Document Detail

Changes in the pharmacokinetics of the low-molecular-weight heparin enoxaparin sodium during pregnancy.
MedLine Citation:
PMID:  10561628     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We sought to evaluate the pharmacokinetics of subcutaneously administered enoxaparin sodium during and after pregnancy. STUDY DESIGN: Daily subcutaneous injections of enoxaparin sodium (40 mg) were administered to 13 pregnant women. On 3 separate occasions, once early in pregnancy (12-15 weeks), once late in pregnancy (30-33 weeks), and once in the nonpregnant state (6-8 weeks post partum), serial blood samples were collected, and plasma was analyzed for antifactor Xa activity. Analysis of variance was used for statistical analysis. P <.05 was significant. RESULTS: The time to maximum concentration and the mean residence time in pregnancy compared with the postpartum state were not significantly different. During early and late pregnancy, maximum concentration and the last measurable anti-factor Xa activity level were lower than in the nonpregnant state (P <.05). The area under the plasma activity-versus-time curve was significantly lower in pregnancy than in the postpartum state (P <.05). CONCLUSION: The pharmacokinetics of enoxaparin sodium are significantly different during pregnancy than in the same women when nonpregnant. The observed difference is likely because of increased renal clearance of enoxaparin during pregnancy. This finding has significant implications for appropriate dosing of enoxaparin in pregnancy.
H L Casele; S A Laifer; D A Woelkers; R Venkataramanan
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  181     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1999 Nov 
Date Detail:
Created Date:  1999-12-02     Completed Date:  1999-12-02     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1113-7     Citation Subset:  AIM; IM    
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Medical School, Evanston, Illinois, USA.
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MeSH Terms
Analysis of Variance
Enoxaparin / administration & dosage,  pharmacokinetics*
Fibrinolytic Agents / administration & dosage,  pharmacokinetics*
Injections, Subcutaneous
Insect Proteins*
Molecular Weight
Postpartum Period* / blood
Pregnancy, High-Risk* / blood*
Salivary Proteins and Peptides / blood
Time Factors
Grant Support
Reg. No./Substance:
0/Enoxaparin; 0/Fibrinolytic Agents; 0/Insect Proteins; 0/Salivary Proteins and Peptides; 0/anticoagulant factor Xa protein, Aedes aegypti

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