Prophylactic enoxaparin dose calculations in Epic change July 14

Aligns with current best-practice recommendations

Starting Tuesday, July 14, Salem Health Hospitals and Clinics will update the default enoxaparin dosing algorithm for VTE prophylaxis in Epic.

Historically, prophylactic enoxaparin doses were calculated based on a patient’s renal function and weight in kilograms. With this update, the default calculated prophylactic dose will be based on renal function and body mass index (BMI). See key changes below and Table 1 for a summary of how enoxaparin doses are chosen.

Key changes:

• Dosing calculations will use renal function and BMI rather than renal function and weight in kilograms.
• For patients with normal renal function and a BMI ≥40 kg/m², the default prophylactic dose will be enoxaparin 40 mg every 12 hours (updated from 30 mg every 12 hours)
• These changes align with current best-practice recommendations for VTE prophylaxis.

As always, providers should use clinical judgment and may select an alternative dose or frequency when warranted based on the patient’s individual thrombotic and bleeding risk. If a default enoxaparin dose is not calculated, the patient falls outside of the approved algorithm. If the provider chooses to use enoxaparin, they will need to select the most appropriate dose; alternatively, subcutaneous heparin can be used.

The VTE prophylaxis guideline document can be found on the Pharmacy SharePoint site here (Salem Health intranet access required).

Questions? Email Jade Bryant, PharmD, Pharmacy Clinical Coordinator. 

Table 1. Enoxaparin for VTE Prophylaxis Dosing Based on Renal Function and BMI.