Lovenox vs Eliquis

Introduction

When it comes to preventing and treating recurrent blood clots, doctors often have to decide between two options: Lovenox and Eliquis.

Both medications act as anticoagulants. Anticoagulants help to reduce the risk of deep vein thrombosis, pulmonary embolism, and other complications.

Both medications come with their own benefits; Lovenox is also an injectable drug that dissolves quickly in the bloodstream; this makes it a great choice for those who need immediate relief from blood clots. However, Eliquis carries its own advantages.

Despite performing the same action, there are several differences between Lovenox and Eliquis.

About Lovenox and Eliquis

What Is Lovenox?

Lovenox is a form of injectable heparin that is prescribed for both short-term and long-term use. It is also known as enoxaparin. Its primary function is to prevent the development of blood clots, which may cause severe difficulties like pulmonary embolism, deep vein thrombosis, or stroke.

Lovenox works by preventing or slowing down the body's production of thrombin that helps form clots.

What Conditions Is Lovenox Approved to Treat?

Lovenox was approved by the U.S. Food and Drug Administration as an anticoagulant in 1993. It is largely available as an injectable.

Lovenox is approved to treat the following conditions;

Deep vein thrombosis.
Pulmonary embolism.
Unstable angina.
Non-Q wave myocardial infarction.

How Does Lovenox Work for Blood Coagulation?

Lovenox, also known as enoxaparin, works by blocking the activity of a substance called factor Xa. This is essential for the formation of blood clots.

Enoxaparin does this by binding to a molecule called antithrombin III, which is a natural inhibitor of clotting factors.

Once enoxaparin and antithrombin III join together, they create a complex that irreversibly inactivates factor Xa. This means that factor Xa can no longer do its job, which is to convert a protein called prothrombin into thrombin.

Thrombin is necessary for the formation of fibrin, a protein that plays a crucial role in clotting. Without thrombin, fibrinogen cannot turn into fibrin, and blood clots cannot form.

Enoxaparin also binds to other antithrombin molecules once it has released factor Xa. It can directly inhibit factor IIa (thrombin), but not as effective as another medicine called unfractionated heparin.

So, by stopping the clotting process in multiple ways, enoxaparin helps to prevent dangerous blood clots from forming and causing health problems.

What Is Eliquis?

Eliquis is commonly known as apixaban. It is an anticoagulant or "blood thinner" medication to reduce the risk of stroke and blood clots in certain people with atrial fibrillation.

Eliquis is also sometimes given as a preventative measure for those who have previously had deep vein thrombosis or pulmonary embolism. Eliquis works by inhibiting several proteins in the blood responsible for the clotting process, thereby reducing the risk of clots forming without significantly increasing the risk of bleeding.

The drug should be taken as prescribed, especially in patients with increased bleeding risks.

What Conditions Is Eliquis Approved to Treat?

Eliquis was approved by the U.S. Food and Drug Administration in 2012 to reduce the risk of stroke and prevent blood clots.

Eliquis is approved to treat the following conditions;

Strokes.
Systemic embolism in patients with nonvalvular atrial fibrillation.
Deep vein thrombosis.
Pulmonary embolism.
Preventing blood clots in patients after hip or knee replacement surgery.

How Does Eliquis Work for Blood Coagulation?

Apixaban works by blocking the activity of a protein called factor Xa. This protein is involved in the formation of blood clots, which can be dangerous if they occur in the wrong place, like the heart or brain.

By inhibiting factor Xa, apixaban prevents the formation of clots and reduces the risk of conditions like stroke, deep vein thrombosis, and pulmonary embolism.

Apixaban also inhibits the activity of another protein called prothrombinase, which is involved in the clotting process. By blocking these proteins, apixaban can help prevent the formation of harmful blood clots.

Effectiveness

How Effective Are Lovenox and Eliquis for Blood Coagulation?

A comparative study found that after the clots were formed with tissue factor, all of the anticoagulants in the study caused a delay in clot formation except for enoxaparin. With rivaroxaban it was less dense and had thicker fibers, which could potentially make them more permeable.

However, when the researchers initiated clot formation with thrombin, they found that there were few effects of anticoagulation, except for enoxaparin, which also caused a delay in clot formation. The study suggests that different types of anticoagulants can have different effects on the structure of blood clots, with enoxaparin consistently leading to less dense and more permeable clots.

Dosage Information

How Is Lovenox Administered for Blood Coagulation?

Lovenox is available in injection form in different doses, including;

Refilled: 30 mg/0.3 mL syringes and 40 mg/0.4 mL.
Graduated prefilled: 60 mg/0.6 mL syringes, 80 mg/0.8 mL, and 100 mg/1 mL.
Multiple-dose vials: 300 mg/3 mL and 150 mg/mL.

Lovenox Dosage Information

The dosage can vary depending on the individual's age, the severity of their problem, and other factors.

How Is Eliquis Administered for Blood Coagulation?

Eliquis is available in tablet form in different doses, including;

2.5mg
5mg.

Eliquis Dosage Information

The dosage can vary depending on the individual's age, the severity of their problem, and other factors.

Side Effects

Both Lovenox and Eliquis have their own side effects. Remember that if you face any of the below-mentioned side effects, immediately talk to your doctor and discontinue your medicine.

