Enoxaparin - VTE treatment in patients unable to take oral anticoagulants

North West Surrey / ASPH local recommendation:

Ashford & St Peter's Hospitals NHS Foundation Trust are changing the brand of enoxaparin from Clexane to Inhixa (equivalent biosimilar product).

Enoxaparin is a biological medicine and must be prescribed by brand in line with MHRA guidance.

There are limited indications for which enoxaparin should be prescribed in primary care but, where indicated, North West Surrey in conjunction with ASPH are recommending that practices change to using the Inhixa® brand for all new initiations to support patient safety.

See the "NWS Enoxaparin brand switch" document for details

East Surrey / SASH local recommendation:

Inhixa is the preferred brand of enoxaparin at Surrey and Sussex Healthcare NHST trust. Enoxaparin is a biological medicine and must be prescribed by brand in line with MHRA guidance.

See Inhixa communication document for GPs below

The Area Prescribing Committee recommends the use of low weight molecular heparins (LWMH) for the treatment of VTE in those patients who are unable to take oral anticoagulants (excluding obstetric patients and those on current cancer chemotherapy).

LMWH will be considered BLUE (no information sheet) on the traffic light system for the above indications (see below for exclusions).

The specialist should prescribe the initial 1st month of drug treatment. Primary care can take over prescribing upon receipt of an agreed treatment plan from the specialist, which must include details of drug dosage, possible side-effects, and action to take if problems arise, as per local guidance.

LMWH will be considered RED for obstetric use and in patients on current cancer chemotherapy.

Primary care prescriber should ensure that patient medication records include any medicine for which prescribing remains the responsibility of secondary or tertiary care. This will ensure that GP records, which are accessed by other healthcare providers, are a true and accurate reflection of the patient's medication

Enoxaparin is a biological medicine and must be prescribed by brand in line with MHRA guidance. Note; differences in the mechanisms for operation in needle guard between presentations of enoxaparin.