Venous thromboembolism (VTE) treatment - enoxaparin dosing if high thrombosis risk
- Table 3 below is only for the management of patients who have a high thrombosis risk (N.B. this list is not exhaustive, use in conjunction with clinical judgement):
- Acute PE
- High risk VTE e.g. iliac vein DVT.
- Initial treatment of VTE in patients with active cancer.
- Weight >110kg.
- VTE whilst anticoagulated (stop anticoagulant and switch to LMWH).
- Consider other recurrent VTE, if felt particularly high risk on an individual basis.
- If the patient has a standard risk of thrombosis - see table 2 for dosing advice.
- If the patient's renal function (creatinine clearance) is <30ml/minute - see table 4 for dosing advice.
Table 3 – Enoxaparin high thrombosis risk dosing
| Actual weight (kg) |
Enoxaparin dose 1mg/kg twice daily |
| 35–44 |
40mg twice daily |
| 45–66 |
60mg twice daily |
| 67–88 |
80mg twice daily |
| 89-110 |
100mg twice daily |
| >110 |
120mg twice daily |
|
NOTES
- If very low or high body weight (e.g. <35kg or >120kg), consider assessing anti-factor Xa activity after 3 consecutive doses to check dose is therapeutic, and after 8-10 doses to check for accumulation. The level should be taken 4 hours post-dose with a target of 0.5-1.2units/ml.
- GGC guidance on heparin dose adjustment for patients with high or low body weight is available on the Clinical Guideline Platform.
|
Guideline reviewed: July 2026
Page updated: July 2026
