Limited coverage drugs – enoxaparin

Last updated on August 26, 2024

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Generic name	enoxaparin
Brand name	Dosage form	Strength
Noromby	prefilled syringe (PFS)	20 mg/0.2 mL 30 mg/0.3 mL 40 mg/0.4 mL 60 mg/0.6 mL 80 mg/0.8 mL 100 mg/mL
Noromby HP	PFS	120 mg/0.8 mL 150 mg/mL
Inclunox	PFS	30 mg/0.3 mL 40 mg/0.4 mL 60 mg/0.6 mL 80 mg/0.8 mL 100 mg/mL
Inclunox HP	PFS	120 mg/0.8 mL 150 mg/mL
Redesca	PFS	30 mg/0.3 mL, 40 mg/0.4 mL, 60 mg/0.6 mL, 80 mg/0.8 mL
Redesca	vial	100 mg/mL 300 mg/3 mL
Redesca HP	PFS	120 mg/0.8 mL 150 mg/mL
Elonox	PFS	30 mg/0.3 mL 40 mg/0.4 mL 60 mg/0.6 mL 80 mg/0.8 mL 100 mg/mL
Elonox HP	PFS	120 mg/0.8 mL 150 mg/mL

Treatment of venous thromboembolism

Special Authority criteria	Approval period
For the treatment of:
Patients with acute deep vein thrombosis or pulmonary embolus who continue to receive care after leaving an acute care (hospital) setting. This treatment bridges the time gap to achieve therapeutic INR on oral anticoagulants; OR	Up to 10 days supply
Patients with treatment failure of oral anticoagulant therapy (recurrence of one or more deep vein thromboses or pulmonary emboli in patients with therapeutic INR on oral anticoagulants); OR	Up to 3 months, then reassessed
Patients with cancer associated thrombosis	Up to 6 months

Prophylaxis of venous thromboembolism

Special Authority criteria	Approval period
For prevention in patients:
Following elective total knee replacement surgery; OR	Up to 14 days
Following elective total hip replacement surgery; OR	Up to 35 days
Following orthopedic surgery for major trauma; OR	Up to 10 days
With lupus anticoagulant syndrome, antiphospholipid syndrome, or thrombophilia; OR	Up to 3 months
Before, during or after pregnancy; OR	Up to 4 weeks post-partum
Following abdominal or pelvic surgery for the management of a malignant tumour (applicable to dalteparin and enoxaparin prescriptions only); OR	Up to 10 days
Following abdominal or pelvic surgery for the management of a malignant tumour (applicable to dalteparin and enoxaparin prescriptions only) and who are at high risk (defined as those with previous history of VTE and/or anesthesia lasting longer than 2 hours and/or bed rest lasting 4 days or longer following surgery)	Up to 28 days for high-risk patients

Practitioner exemptions

PharmaCare coverage will be provided for a patient who meets the Limited Coverage criteria, and whose prescription is written by an orthopedic surgeon who has entered into a Collaborative Prescribing Agreement (PDF, 291KB)
Due to the individual nature of each Collaborative Prescribing Agreement, the agreement must be signed by the prescriber and not their delegate

Special notes

The total duration of therapy includes the period during which doses are administered post-operatively in an acute care (hospital) setting. The approval period is for the balance of the total duration after discharge (i.e., for outpatients only)

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