Feasibility and safety of enoxaparin whole milligram dosing in premature and term neonates

Objective: The objective of our study was to determine the feasibility and safety of enoxaparin whole milligram dosing in premature and term neonates, and to assess response to treatment. Study Design: Retrospective study of neonates with thrombosis treated between January 2008 and December 2014. Result: Nineteen premature and 21 term neonates were treated with whole milligram doses of enoxaparin. The mean starting and therapeutic enoxaparin doses were 1.72±0.17 and 1.86±0.17 mg kg −1 , respectively. Twenty-five (64%) reached therapeutic antifactor Xa (anti-Xa) levels with the starting dose, whereas 14 (36%) required dose adjustments. One neonate reached a supratherapeutic anti-Xa level (>1.0 IU ml −1 ) in the loading phase. No bleeding episodes occurred. The mean treatment duration was 12 weeks. Among 34 (85%) evaluable patients, 23 (68%) had a complete response, 9 (26%) partial and 2 (6%) had a stable thrombotic state. Conclusion: Whole milligram dosing of enoxaparin for thrombosis is feasible, safe and effective in premature and term neonates.