CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

November 6th, 2013

FDA Issues Recommendations on Spinal Catheters & Enoxaparin

The FDA is advising clinicians to “carefully consider” the timing of spinal catheter insertion and removal in patients taking low-molecular-weight heparins (e.g., Lovenox and generic enoxaparin), with an additional recommendation to delay dosing these drugs after catheter removal to lower the risk for spinal column bleeding and paralysis.

Among the specific recommendations:

  • Spinal catheter placement or removal should be postponed for at least 12 hours after administration of prophylactic doses of enoxaparin (e.g., those used to prevent deep vein thrombosis); longer, 24-hour delays may be considered for patients on higher therapeutic doses of enoxaparin.

  • A postprocedure dose of enoxaparin generally should be given no earlier than 4 hours after catheter removal.

The products’ labels will be updated with the new guidance.

Originally published in Physician’s First Watch

Categories: Uncategorized


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