efficacy and safety of two different enoxaparin doses for thromboprophylaxis in non-critically ill patients: a randomized controlled trial

Background: recently, a few studies based on anti-factor xa activity levels have propounded doubtful and sub-prophylactic levels by the usual dose of enoxaparin in surgical and critically ill patients. in this study, we assessed two doses of enoxaparin in adult non-critically ill patients. methods: patients were randomly assigned into two groups of intervention and control. while the intervention group received enoxaparin with a daily dose of 60 mg, the control group received enoxaparin 40 mg. anti-factor xa activity was measured based on the peak steady-state levels. the level of 0.2 to 0.4 iu/ml was considered as a prophylactic goal. all individuals were followed for bleeding or thromboembolic events during admission. results: the mean levels of anti-factor xa were 0.29 ± 0.13 iu/ml in the control group (n = 31) and 0.44 ± 0.19 iu/ml in the intervention group (n = 29). more patients in the control group had an optimal level of anti-factor xa compared to the patients in the intervention group (62.1% vs. 29%). no adverse outcomes were detected in any of the groups. conclusions: enoxaparin dose of 60 mg daily provided anti-factor xa level higher than desired in most patients. in non-critically ill patients, the dose of 40 mg is the proper dose for thromboprophylaxis.