleeding, which is increased by the placement of epidural catheters. Carefully monitor the patient to prevent spinal and dural bleeding. If neurological dysfunction is found, stop taking the drug immediately.
6. Since different LMWH is not equivalent, different products are not used in the same course of treatment.
7. Enoxaparin sodium should not be used more than 24h after opening the bottle.