#EMConf: Reversal of Lovenox

Thu, 11/08/2018 - 7:00am
Author: 
Reid Phillips MD
Editor: 
John Cafaro MD

Recommend against reversal of LMWH in patients receiving prophylactic dosing of LMWH. 

Low quality of evidence for the use of FFP or PCC to reverse LMWH. 

Protamine:

  • Dosed within 8 hours - 1 mg IV per 1 mg Lovenox (up to 50 mg in a single dose).
  • Dosed within 8-12 hours - 0.5 mg IV per 1 mg Lovenox (up to 50 mg in a single dose). 
  • Minimal utility in reversal of >12h from dosing. 

rFVIIa: 90 ug/kg iV if Protamine is contraindicated.