When This Medicine Should Not Be Used:
You should not use this medicine if you have had an allergic reaction to enoxaparin, heparin, benzyl alcohol, or products made from pork. You should not use enoxaparin if you have bleeding disorders or any active bleeding.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin.
• A nurse or other health provider will give you this medicine. It may also be given by a home health caregiver.
• You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
• You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas.
• Use a new needle and syringe each time you inject your medicine.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using blood thinners (such as clopidogrel, warfarin, or Coumadin®). Tell your doctor if you are also using dipyridamole (Persantine®), ketorolac (Toradol®), or sulfinpyrazone (Anturane®).
• Make sure your doctor knows if you are using pain or arthritis medicine (such as aspirin, Advil®, Aleve®, Motrin®, Orudis®, Dolobid®, Feldene®, Indocin®, Relafen®, or Voltaren®). Avoid taking aspirin or medicines that contain aspirin, unless your doctor tells you to.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have liver disease, kidney disease, blood vessel problems, diabetes, a heart infection, uncontrolled high blood pressure, a stomach ulcer or bleeding, or a bleeding disorder such as hemophilia. Tell your doctor if you have a bleeding disorder caused by heparin.
• Make sure your doctor knows if you have recently had a stroke, or surgery on your eyes, brain, or spine. Tell your doctor if you have had a heart valve replaced.
• This medicine may cause bleeding or bruising. This risk is higher if you have a catheter in your back for pain medicine or anesthesia (sometimes called an "epidural"), or if you have kidney problems. The risk of bleeding increases if your kidney problems get worse. Discuss this with your doctor if you are concerned.
• You may bleed and bruise more easily while you are using this medicine. Be extra careful to avoid injuries until the effects of the medicine have worn off. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers. Avoid picking your nose. If you need to blow your nose, blow it gently.
• Watch for any bleeding from open areas such as around the injection site. Also check for blood in your urine or stool. If you have any bleeding or injuries, tell your doctor right away.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blood in your urine.
• Bloody or black, tarry stools.
• Chest pain, shortness of breath, or coughing up blood.
• Fever.
• Large, flat, blue or purplish patches in the skin.
• Numbness or weakness in your arm or leg, or on one side of your body.
• Pain in your lower leg (calf).
• Sudden or severe headache, problems with vision, speech, or walking.
• Swelling in your hands, ankles, or feet.
• Uneven heartbeat.
• Unusual bleeding or bruising.
• Vomiting blood or material that looks like coffee grounds.
• Warmth or redness in your face, neck, arms, or upper chest.

If you notice these less serious side effects, talk with your doctor:

• Confusion.
• Nausea or diarrhea.
• Pain, redness, bruising, swelling, or a lump under your skin where the shot was given.

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088