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Long-term lovenox therapy


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My dad had a DVT with a small PE while hospitalized for complications from chemo over a year ago (his cancer hx is below). They put him on Lovenox and have never taken him off. His insurance covers Lovenox so cost is not a factor (thank God). I guess my question is would he otherwise be placed on coumadin long-term or do some docs just d/c blood thinning tx after a certain amount of time? He really has no side effects from Lovenox (beside scar tissue encircling his entire abdomen...poor guy)....and he beleives that part of the reason he hasn't had mets yet is b/c the Lovenox makes his platlets less sticky (some potential theroy we have read along the way). Is the lovenox still necessary? Thank you so much.

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In people with active cancer who have had a blood clot, I generally recommend life long anticoagulation. I usually switch people over to coumadin which is many many times less expensive and doesn't require an injection. The theory that lovenox prevents lung cancer from spreading has not been born out in clinical trials. I do have some patients who I keep on lovenox because coumadin will be difficult to regulate or I think their risk of recurrent clot is so high that coumadin is not enough.

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Thanks so much for the information. It would be great if we could adjust my dad's Lovenox dose so he could get just one shot per day....right now he gets 80mg BID. What would you suggest and I'll run it by his oncologist?? Thanks again so much for your time and knowledge, Teresa

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