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Dosing & administration
Dosing varies by indication and patient profile. Always follow your institution's current prescribing guidelines.
Renal impairment
Consult protocols for adjustment.
Liver impairment
Consult protocols for adjustment.
Use during pregnancy
1st trimester
Safe. Preferred anticoagulant over warfarin for VTE treatment and prevention.
2nd trimester
Safe. Monitor anti-Xa levels in high-risk scenarios (renal impairment, extremes of weight, recurrent VTE).
3rd trimester
Safe until 36–37 weeks. Transition to UFH at that point to allow reversible anticoagulation for neuraxial anesthesia.
Clinical note
Standard of care for VTE prevention and treatment in pregnancy. Does not cross the placenta due to its large molecular weight. No teratogenicity. Requires dose adjustment in pregnancy (weight-based; anti-Xa monitoring in some cases). Renal function monitoring recommended. Switch to unfractionated heparin (UFH) at 36–37 weeks to allow neuraxial anesthesia planning.
Breastfeeding
Safe. High molecular weight prevents meaningful breast milk excretion; not orally bioavailable so negligible infant risk.
