Clexane 40


If from "Clexane 40® “, a heparin pre-filled syringe is usually meant that contains 4000 IU (international units). This corresponds to 40 mg enoxaparin sodium of the active ingredient enoxaparin.

Clexane 40® “is the trade name of this drug. The drug is dissolved in a defined volume of 0.4 ml.

In addition to this dosage, there are other dosages (e.g. Clexane 20® = 2000IE in 0.2ml; Clexane 80® = 8000IE in 0.8ml).

Mode of action

The active ingredient enoxaparin is discontinued low molecular weight heparin represent.
All low molecular weight heparins intervene in the natural blood coagulation and inhibit it by reducing the effect of an endogenous coagulation factor (Factor Xa) amplify.

One speaks of low molecular weight heparins, because from a chemical point of view these are very small molecules (consisting of approx. 15 sugar units).
In addition to enoxaparin, the active ingredient in "Clexane 40®“, Also include Certoparin, Dalteparin, Nadroparin, Reviparin and Tinzaparin.

Also the unfractionated heparins and Fondaparinux have a similar effect and therefore belong to the large group of heparins.


Clexane 40®"Is prescribed for:

  • Thrombosis prophylaxis, especially in the context of immobilization before, during and after operations
  • Thrombotherapy: lies a thrombosis (especially the leg and pelvic veins), Clexane® used for therapy of this
  • Pulmonary embolism: Clexane is also used in the treatment of pulmonary embolism® used
  • Patients with a long-term anticoagulant therapy
    (e.g. Marcumar, Xarelto®) with certain diseases (e.g. Atrial fibrillation, artificial heart valves): for bridging therapy before interventions, this medication must be supplemented with higher doses of heparins (up to two times Clexane 80®) be replaced.


Enoxaparin should be dosed according to the weight. The dosage also depends on the desired degree of anticoagulation.
To Thrombosis prophylaxis as part of operations on Musculoskeletal system (especially hips, legs) and for prophylaxis in other non-surgical diseases that lead to immobility, "Clexane 40®“Prescribed, ie a dosage of 4000 IU / day.

Is the Kidney function restricted, the dose of Clexane® be adjusted. Otherwise there may be an accumulation of the drug in the blood come.

On the day of an operation, "Clexane 40®“Shouldn't be given until 12 hours after the operation, so that's it Risk of bleeding not significantly increased during the operation or for postoperative bleeding.

The effect can be determined by determining the Factor Xa activity be monitored. However, this is not done routinely. This provision is sometimes used in children, pregnant women and patients with impaired kidney function.

Read a lot more information about dosage at: Dosage of Clexane

How to use

As already mentioned, "Clexane 40®“As a pre-filled syringe and can therefore be administered by the patient himself or his relatives.

Low molecular weight heparins are supposed to subcutaneous (i.e. directly into the subcutaneous fatty tissue). The abdominal wall is best suited for this.
To Disinfection of the injection site, you take a small fold of skin between two fingers and stick the needle vertically into this skin fold up to the end. Then the drug can be applied slowly.
Then the needle can be pulled out again.


The pre-filled syringes can be used in Room temperature (not higher than 25 ° C) until the expiry date. In particular, care should be taken to ensure that children do not have access to medication.

Side effects

  • Bleeding: If severe bleeding occurs during treatment with heparin, the administration of Protamine the heparin effect can be canceled in an emergency.

  • Drop in platelets (Thrombopenia): Too low a number of blood platelets also increases the risk of bleeding. During therapy with heparin, the concentration of blood platelets must therefore be determined regularly. If this drops too much, the drug must be discontinued.

  • Hair loss (Alopecia): However, this ends after discontinuation of Clexane

  • Increase in liver values (Transaminases)

  • osteoporosis: especially with prolonged use (> 6 months)

  • Skin changes

Read a lot more information at: Side effects of Clexane

Interaction with other drugs

The anticoagulant effect of "Clexane 40®“May be reduced if certain other drugs are taken at the same time.

Which includes: Antihistamines (e.g. used for allergies), Tetracyclines(Antibiotics) and Glycerol nitrate (e.g. used for certain heart diseases).

Used in addition to therapy with heparins at the same time aspirin® taken, this should be discussed with the doctor, because this combination therapy works with one clearly higher risk of bleeding hand in hand.


  • allergy against heparin

  • Drop in platelets under therapy with "Clexane 40®“Or other heparins

  • Increased willingness to bleed due to other blood clotting disorders

  • Increased risk of bleeding (shortly before operations)

For use during pregnancy and breastfeeding see the article "Clexane pregnancy“.