How to self-inject with
Lovenox

NURSE, VOICE-OVER:

Lovenox can help reduce the risk of developing deep vein thrombosis (DVT) blood clots, which may lead to pulmonary embolism (PE), in patients undergoing abdominal surgery, hip- or knee-replacement surgery, or in acutely ill medical patients with severely restricted mobility.

If you are receiving epidural or spinal anesthesia or undergoing spinal puncture, and taking Lovenox (enoxaparin sodium injection), you may be at increased risk of developing a blood clot in or around the spine, which can result in long-term paralysis. Your risk may be further increased if you:

Take nonsteroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, or other anticoagulants, such as aspirin or blood thinners · Have an indwelling epidural catheter · Have a history of spinal trauma, or repeated spinal anesthesia or punctures · Have a history of spinal deformities or spinal surgery.

It is important to contact your doctor immediately if you experience symptoms such as tingling, numbness (especially in the lower limbs), or muscular weakness.

Please see Important Safety Information for Lovenox at the end of this video. Please see full Prescribing Information for Lovenox, including Boxed WARNING at Lovenox.com.

NURSE: (Actor Portrayal)

Hi there. You’ve just been prescribed Lovenox, or Winthrop’s Enoxaparin Sodium Injection, an authorized generic. As you have already discussed with your healthcare professional, Lovenox helps to prevent a DVT blood clot, also called deep vein thrombosis.

NURSE, VOICE-OVER:

These blood clots form in the deep veins of your legs, and if a clot breaks free and travels to your lungs, it could cause a pulmonary embolism, which has the potential to be fatal.

Your risk is higher if you have certain health conditions, or if you’ve just been hospitalized, or have been spending an extended period of time off your feet.

NURSE:

That’s why it’s important to continue these injections on your own. You’ve probably already been taught how to self-inject by your healthcare professional, but this video may also be a helpful reference. This video is intended to help you understand the steps of how to inject, so you feel more comfortable with the process. And whether you’re using Lovenox or the authorized generic, Winthrop’s Enoxaparin Sodium Injection, which is identical by design, the steps are the same. To walk you through the process, let me introduce you to Amy, a person like you who’s also using Lovenox.

PATIENT: (Actor Portrayal)

Hey, I’m Amy. I’m going to show you how I inject Lovenox, the same way my healthcare professional showed me. I‘ll be going over the steps you need to know.

PATIENT, VOICE-OVER:

Be sure to tell your doctors and dentists about all of the medications you are taking, including those you are taking without a prescription, such as aspirin or other NSAIDs. Also, be sure to tell your healthcare professionals you are taking Lovenox before any surgery is scheduled and before any new drug is taken.

PATIENT:

You can always call your healthcare professional if you have any questions or concerns. Remember, you can also talk to your pharmacist when you pick up your prescription.

Lovenox pre-filled syringes come in different doses and strengths, so your packaging and syringe may not look exactly like mine, but the process for injecting is the same.

If you don’t feel comfortable injecting Lovenox yourself, you can have a family member or a caregiver do it—just make sure they’ve been shown how by a healthcare professional.

PATIENT, VOICE-OVER:

Make sure you inject Lovenox exactly how your healthcare professional prescribed, for the exact number of days. Be sure to take each dose at the same time every day, and don’t skip any doses.

PATIENT:

Okay, let’s get started. Make sure you’ve washed your hands, and then find a place where you can sit or lie down comfortably and see your stomach.

Next, find a spot on the left or right side of your abdomen at least two inches away from your belly button.

Make sure to alternate sides with each injection, and don’t inject into a rash, or any scarred or bruised tissue.

Grab an alcohol swab and clean the spot where you’re going to inject. Let it dry completely to help avoid any stinging.

Now, grab the syringe and remove the cap from the needle. Make sure you pull it straight off and don’t twist it to avoid bending the needle. You’ll see that the needle is small and thin, just big enough to reach the fatty tissue right underneath the skin. Be careful not to set the needle down, or let it touch anything, to make sure it remains clean.

There’s a small bubble inside the syringe. Don’t expel the air bubble unless your healthcare professional instructs you to adjust your dose. It’s safe to give yourself the injection even with the air bubble.

PATIENT, VOICE-OVER:

If your healthcare professional has prescribed less than a full syringe, point the needle down, keep a careful eye on the numbers and expel the excess portion until the dosage in the syringe is the same that your healthcare professional has prescribed.

PATIENT:

Now go ahead and place the syringe in the hand you write with, and hold it like a pencil. Use your other hand to make a fold in your skin by pinching an inch of the cleaned area on your abdomen. Then, insert the full length of the needle straight into the fold at a 90-degree angle.

