Wednesday 11 April 2012

Side Effects of Clexane (Enoxaparin)

CC courtesy of Hanu Amir, Flickr

Bruising From Clexane

I caught sight of myself in the mirror and was shocked at what I saw and was surprised that I couldn't feel it. I looked down and my lower stomach was black and blue, when I touched it I recoiled in pain. These are some of the side effects of my daily injections. I have to take 120mg (80ml) of injectable heparin (Clexane/Enoxaparin) twice a day (12 hours apart).

What Is Clexane?

The job of clexane (injectable heparin) is to prevent blood clots forming and I'm taking this at the moment to first of all help keep me alive by stabilizing my current clots and to reduce my platelet count to reduce my risk of clotting. The reason I'm black and blue is two fold: first of all it's a side effect (I'll get to those in a mo) and second of all we're running out of places to stick them (my partner in crime does the injections for me).

Side Effects

I thought it might be useful to give you all a run down of the side effects that I'm experiencing with this low weight heparin:
  • Bleeding - kind of obvious there
  • Pain and irritation at the injection site - yep, if you nick a nerve, a blood vessel or even push the fluid in too quickly it can hurt like a monkey
  • Blood clots which can form a lump at the site - this normally happens if I accidently knock the site soon after injecting and they become very tender so be careful!
  • Breakdown of skin cells - at the moment I've got a weird thing with my feet at the moment where the skin is breaking down too quickly and the skin on my face is flakey
  • Hair loss - not too bad but related to the above symptom
  • Heavier periods for women - less ability to clot properly
  • Decrease in the number of platelets - this is what I need but can be bad for some people
  • Necrosis (cell death) at the site - I haven't got this just some severe bruising
  • Blood clots in the spinal cord - only really happens if you are having a spinal or epidural anesthesia so you'll be hospitalized anyway
  • Osteoporosis - a possibly side effect that can happen after long-term dosages which is slightly worrying as they don't say how long and I've already been on this for three months now.

A Little Something For the Bruising

The bruising from Clexane can be quite severe and painful. Since going back to my doctor about the side effects she recommended trying arnica either in pills or cream form. I've tried both but I found the cream to be more effective as it also provides a soothing feeling as well; the pills are better suited to bruise prevention rather than removal.

So there we are. A lovely list for all you clexane lovers - can you hear the sarcasm? - who might be a little worried about some side effects. If I've missed any out leave a note in the comments.


  1. hi
    ive been on 120 of clexane for abouut 6 months now. due to warfarin not working after being on it for 15 yrs !! for dvt's in legs....recently the injections have become more painfull and i dont no why ! the bruising is awful and my belly is so lumpy and painfull...i keep knocking it, which is soooo painfull...guess thats normal...apart from as i said the injections becoming more running out of my tummy looks like ive been in a boxing match with mike tyson !! guess its worth getting it checked also very achy in my whole body...joints being the most this another side effect i wonder?
    anyway after reading your info it was very helpful

    1. Hi Karen, thanks for stopping by. I just wanted to answer your questions and offer some advice to you. First of all if you're running out of space on your tummy then you can use the fattiest part of your thighs (I use the top inside bit) for a couple of days to let the bruises heal. As for the bruises I would recommend Arnica cream (check out: it helps to heal them pretty quickly - I use this as well. If you're getting lumps around the injection site I would recommend wearing your clothes as lose as possible or even wearing a dress to avoid contact with the area - again to help the healing process. As a side note is it cold where you are at the moment? I find that winter is the worst time of year for my injections, I don't know why but it just makes everything worse.
      As for the aches and pains has your weight changed recently? If you've dropped some weight you might be on too much Clexane, and if you've gained some weight you might not be on enough. Either way I recommend speaking to your doctor about it asap as it might be some other warning signs cropping up.
      If you have any other questions just get in contact :-)

  2. Thank you so much for sharing your story on the web it is useful to hear other peoples experiences with this drug.
    I have been on clexane for for 9 years now. My dose increase last year to 170ml twice a day as i suffered yet another clot and then another stroke whilst being on the injections.
    Like you, I am Warfarin resistant. I wondered what made you start on the clexane and if yours like mine is life long? My stomach is also awfully bruised after all these years and I barely can have an injection now without bleeding from the site. It would be really useful to know if you have a named condition.
    I have been told that i supposedly have a condition all of my own! I have had 4 DVTs, 3 Pulmonary Embolisms and 2 Strokes, despite being on anticoagulation. They are unaware as to why I keep getting clots as my Thrombophilia screen is normal. Any information you have so I can compare would be really useful. Thank you for taking the time to read this post and I appreciate any response you may give. It is really frightening living on the edge of a deadly clot everyday and I am trying to find out anything at all that I can do to help myself :)
    Warmest regards to you and all in the same position having to take these injections

