A minimum of 24 hours notice is required to request these syringes via pharmacy. They have a 10-day expiry from the date of preparation. These syringes are prepared by an external contractor under sterile conditions. Administration of LMWH Doses less than 10mgįor patients prescribed doses less than 10mg, a special request can be made to pharmacy to have 10mg/0.5mL syringes prepared. Some children find the application of ice for 3-5 minutes prior to the injection being given minimizes this irritation.ģ. This irritation usually passes within 5 minutes. * LMWH can cause irritation of the subcutaneous tissues following injection via either method. There are reported cases of premature neonates requiring blood transfusions secondary to haemorrhaging into a subcutaneous space following the repeated injection of LMWH into an insuflon TM catheter. Whilst there is no evidence regarding a minimum weight at which an insuflon TM catheter can be used to administer LMWH, is it advisable to avoid using insuflon TM catheters in most premature neonates and infants less than 3kg. Injection via an insuflon TM catheter can be performed in infants and children with sufficient subcutaneous tissue. This aids in minimizing the size of the bruise that may develop at the injection site. Rather, place firm, even pressure to the site of injection for 1-5 minutes. After removal of the needle, do not rub the site. The skinfold should be held throughout the injection. This can be achieved by either by rotating injection sites or by injecting into an insuflon TM catheter.ĭirect subcutaneous injection should be given into a subcutaneous tissue skinfold of the abdomen or the upper-outer aspect of the thigh. LMWH is administered via subcutaneous route. Recommended LMWH dosing for infants and childrenĢ. LMWH monitoring table for ongoing/long term anti-Xa monitoring The prescribed dose should be calculated according to Table 1, depending upon the patient’s weight and whether LMWH is indicated for the treatment or prevention of thrombosis.ġ.5mg/kg/BD rounded up to nearest whole numberġmg/kg/BD rounded up to nearest whole numberġmg/kg/BD rounded down to nearest 10mg, capped at 100mg BD Weigh patient and obtain a baseline FBE, APTT, INR and renal function. S = dose available in pre-filled syringe.ġ. The decision to use LMWH instead of standard heparin or warfarin will depend upon the clinical scenario and individual patient factors such as risk of bleeding or availability of venous access. Low Molecular Weight Heparins are used for the prophylaxis or treatment of deep vein thrombosis. All RCH patients requiring LMWH therapy should be referred to the Clinical Haematology Department. In neonates and children, the Low Molecular Weight Heparin of choice is 'Enoxaparin' (Clexane) as this is the only LMWH available in Australia that has had paediatric dose-finding studies.

Antidote of heparin