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Individuals using this medication should be aware of the potential risk of bleeding near the spinal cord following certain spinal procedures. This bleeding can lead to prolonged or permanent paralysis. It is important to discuss the potential benefits and risks with your doctor prior to undergoing any spinal procedure. Your doctor may advise you to discontinue the medication for a specified period before and after the procedure. Follow your doctor's instructions meticulously.

• The likelihood of bleeding increases if you have a spinal deformity or have previously undergone spinal procedures or surgeries, such as epidural catheter placement or difficult epidural/spinal puncture.
• The risk may also be heightened if you are taking other medications that can cause bleeding or bruising, including antiplatelet drugs like clopidogrel, anticoagulants such as warfarin or rivaroxaban, and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.
• Immediately inform your doctor if you experience symptoms such as back pain, numbness, tingling, or weakness in the legs, or if you lose control of your bowels or bladder (incontinence).

When using this medication, you might notice mild irritation, pain, bruising, redness, or swelling at the injection site. Fatigue and fever are also possible but generally not serious. If these symptoms persist or worsen, it's important to inform your healthcare provider promptly.

It's important to be aware that this medication can impact blood clotting proteins, potentially leading to bleeding. Seek immediate medical attention if you experience unusual pain, swelling, discomfort, prolonged or easy bruising, dark urine, black stools, severe headaches, confusion, vision changes, dizziness, fainting, seizures, weakness, or numbness.

While rare, a serious allergic reaction could occur. Contact emergency services if you experience symptoms such as a rash, severe itching or swelling of the face, tongue, or throat, extreme dizziness, or difficulty breathing.

These are not all the possible side effects. If you notice other unusual symptoms, reach out to your healthcare provider for advice.

Certain medications may interact with this drug. Mifepristone is one example. Additionally, this medication is sometimes used with drugs that have blood-thinning effects, like Aspirin, Clopidogrel, or Warfarin. If your doctor prescribes these combinations, you will need to be monitored closely to reduce the risk of bleeding. Attend all your medical and lab appointments as scheduled.

Pay close attention to both prescription and over-the-counter medicine labels. Many contain pain relievers or fever reducers (like NSAIDs such as Ibuprofen, Naproxen, or aspirin) that can heighten the risk of bleeding when used with enoxaparin. However, if your doctor has recommended taking low-dose aspirin (typically 81-162 milligrams per day) to prevent heart attacks or strokes, continue taking it unless advised otherwise by your doctor. Consult with your doctor or pharmacist if you have any questions.