Anticoagulation Meds 💉

Reference guide for anticoagulation medications. LMWH dosing calculators, drug table, and prescribing for anticoagulation and antiplatelet therapy.

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💉 LMWH dosing calculators

Weight-based dosing for enoxaparin (Clexane) and tinzaparin (Innohep) — use the dedicated calculators below.

Tinzaparin dosing (Innohep)Enoxaparin dosing (Clexane)

💊 Anticoagulants & Antiplatelets

Includes common medications used for anticoagulation and antiplatelet therapy in hospital settings.
Refer to renal and hepatic considerations when prescribing.

Peri-procedural anticoagulation holds Warfarin 🩸

Anticoagulation Medications

Reference table for anticoagulation therapy

Drug	Dose	Frequency	Route	Notes
Enoxaparin (Clexane)	20-40mg	OD	SC	40mg OD standard dose. 40mg BD if BMI >40 or >120kg. 20mg for low risk or GFR <30.
Tinzaparin (Innohep)	3500-4500iu	OD	SC	VTE prophylaxis <100kg.
Aspirin	75-300mg	OD	PO	75mg stent protection. 300mg for MI/CVA.
Clopidogrel (Plavix)	75-600mg	OD	PO
Prasugrel (Efient)	5-60mg	OD	PO	PCI: 60mg load, 10mg maintenance. 5mg if <60kg. Avoid if prior TIA/stroke.
Rivaroxaban (Xarelto)	20mg	OD	PO	GFR 30-49: 15mg. GFR <30: do not use.
Edoxaban (Lixiana)	60mg	OD	PO	Cr 15-50 OR <60kg OR inhibitors: 30mg.
Apixaban (Eliquis)	2.5-5mg	BD	PO	Use 2.5mg BD if two of: Creat >133, Age >80, Weight <60kg. GFR 15-30: 2.5mg BD.

Enoxaparin (Clexane)

Dose:20-40mg

Frequency:OD

Notes: 40mg OD standard dose. 40mg BD if BMI >40 or >120kg. 20mg for low risk or GFR <30.

Tinzaparin (Innohep)

Dose:3500-4500iu

Frequency:OD

Notes: VTE prophylaxis <100kg.

Aspirin

Dose:75-300mg

Frequency:OD

Notes: 75mg stent protection. 300mg for MI/CVA.

Clopidogrel (Plavix)

Dose:75-600mg

Frequency:OD

Prasugrel (Efient)

Dose:5-60mg

Frequency:OD

Notes: PCI: 60mg load, 10mg maintenance. 5mg if <60kg. Avoid if prior TIA/stroke.

Rivaroxaban (Xarelto)

Dose:20mg

Frequency:OD

Notes: GFR 30-49: 15mg. GFR <30: do not use.

Edoxaban (Lixiana)

Dose:60mg

Frequency:OD

Notes: Cr 15-50 OR <60kg OR inhibitors: 30mg.

Apixaban (Eliquis)

Dose:2.5-5mg

Frequency:BD

Notes: Use 2.5mg BD if two of: Creat >133, Age >80, Weight <60kg. GFR 15-30: 2.5mg BD.

SmPCs (medicines.ie / HPRA)

Enoxaparin (Clexane 4,000 IU / 40 mg)Tinzaparin (Innohep 12,000 IU syringe)Aspirin (Aspirin Krka 75 mg, HPRA)Clopidogrel (75 mg tablets, HPRA)Prasugrel (Prasugrel Viatris 10 mg)Rivaroxaban (Xarelto 20 mg)Edoxaban (Lixiana)Apixaban (Eliquis 5 mg)

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Drug

Dose

Frequency

Route

Notes

Enoxaparin (Clexane)

20-40mg

40mg OD standard dose. 40mg BD if BMI >40 or >120kg. 20mg for low risk or GFR <30.

Tinzaparin (Innohep)

3500-4500iu

VTE prophylaxis <100kg.

Aspirin

75-300mg

75mg stent protection. 300mg for MI/CVA.

Clopidogrel (Plavix)

75-600mg

Prasugrel (Efient)

5-60mg

PCI: 60mg load, 10mg maintenance. 5mg if <60kg. Avoid if prior TIA/stroke.

Rivaroxaban (Xarelto)

20mg

GFR 30-49: 15mg. GFR <30: do not use.

Edoxaban (Lixiana)

60mg

Cr 15-50 OR <60kg OR inhibitors: 30mg.

Apixaban (Eliquis)

2.5-5mg

Use 2.5mg BD if two of: Creat >133, Age >80, Weight <60kg. GFR 15-30: 2.5mg BD.