Press the plunger down with your thumb until the syringe is completely empty. It’s important to keep pinching that fold of skin until the injection is done—that way the medication doesn’t enter any muscle, which could be painful.

Once the syringe is empty, pull the needle straight out and then let go of your skin. Don’t try to put the needle cap back on the syringe after the injection.

Point the syringe away from you and anyone else around you, keeping your finger on the plunger rod. Then activate the safety shield by firmly pushing down on the plunger rod until you hear a click.

Place the used syringe and cap in your sharps disposal container, and now the injection is finished.

PATIENT, VOICE-OVER:

Never throw away a used syringe, and never put the sharps container into the regular garbage — also, never reuse syringes.

You should call your doctor immediately if you notice any of the following: unusual bleeding or bleeding that lasts a long time, unusual bruising, signs of thrombocytopenia (such as a rash or dark spots under the skin), tingling or numbness (especially in the lower limbs), and muscular weakness. Do not stop taking Lovenox without first talking to the doctor who prescribed it for you. For specific questions about your health, you should always consult your doctor or a qualified healthcare professional who is responsible for your care.

PATIENT:

Okay, that’s it—all done! I hope this demonstration helps.

If you have any questions, talk to your healthcare professional or call the Lovenox Patient Support Line at 1-800-633-1610, option 1. Keep watching to learn additional Important Safety Information for Lovenox.

Lovenox Important Safety Information and Indications

NURSE, VOICE-OVER:

Important Safety Information for Lovenox^®

If you are receiving epidural or spinal anesthesia or undergoing spinal puncture, and taking Lovenox (enoxaparin sodium injection), you may be at increased risk of developing a blood clot in or around the spine, which can result in long-term paralysis. Your risk may be further increased if you:

• Take nonsteroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, or other anticoagulants, such as aspirin or blood thinners
• Have an indwelling epidural catheter
• Have a history of spinal trauma, or repeated spinal anesthesia or punctures
• Have a history of spinal deformities or spinal surgery

It is important to contact your doctor immediately if you experience symptoms such as tingling, numbness (especially in the lower limbs), or muscular weakness.

Lovenox should not be used in patients who are actively bleeding or who have a low count of blood cells called platelets, which aid in clotting. This is a condition called "thrombocytopenia." Lovenox also should not be used in patients who are allergic or sensitive to Lovenox or enoxaparin, heparin, or pork products.

Lovenox must be used with care in patients who have any of the following: problems with clotting, uncontrolled high blood pressure, a recent ulcer, impaired vision due to diabetes, kidney problems, and excessive bleeding. Pregnant women with mechanical prosthetic (artificial) heart valves may be at higher risk for blood clots. These patients who are treated with Lovenox must be carefully monitored by their doctor.

Some patients on Lovenox can experience drops in their platelet counts, a condition called "thrombocytopenia." Also, a serious but rare condition called "heparin-induced thrombocytopenia" can occur with Lovenox. If you have had this condition, you must promptly notify your healthcare professional.

Lovenox alters the blood's ability to clot. Excessive bleeding (hemorrhage), leading to death, has occurred with Lovenox. Bleeding can occur at any site with Lovenox use. The use of aspirin and other NSAIDs may enhance the risk of excessive bleeding. Be sure to tell all your doctors and dentist about all of the medications you are taking, including those you are taking without a prescription, such as aspirin or other NSAIDs. Also be sure to tell your doctor or dentist you are taking Lovenox before any surgery is scheduled and before any new drug is taken.

All patients should be carefully monitored by their doctor while taking Lovenox. Your doctor is likely to obtain blood tests that measure your blood count and check for signs of hidden bleeding while you are on Lovenox.

You should call your doctor immediately if you notice any of the following: unusual bleeding or bleeding that lasts a long time, unusual bruising, signs of thrombocytopenia (such as a rash or dark spots under the skin), tingling or numbness (especially in the lower limbs), or muscular weakness.

The most common side effects from the use of Lovenox are local irritation, pain, bruising, or redness of the skin at the site of injection. Other common side effects include bleeding, anemia, diarrhea, nausea, ecchymosis, fever, edema, peripheral edema, dyspnea, confusion.

Do not stop taking Lovenox without first talking to the doctor who prescribed it for you.

For specific questions about your health, you should always consult your doctor or a qualified healthcare professional who is responsible for your care.

For more information, call sanofi-aventis U.S. Medical Information Services at 1-800-633-1610.

Indications:

Lovenox can help reduce the risk of developing DVT blood clots, which may lead to PE, in patients undergoing abdominal surgery, hip- or knee-replacement surgery, or in acutely ill medical patients with severely restricted mobility.

Please see Full Prescribing Information, including boxed WARNING, for additional important information.

Prescription Lovenox is available in pharmacies.

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