Document Detail

Enoxaparin-induced alopecia in patients with cerebral venous thrombosis.
MedLine Citation:
PMID:  16958830     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To report three cases of alopecia induced by the anticoagulant enoxaparin in cerebral venous thrombosis (CVT) patients. CASE SUMMARY: Three female patients were treated initially with direct intrasinus urokinase, and then followed by low-molecular-weight heparin (LMWH) enoxaparin at 1 mg/kg given subcutaneously twice daily for 3 weeks. It was switched to oral anticoagulant warfarin at 5 mg daily for another 6 months. Nearly 3 weeks after the initiation of anticoagulation, all of the three patients complained of excessive hair loss with large areas of patchy, non-scarring alopecia. Hair growth returned to normal within 1 month after the completion of enoxaparin. DISCUSSION: Unfractionated heparin remains the first-line treatment of CVT because of its efficacy, safety and feasibility. Alopecia has been reported as a side effect of LMWHs dalteparin and tinzaparin. The pattern of hair loss, telogen effluvium, involves the induction of the hair follicle into a resting phase without apparent pathologic implication. In addition, this article also reviewed other medications taken by the patients that are possibly associated with hair loss. CONCLUSION: From the review of literature, there is no report of alopecia caused by urokinase. Using the Naranjo ADR Probability Scale, a score of 6 suggests that enoxaparin was the probable cause of alopecia in our three patients. This report introduces evidence of alopecia as a probable side effect of enoxaparin, but stresses the efficacy and safety of LMWH. As this is not a life-threatening disorder, we hope to increase the awareness of pharmacists and clinicians to this relatively rare but important side effect.
Y-Y Wang; H L Po
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of clinical pharmacy and therapeutics     Volume:  31     ISSN:  0269-4727     ISO Abbreviation:  J Clin Pharm Ther     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-08     Completed Date:  2006-12-15     Revised Date:  2008-05-28    
Medline Journal Info:
Nlm Unique ID:  8704308     Medline TA:  J Clin Pharm Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  513-7     Citation Subset:  IM    
Clinical Pharmacy, Department of Pharmacy, Mackay Memorial Hospital, Taipei, Taiwan.
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MeSH Terms
Alopecia / chemically induced*
Anticoagulants / adverse effects*,  therapeutic use
Enoxaparin / adverse effects*,  therapeutic use
Intracranial Thrombosis / drug therapy
Middle Aged
Reg. No./Substance:
0/Anticoagulants; 0/Enoxaparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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