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Drug Dosing: Geriatric Patients

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...

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Updated: Jun 24, 2026

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood

Published on: October 12, 2012

Enoxaparin dosing in the elderly using adjusted body weight.

Frederick Leri¹, Stephen J Voyce, Salvatore Scialla

¹Department of Clinical Pharmacy, Moses Taylor Hospital, Scranton, PA 18510, USA. fleri@mth.org

Journal of Thrombosis and Thrombolysis

|March 14, 2009

Summary

Adjusted body weight (ABW) dosing of enoxaparin in elderly patients improved therapeutic anti-Xa activity. This dosing strategy reduced supratherapeutic levels and was more effective in women.

Related Experiment Videos

Last Updated: Jun 24, 2026

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood

Published on: October 12, 2012

Area of Science:

Pharmacology
Geriatric Medicine
Clinical Pharmacy

Background:

Enoxaparin dosing in elderly patients requires careful consideration due to potential pharmacokinetic changes.
Standard dosing may lead to supratherapeutic anti-Xa activity in this population.
Adjusted body weight (ABW) dosing is a potential strategy to optimize enoxaparin therapy.

Purpose of the Study:

To prospectively compare anti-Xa activity in elderly subjects receiving enoxaparin via standard versus ABW dosing.
To evaluate the safety and efficacy of ABW enoxaparin dosing in patients aged 65 and older.

Main Methods:

Prospective comparison of enoxaparin dosing strategies in 61 elderly subjects (>65 years).
Measurement of anti-Xa activity in relation to standard and ABW dosing.
Analysis of patient demographics including age, weight, serum creatinine, and creatinine clearance (CrCl).

Main Results:

ABW dosing resulted in 57% achieving 0.5-1.0 IU/ml and 80% achieving 0.5-1.2 IU/ml anti-Xa activity.
ABW dosing showed a more favorable mean anti-Xa activity (0.98 IU/ml) compared to standard dosing (1.28 IU/ml).
ABW dosing significantly reduced supratherapeutic anti-Xa levels (0% vs. 28%) and increased therapeutic levels in women (64% vs. 25%).

Conclusions:

Adjusted body weight dosing of enoxaparin may be beneficial for elderly patients (≥65 years).
The benefits of ABW enoxaparin dosing appear more pronounced in female patients.
Optimized enoxaparin dosing through ABW can improve therapeutic outcomes in the geriatric population.