2.1. Adults

When prescribed as preventive therapy, LMWH should be administered until the risk of deep venous thrombosis has diminished. When utilized in the management of DVT and pulmonary embolism, warfarin therapy is typically initiated within 72 hours of enoxaparin therapy. Enoxaparin is continued until a therapeutic anticoagulant effect with warfarin has been achieved1-3 . If using Direct-Acting Oral Anticoagulant (DOAC) therapy, then LMWH is typically discontinued upon initiation of DOAC therapy1,2,5-8. LMWH treatment duration varies with respect to therapeutic indication and is summarized in Table 3.

Table 3. LMWH Recommended Treatment Duration (Adults)1-4, 9-15
Treatment Indication Drug Name Treatment Duration Range Maximum Treatment Duration
DVT/PE prophylaxis for hip replacement surgery Enoxaparin 7 to 10 days^ 21 days^
DVT/PE prophylaxis for hip replacement surgery Dalteparin 5 to 10 days 14 days^ 
DVT/PE prophylaxis for knee replacement surgery Enoxaparin 7 to 10 days 14 days^
DVT/PE prophylaxis for abdominal surgery Enoxaparin 7 to 10 days 12 days
DVT/PE prophylaxis for abdominal surgery Dalteparin 5 to 10 days 10 days 
DVT/PE prophylaxis for acute illness and significantly limited mobility Enoxaparin 6 to 11 days 14 days
DVT/PE prophylaxis for acute illness and significantly limited mobility Dalteparin 12 to 14 days 14 days
DVT/PE treatment in cancer patients Dalteparin 6 months 6 months
Outpatient DVT treatment without pulmonary embolus (PE) Enoxaparin 7 days 17 days
Inpatient DVT treatment with or without PE Enoxaparin 7 days 17 days
Unstable angina/non-Q-wave myocardial infarction (MI) Enoxaparin 2 to 8 days 12.5 days
Unstable angina/non-Q-wave myocardial infarction (MI) Dalteparin 5 to 8 daysup to 8 days or hospital discharge, whichever is first 8 days
Acute STEMI Enoxaparin   not determined

Legend:

  • ^In patients undergoing orthopedic surgery, dalteparin and enoxaparin may be continued for 28 to 35 days13.