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 achieved^1,2. If using Direct-Acting Oral Anticoagulant (DOAC) therapy, then LMWH is typically discontinued upon initiation of DOAC therapy^1,4-7.

LMWH treatment duration varies with respect to therapeutic indication and is summarized in Table 3.

Table 3. LMWH Recommended Treatment Duration (Adults)^{1-3, 8-13}

Drug Name	Treatment Indication	Treatment Duration Range	Maximum Treatment Duration
dalteparin	DVT/PE prophylaxis for hip replacement surgery	5 to 10 days	14 days^
	DVT/PE prophylaxis for abdominal surgery	5 to 10 days	10 days
	DVT/PE prophylaxis for acute illness and significantly limited mobility	12 to 14 days	14 days
	DVT/PE treatment in cancer patients	6 months	6 months
	unstable angina/non-Q-wave myocardial infarction (MI)	5 to 8 days	8 days
enoxaparin	DVT/PE prophylaxis for hip replacement surgery	7 - 10 days	21 days^
	DVT/PE prophylaxis for knee replacement surgery	7 - 10 days	21 days^
	DVT/PE prophylaxis for abdominal surgery	7 - 10 days	12 days
	DVT/PE prophylaxis for acute illness and significantly limited mobility	6 – 11 days	14 days
	outpatient DVT treatment without pulmonary embolus (PE)	7 days	17 days
	inpatient DVT treatment with or without PE	7 days	17 days
	unstable angina/non-Q-wave myocardial infarction (MI)	2 – 8 days	8 days
	acute STEMI	up to 8 days or hospital discharge, whichever is first	not determined

Legend:

• ^ = In patients undergoing orthopedic surgery, dalteparin and enoxaparin may be continued for 28 to 35 days¹².