Doses

LMWH: Enoxaparin

UFH

Adapted to body weight

Used in impaired renal function

Regular prophylactic

40 mg sc 1×/d

7500UI 2^*/d

20 mg sc 1 ×/d

when

♀ < 50 kg bw

♂ < 60 kg bw

60 mg sc 1 ×/d

when

BMI > 50 kg/m²

Therapeutic

Max 0.8 mg/Kg/bw 2x/d

+ Surveillance of anti-Xa

In a perfusor, with an aPTT therapeutic range between 60-80 sec.