Noxarin 40 mg Pre filled syrin 40 mg/.4 ml Injection

Noxarin 40 mg Pre filled syrin 40 mg/.4 ml injection by Opsonin Pharma Limited is an injectable anticoagulant medicine that contains Enoxaprin. In Bangladesh, it is mainly used to help prevent or treat harmful blood clots in conditions such as deep vein thrombosis, pulmonary embolism, and certain acute heart conditions as prescribed by a doctor.

Enoxaprin works by reducing the activity of clotting factor Xa and, to a lesser extent, thrombin, which helps stop clots from forming or growing. A key caution is that it can cause serious bleeding, so it must be used only with appropriate medical supervision.

• Prevention of deep vein thrombosis in patients undergoing certain surgeries or with reduced mobility due to acute illness.
• Treatment of deep vein thrombosis, with or without pulmonary embolism.
• Treatment of unstable angina and non-ST elevation myocardial infarction, usually with aspirin when appropriate.
• Treatment of acute ST elevation myocardial infarction as part of a doctor-directed treatment plan.
• Prevention of clotting in the extracorporeal circuit during haemodialysis, where indicated.

Enoxaprin injection dosing depends on the indication, body weight, kidney function, age, bleeding risk, and whether it is being used for prevention or treatment of clots. It is usually given by subcutaneous injection, while some heart attack regimens may involve intravenous use in hospital. Do not change the dose, timing, or duration yourself; follow the prescribing doctor’s instructions exactly.

• Bleeding, bruising, or pain at the injection site.
• Nosebleeds, gum bleeding, or easy bruising.
• Low red blood cell count due to bleeding.
• Low platelet count, including rare heparin-induced thrombocytopenia.
• Raised liver enzymes, usually without symptoms.
• Allergic reactions such as rash, itching, swelling, or breathing difficulty.
• Serious internal bleeding, which may cause black stools, blood in urine, vomiting blood, severe headache, weakness, dizziness, or fainting.
• Rare spinal or epidural haematoma in patients receiving spinal/epidural anaesthesia or lumbar puncture, which can cause nerve injury.

Use Enoxaprin with extra caution in people with kidney disease, a history of bleeding, stomach ulcer, recent stroke, uncontrolled high blood pressure, recent surgery, eye or brain procedures, low platelet counts, liver disease, older age, or low body weight. Tell healthcare professionals before any operation, dental procedure, spinal/epidural anaesthesia, or lumbar puncture. Do not inject into muscle. Use under a registered doctor's or pharmacist's guidance.

• Other anticoagulants such as warfarin, heparin, dabigatran, rivaroxaban, apixaban, or edoxaban may increase bleeding risk.
• Antiplatelet medicines such as aspirin, clopidogrel, prasugrel, ticagrelor, or dipyridamole may increase bleeding risk.
• Non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, diclofenac, or ketorolac may increase bleeding risk.
• Thrombolytic medicines such as alteplase, streptokinase, or tenecteplase greatly increase bleeding risk.
• Some antidepressants such as SSRIs and SNRIs may increase bleeding risk.
• Herbal products or supplements that may increase bleeding risk, such as ginkgo, garlic, ginseng, or high-dose fish oil, should be discussed with a healthcare professional.

• Active major bleeding.
• Known hypersensitivity to enoxaparin, heparin, heparin derivatives, or pork-derived products.
• History of immune-mediated heparin-induced thrombocytopenia with enoxaparin or heparin, unless a specialist advises otherwise.
• Use of multi-dose formulations containing benzyl alcohol in premature neonates or neonates, where applicable.

Enoxaprin is commonly used in pregnancy when an anticoagulant is needed, because it does not significantly cross the placenta, but it should be used only when prescribed and monitored by a doctor. Pregnant patients with mechanical heart valves need specialist management. It is generally considered compatible with breastfeeding because clinically significant transfer into breast milk is unlikely, but medical advice is still recommended.

Store the injection as directed on the product label, generally at room temperature away from excessive heat, direct light, and moisture. Do not freeze. Keep out of reach of children. Do not use if the solution is discoloured, cloudy, contains particles, or the packaging is damaged; dispose of used syringes safely in a sharps container.