Difference Between Coumadin and Lovenox
Monitoring and Dosing Differences
Coumadin requires frequent monitoring using the prothrombin time ("protime" or PT) or international normalized ratio (INR) tests. Lovenox usually requires no monitoring whatsoever, except in unusual circumstances.
Coumadin dosing is notoriously difficult. The drug is very "touchy," and frequent dose adjustments are often required. It is very difficult to predict which dose will be the most appropriate for an individual; in most cases, the best dose is determined through trial and error. Lovenox dosing is simple and straightforward, with dosage adjustments almost never being required.
Using Coumadin and Lovenox Together
It is quite common for a person to be taking both Coumadin and Lovenox at the same time. Lovenox begins working right away, while Coumadin does not. In fact, in the period of time when a person first begins taking Coumadin, the drug may actually increase the risk of clots for a short period of time.
Therefore, Coumadin and Lovenox are often taken together. The Lovenox prevents clots while the Coumadin begins working. The Lovenox can be stopped once the INR is in the appropriate range.
A similar situation sometimes occurs in people who have been taking Coumadin for a while. If a PT/INR test shows that the person is at a high risk for clots, a healthcare provider may recommend using Lovenox as a "bridge therapy" while the Coumadin dose is being adjusted.
There are many important differences between Lovenox and Coumadin. However, it is usually quite clear when Coumadin, Lovenox, or both medications should be used. In most cases, it is simply not an option to use Coumadin when Lovenox is necessary (despite the fear of needles or the high cost of Lovenox). Each medication has its own unique advantages and disadvantages and its own place in preventing and treating blood clots.