What is the role of enoxaparin (Lovenox) in the treatment of antithrombin III (ATIII) deficiency?

Updated: Mar 04, 2020
  • Author: James L Harper, MD; Chief Editor: Hassan M Yaish, MD  more...
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Enoxaparin (Lovenox), a low–molecular-weight heparin (LMWH), is frequently used to prevent thrombi, as well as to prevent the propagation of thrombi that have already occurred. In antithrombin III deficiency, however, the activity of LMWH is not as reliable as in an otherwise healthy person. Careful monitoring of the anti-Xa activity in the patient should be performed. Consider alternative anticoagulation medications (eg, warfarin) because the effectiveness of LMWH is likely reduced.

Once a patient with congenital antithrombin III deficiency has developed thrombosis, anticoagulation is more strongly indicated. Replacement with recombinant antithrombin is not indicated for the treatment of thrombi.

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