What Are the Most Common Side Effects of Lovenox?

The most common side effects of Lovenox include the following;

Diarrhea.
Fever
Anemia
Skin discoloration.
Shortness of breath.
Confusion.
Non-major bleeding gums, nose bleeds, and vaginal bleeding.
Swelling (edema).
Pain at the site of injection.
A low blood platelet count may show up in blood tests.
A high level of the enzyme aminotransferase in blood.

Are There Any Potentially Serious Side Effects of Lovenox?

Some of the serious side effects of Lovenox include the following;

Severe allergies.
Major bleeding like hemorrhage.
Epidural or spinal hematoma.

What Are the Most Common Side Effects of Eliquis?

The most common side effects of Eliquis include the following;

Bleeding from the anus or vagina.
Bruises on skin.
Anemia.
Blood in the urine.
Blood in feces.
Diarrhea.
Nausea.
Dizziness.

Are There Any Potentially Serious Side Effects of Eliquis?

Some of the serious side effects of Eliquis include the following;

Myocardial infarction or stroke.
Coughing with blood.
Black stools with blood.
Increased flow in menstrual bleeding.

Warnings and General Precautions for Lovenox and Eliquis

As with any medication, there are warnings and general precautions for taking Lovenox and Eliquis. It is important to read the package insert before taking either medication as it contains detailed information about contraindications, dosing, side effects, drug interactions, and other safety considerations to be aware of when taking these medications.

Contraindications and Important Interactions for Lovenox and Eliquis

Contraindications

Lovenox

Consider talking to your doctor before taking any medication if you have the following diseases;

Hemophilia
Peptic ulcer
Prematurity
Retinopathy

Do not take it if you have a known hypersensitivity to the Lovenox or any of its components

Lovenox should not be used in individuals undergoing spinal or epidural anesthesia, as it can increase the risk of spinal hematoma.

Lovenox should be used cautiously in individuals with uncontrolled hypertension, as it can increase the risk of bleeding.

Eliquis

Consider talking to your doctor before taking any medication if you have the following diseases;

Hepatic Impairment
Bleeding
Valvular heart disease

Do not take it if you have a known hypersensitivity to the Eliquis or any of its components.

Eliquis should not be used in patients with active bleeding, such as gastrointestinal or intracranial bleeding.

Eliquis should not be used in individuals with prosthetic heart valves, as it has not been studied in this population and may increase the risk of thromboembolic events

Drug/Medication Interactions

Lovenox

Albuterol
Aspirin
Colace (docusate)
Coumadin (warfarin)
Lasix (furosemide)
Lisinopril
Losartan

Eliquis

Amiodarone
Amlodipine
Aspirin
Diltiazem
Spironolactone
Potassium chloride
Metoprolol Tartrate (metoprolol)

Contraindications

Lovenox

Lovenox works by preventing blood clots from forming, while vitamin K plays a role in blood clotting. Eating large amounts of vitamin K-rich foods, such as leafy greens and broccoli, can counteract the effects of Lovenox.

Drinking alcohol can increase the risk of bleeding when taking Lovenox. It is recommended to limit alcohol consumption or avoid it altogether while taking this medication.

Some herbal supplements, such as ginkgo biloba and ginger, can also increase the risk of bleeding when taken with Lovenox. It is important to talk to a healthcare provider before taking any herbal supplements while on Lovenox.

Eliquis

Fish oil supplements contain omega-3 fatty acids, which have blood-thinning properties. Taking high doses of fish oil supplements while on Eliquis can increase the risk of bleeding.

St. John's Wort is an herbal supplement that can interact with many medications, including Eliquis. Taking St. John's Wort while on this medication can decrease its effectiveness, increasing the risk of blood clots.

Non-steroidal anti-inflammatory drugs such as ibuprofen and aspirin can also increase the risk of bleeding when taken with Eliquis. It is best to talk to a healthcare provider before taking any NSAIDs while on Eliquis.

Cost Comparison

How Much Do Lovenox and Eliquis Cost?

The average price for 5mg for 60 tablets of Eliquis is around $500. The average price for 40 mg/0.4 ml is around $380. It is important to remember that the cost of Lovenox and Eliquis can vary depending on various factors such as the dosage, location, insurance coverage, and whether you are purchasing the generic or brand-name versions.

The Popularity of Lovenox and Eliquis

According to the statistics, the estimated number of prescriptions of Lovenox in the U.S. during 2020 was around 500 thousand, ranking at ³⁷⁵ on the rating list. Eliquis, on the other hand, had around 3 million prescriptions in the U.S. during 2020 and ranked 48th on the rating list.

According to data from IQVIA, in 2020, Eliquis was the second most commonly prescribed medication in the United States, with over 25 million prescriptions filled.

Lovenox was also a commonly prescribed medication, with over 9 million prescriptions filled in the same year.

Conclusion

Takeaway

To sum it up, Lovenox and Eliquis are both anticoagulant medications used to prevent blood clots. It is important to consider patients' individual needs and interests when deciding between Lovenox or Eliquis. While there are similarities, like the decrease in risk of stroke for AFib cases, there are also significant differences, such as the availability and administration.

Ultimately, medical professionals must work collaboratively with the patient to determine a decision optimized for their lifestyle and health goals. This information can help ensure appropriate client care is provided safely and beneficially.