Interactions : אינטראקציות

4.5       Interaction with other medicinal products and other forms of interaction

Concomitant use not recommended:
• Medicinal products affecting haemostasis (see sections 4.4)
It is recommended that some agents which affect haemostasis should be discontinued prior to enoxaparin sodium therapy unless strictly indicated. If the combination is indicated, enoxaparin sodium should be used with careful clinical and laboratory monitoring when appropriate. These agents include medicinal products such as:
- Systemic salicylates, acetylsalicylic acid at anti-inflammatory doses, and NSAIDs including ketorolac,
- Other thrombolytics (e.g. alteplase, reteplase, streptokinase, tenecteplase, urokinase) and anticoagulants (see section 4.2).

Concomitant use with caution:
The following medicinal products may be administered with caution concomitantly with enoxaparin sodium:
•   Other medicinal products affecting haemostasis such as:
- Platelet aggregation inhibitors including acetylsalicylic acid used at antiaggregant dose (cardioprotection), clopidogrel, ticlopidine, and glycoprotein IIb/IIIa antagonists indicated in acute coronary syndrome due to the risk of bleeding, - Dextran 40,
- Systemic glucocorticoids.

• Medicinal products increasing potassium levels:
Medicinal products that increase serum potassium levels may be administered concurrently with enoxaparin sodium under careful clinical and laboratory monitoring (see sections 4.4 and 4.8).