Warning and Precaution

You should not use enoxaparin if you are allergic to enoxaparin, heparin, benzyl alcohol, or pork products, or if you have:

• active or uncontrolled bleeding; or
• if you had decreased platelets in your blood after testing positive for a certain antibody while using enoxaparin within the past 100 days.

Enoxaparin may cause you to bleed more easily, especially if you have:

• a bleeding disorder that is inherited or caused by disease;
• hemorrhagic stroke;
• an infection of the lining of your heart (also called bacterial endocarditis);
• stomach or intestinal bleeding or ulcer; or
• recent brain, spine, or eye surgery.

Enoxaparin can cause a very serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural). This type of blood clot could cause long-term or permanent paralysis, and may be more likely to occur if:

• you have a spinal cord injury;
• you have a spinal catheter in place or if a catheter has been recently removed;
• you have a history of spinal surgery or repeated spinal taps;
• you have recently had a spinal tap or epidural anesthesia;
• you take aspirin or an NSAID (nonsteroidal anti-inflammatory drug)–ibuprofen (Advil, Motrin), naproxen (Aleve), diclofenac, indomethacin, meloxicam, and others; or
• you are using a blood thinner (warfarin, Coumadin) or other medicines to treat or prevent blood clots.

Tell your doctor if you have ever had:

• a bleeding disorder such as hemophilia;
• kidney or liver disease;
• uncontrolled high blood pressure;
• eye problems caused by diabetes;
• a stomach ulcer; or
• low blood platelets after receiving heparin.

Tell your doctor if you are pregnant. If you use enoxaparin during pregnancy, make sure your doctor knows if you have a mechanical heart valve.

It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.