Weight-based dosing of thromboprophylaxis for acutely ill medical patients at high VTE risk (without bleeding risk factors)
| Weight, kg . | No renal impairment; eGFR ≥30 mL/min . | Renal impairment; eGFR 15-30 mL/min . | End-stage renal impairment; eGFR <15 mL/min or dialysis dependent . |
|---|---|---|---|
| <50 | Enoxaparin: 20 mg daily | Contact hematology for advice | Unfractionated heparin: 5000 U bd |
| 50-100 | Enoxaparin: 40 mg daily | Enoxaparin: 20 mg daily | Unfractionated heparin: 5000 U bd |
| 101-150 | Enoxaparin: 40 mg bd or 80 mg daily | Enoxaparin: 20 mg daily | Unfractionated heparin: 5000 U tds |
| >150 | Enoxaparin: 60 mg bd or 120 mg daily | Contact hematology for advice | Unfractionated heparin: 5000 U tds |
| Weight, kg . | No renal impairment; eGFR ≥30 mL/min . | Renal impairment; eGFR 15-30 mL/min . | End-stage renal impairment; eGFR <15 mL/min or dialysis dependent . |
|---|---|---|---|
| <50 | Enoxaparin: 20 mg daily | Contact hematology for advice | Unfractionated heparin: 5000 U bd |
| 50-100 | Enoxaparin: 40 mg daily | Enoxaparin: 20 mg daily | Unfractionated heparin: 5000 U bd |
| 101-150 | Enoxaparin: 40 mg bd or 80 mg daily | Enoxaparin: 20 mg daily | Unfractionated heparin: 5000 U tds |
| >150 | Enoxaparin: 60 mg bd or 120 mg daily | Contact hematology for advice | Unfractionated heparin: 5000 U tds |
bd, twice daily; eGFR, estimated glomerular filtration rate; tds, 3 times daily.