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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 28194
Experience:  MD
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Hi, I am on 0.8 mg Enoxoparin (Clexane) daily (I live in the

Customer Question

Hi, I am on 0.8 mg Enoxoparin (Clexane) daily (I live in the UK). I am also a self-harmer. Last night, I injected one shot subcutaneously as directed, and 2 intravenously. Today, because my stomach is so bruised, I put my needle just below my rib on my left. Now it is really hurting. Will I have done myself any damage?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr Basu replied 2 years ago.

Dr. D.J. :

The views expressed by me are for educational purposes only and do not establish a doctor patient relationship.

Dr. D.J. :

Hi there,

This is Dr. D.J., experienced Internal Medicine Specialist.

I am here to address your concerns and provide great service.

Dr. D.J. :

That is a lot of enoxaparin dosage.

Dr. D.J. :

Intravenous use increases the risk of bleeding inside the organs.

Dr. D.J. :

Stomach bruising suggests that possibility.

Dr. D.J. :

You may be bleeding inside.

Dr. D.J. :

Do you notice any dark stools yet?

JACUSTOMER-3l9qsvef- : My stomach is always bruised
Dr. D.J. :

ok

JACUSTOMER-3l9qsvef- : no dark stools
Dr. D.J. :

see, since you already have taken excess dose of enoxaparin, you shoudl not take any further dosage for at least 2 days.

JACUSTOMER-3l9qsvef- : i have a huge lump which I have had for 2 weeks
Dr. D.J. :

You also need to see your doctor for a clinical evaluation to rule out any internal bleeding.

Dr. D.J. :

Why was it prescribed?

JACUSTOMER-3l9qsvef- : I have had 2 DVTs. I am on it for life
Dr. D.J. :

ok

Dr. D.J. :

why not coumadin?

JACUSTOMER-3l9qsvef- : Warfarin?
Dr. D.J. :

yes

JACUSTOMER-3l9qsvef- : Because I was too inconsistent with my dosing. I was choosing what to take so my INR was up and down too much. Haematology discharged me and put me on Clexane
Dr. D.J. :

ok

Dr. D.J. :

warfarin related bleeding is easy to manage given your self harming tendency.

JACUSTOMER-3l9qsvef- : Since then nobody has checked my INR
Dr. D.J. :

INR will not be affected by the enoxaparin.

JACUSTOMER-3l9qsvef- : I've been on the injections for 18 months
Dr. D.J. :

Enoxaparin works differently.

Dr. D.J. :

ok

Dr. D.J. :

most likely you are safe.

Dr. D.J. :

but the lump should be examined.

JACUSTOMER-3l9qsvef- : Somebody said my blood should still be checked
Dr. D.J. :

the collection of blood can be drained if no further bleeding.

Dr. D.J. :

not INR.

JACUSTOMER-3l9qsvef- : .?
Dr. D.J. :

that will be normal.

Dr. D.J. :

it is checked by the factor Xa activity

Dr. D.J. :

complex to understand

Dr. D.J. :

the coagulation pathway can be affected by different ways.

Dr. D.J. :

warfarin blocks vitamin K action.

Dr. D.J. :

this action controls INR

JACUSTOMER-3l9qsvef- : What collection of blood can be drained?
Dr. D.J. :

Enoxaparin affects factor Xa action which is independent of INR

Dr. D.J. :

the lump you talked about.

Dr. D.J. :

if there is collection of blood inside the lump

JACUSTOMER-3l9qsvef- : Ok..
Dr. D.J. :

not necessary usuall.y

JACUSTOMER-3l9qsvef- : I could do that myself. I have syringes here
Dr. D.J. :

not safe--since it can cause more bleeding

Dr. D.J. :

better to leave it to your doctor.

Dr. D.J. :

so if no dark stool, or blood in vomiting, or any change in mental status, then bleeding from intestine and inside the brain unlikely.

Dr. D.J. :

these are the ones we worry about with overdosage.

JACUSTOMER-3l9qsvef- : no, just feel nauseous and got headache
JACUSTOMER-3l9qsvef- : Would I have other symptoms by now?
Dr. D.J. :

ok --see the headache can be a sign of brain hemorrhage especially if it is severe and worsens suddenly.

JACUSTOMER-3l9qsvef- : Just an annoying headache at the moment
Dr. D.J. :

ok monitor it -if worsens further then you should go to the local hospital.

Dr. D.J. :

I will still suggest to see your doctor given this new event.

JACUSTOMER-3l9qsvef- : I can't tell my doctor. That's why I'm on here
Dr. D.J. :

I meant for clinical evaluation.

Dr. D.J. :

hre, i gave you the signs to look out for.

Dr. D.J. :

If they appear, then you will need clinical evaluation not possible online.

JACUSTOMER-3l9qsvef- : Ok. Thanks
Dr. D.J. :

you should withold enoxaparin for at least 2 days --since you have taken more than usual dosage.

JACUSTOMER-3l9qsvef- : ok
Dr. D.J. :

any other question?

JACUSTOMER-3l9qsvef- : no, I don't think so. Thank you
Dr. D.J. :

very welcome

Dr. D.J. :

It was my pleasure to help you today.
Best wishes,
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