What Are the Best Enoxaparin Injection Sites?

Maggie J. Hall

Health care professionals and the manufacturer consider the abdominal area the best location for enoxaparin injection sites because of the rate of absorption. Enoxaparin belongs to the group of medications known as anticoagulants and is a low molecular weight heparin. Physicians use it to slow or inhibit the body’s clotting ability. Alcohol and over-the-counter and prescription preparations may enhance the drug's anti-clotting abilities. The manufacturer does not recommend using the compound prior to invasive spinal procedures.

Some drugs may interact with enoxaparin, causing negative effects.
Some drugs may interact with enoxaparin, causing negative effects.

Administering heparin type medications in the abdominal region is preferred because the absorption rate is slower than when the substance is injected intramuscularly or intravenously. The abdominal region has the most adipose, or fatty, tissue, which has no vascular circulation. The body absorbs the medication at a slower rate through fat than at enoxaparin injection sites having highly vascular muscle tissue.

Enoxaparin may be prescribed to treat deep vein thrombosis, or the formation of clots in the blood vessels of the leg, which often results in pain.
Enoxaparin may be prescribed to treat deep vein thrombosis, or the formation of clots in the blood vessels of the leg, which often results in pain.

The surface area covering this region begins 2 inches away from the naval, or umbilicus, in all directions and moves outward to the sides and includes the love handles. This portion of skin is what a wide cummerbund would cover and provides many enoxaparin injection sites. Following alcohol cleansing, patients self-administer enoxaparin while lying down and pinching a fold of skin in the abdominal region. Individuals insert the needle into the fold at a 90-degree angle. They cannot massage or rub the injection site after needle removal.

Patients suffering from angina may be susceptible to clot formation.
Patients suffering from angina may be susceptible to clot formation.

Enoxaparin enhances the activity of antithrombin, a chemical that neutralizes clotting factors II, Xa, and prothrombin. This type of anticoagulant prevents thrombin from converting to prothrombin and prevents fibrinogen from converting to fibrin. Typical uses of enoxaparin include extending clotting time in patients who are susceptible to clot formation. These individuals may have angina, abnormal heart rhythms, or a history of heart attacks. Physicians might also prescribe the medication for patients following a deep vein thrombosis or as preventative maintenance following surgery.

The abdominal area is the best location for enoxaparin injection sites.
The abdominal area is the best location for enoxaparin injection sites.

Patients typically experience bruising around enoxaparin injection sites. Other common enoxaparin side effects are unusual bruising and bleeding anywhere in the body, diarrhea, and nausea. Excessive bleeding can lead to anemia and thrombocytopenia. Local and systemic allergic reactions related to enoxaparin injection sites include hives, itching, vasculitis, and anaphylaxis. The safety of enoxaparin is questionable when patients undergo invasive spinal procedures while taking the medication, as hematomas may occur. Compression pressure following blood infiltration may damage nerve tissue causing long term or permanent paralysis.

Enoxaparin drug interactions include alcohol and herbal preparations containing feverfew, garlic, ginseng, and gingko biloba all of which inhibit clotting ability. Aspirin, ibuprofen, and other non-steroidal anti-inflammatory drugs (NSAIDs) generally interfere with clotting. Taking the anticoagulant with other prescription medications that inhibit platelet activity or prevent platelet adhesion also enhances the effects of enoxaparin.

Local and systemic allergic reactions related to enoxaparin injection sites may include hives.
Local and systemic allergic reactions related to enoxaparin injection sites may include hives.

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