    1. Hi there, thanks for stopping by. I have a condition called Heterozygous Factor V Leiden ( basically I have a lot of trouble breaking down my own clots so they grow and grow whilst sending little ones all over the place. My Thrombophillia screen is normal too and it has taken them 5 years to figure this out for me. You might want to ask your doctor about clotting factor diseases or maybe Hughes Syndrome (sticky blood).
      I understand the bruised tummy look :-( I pretty much bleed each time I inject now too. You can also inject into the upper thigh on the fatty bit if you're having trouble on your tummy - I do this a few days a month to give my tummy a chance to heal. Arnica ( has helped a lot for me in getting the bruising down so I'd recommend trying some of that too.
      I've been on Clexane now for about a year now and my hematologist is trying to get my onto warfarin as he's worried about bone thinning as it runs in my family. I think as long as I'm safe and not going to clot then I'm willing to try anything.
      Good luck in your search and feel free to get in contact if you have any further questions. Bobby.

  3. Hi Rebecca
    I have been on clexane now for 3 years after being on Warfarin for 7 years. I am homozygous for Factor V Leiden which is a lot less common than those who are hetrozygous. I have literally clotted everywhere! Lungs, legs, arms, optic nerve, brain stem,and the list goes on. Consequently these have caused other major medical issues. I too, have many bruises etc from clexane injecting which I do myself as then I find it hurts less. I inject usually on my upper legs and have been told that you can also inject in the fatty part of the upper arm. It also helps to rotate sites. I was told not to rub the injection site or press it after injecting and this seems to reduce bruising. I find it also easier and less painful to inject after a warm shower when the muscles are relaxed.

    I would love to know really what the long term affects of clexane is and when I asked my haematologist she said basically bone thinning and did not want to go further with possible complications.

    All the best

    1. Hi Kathy, thanks for stopping by. From what my hematologist has told me the only real concern is with bone thinning. You might also become anemic if you have heavy periods but that can be sorted out with some iron supplements. Otherwise it's pretty much the bruising that you have to contend with on a daily basis.
      I understand that Clexane is a very safe medication and as long as you keep on eye on your bone density then you'll be fine.
      Take care.

  4. Hi, glad I found your blog. 38M UK - homozygous fvl here, had several clots in the past and been on clexane for 2 years (supposed to be lifelong). I am very bad at taking it though, for all the reasons mentioned above, so must admit I don't take it every day. I've been suggested two different types of oral medication which are now available in the UK. I will try to find the names. Cheers.

  5. I can't do it in my belly! I do it top of my leg. I'm 24, from UK fvl, my consultant wants to move me on to warfarin, i have been on clexane for about 2 years, with the view of moving me to warfarin from the beginning. I'm a bit worried, I don't see why they wouldn't keep me on clexane. Apart from the bone thinning? L

  6. Hi anonymous I am on lifelong clexane too for similar reasons to yourself. I too have strokes clots and bleeds. I take twice a day but set alarms on my phone to remind me. used to take once a day which was easy but twice a day has taken some adjusting to....hence the alarms, My bruising and lumping has suddenly become a problem and joint pain is bad too. I am on a thinning plan nut my dosage is correct. it seems as if luid reduction has something to do with the increase in symptoms.

  7. Hi guys, I have once daily clexane injections too, it totally sucks, they sting, cause huge bruises and lumps. I'm stuck on it for life following 9 heart attacks, a stroke and a PE that ended up with foot being amputated. I have APS a clotting disease and found I was warfarin resistant after my femeral artery was blocked. It is interesting to see that others are taking clexane daily for life..I thought I was the only unfortunate one. T

    1. Hi T, thanks for stopping by. You're certainly not alone in feeling those bruises and lumps. I don't know if you do so already but I found that rotating injection sites really helped: starting as far up and left on the stomach as possible and working down and to the right in a zig zag pattern until I reach the right side of my stomach and then go back the opposite way. I've found that by the time you've done a circuit the starting side is pretty much healed up. Let me know if that helps :-)