Lovenox *gulp*

August 28, 2009

After my first loss I asked my doctor to run any tests she had to find out why. She was kind of enough to oblige though I’ve heard some docs won’t run these until three or more. While waiting for these results I got pregnant again. She called me 5 weeks into my pregnancy and asked me to take a baby aspirin because I tested positive for lupus anticoagulent and referred me to a maternal fetal specialist to discuss lovenox. He ordered a series of 15 tests on me.  In the meantime I lost that pregnancy. A few days after the loss I learned my lupus anticoagulent was now negative though there were other numbers that were borderline high. She said next time I got pregnant to get lovenox immediately upon a positive test. True to her word as soon as I called in she wrote me a prescription for lovenox.

I waited to fill my appointment until the next day because I had an appointment with a hematologist. He said he didn’t think lovenox was medically necessary for me and that I should wait two weeks for him to run some more tests on me. I asked him why did I test positive for lupus first go around, and then negative the next go around. He said sometimes lupus anticoagulent follows one pregnancy but not another. I asked him if now I was safe in this pregnancy, he said I can’t be certain. So while he said I didn’t need to take lovenox he did say that if my OB  felt I should, I can go ahead and take it. I began leaning towards taking it since the thought of this lupus thing coming and going like an apparition trying to steal my pregnancies freaked me out. But I still hesitated. Dr. F said not necessary and he’s an expert on all things blood. Jack thought I should wait out the two weeks.

After fretting for sometime someone advised me the obvious: ask you OBGYN. The hematolist may be a blood doc but he works with cancer, this is a recurrent pregnancy loss issue, you should trust the people who work with the preggo people. So I e-mailed my OB-GYN last night and she said she wanted me on it on the advice of the maternal fetal specialist.

I’m freaking out now. I am hoping by listing my fears they’ll seem less scary:

1) Lovenox costs $1,000/month. My insurance covered it this go aroud but I’m switching insurance in October because my job ends. What if the new insurance gives me problems?
2) I got a positive pregnancy test TUESDAY at 13dpo. Now its FRIDAY 16dpo. I didn’t start too late did I? I’m so upset that I waited. I should’ve gone with my instinct and just started stabbing myself with the needles as soon as they were ordered. The hematologist just confused me. UGH. It’s always better safe than sorry.

Nope, still scared. Please don’t let it be too late. Please don’t let it be too late.

Anyone have any advice on how to take Lovenox?


  1. Kate, I did Haparin (which is very similar to Lovenox, I would have prefered Lovenox). 16 dpo is NOT too late to start. If any small clots may have started the Lovenox will help break them up before the placenta forms and takes over. Your insurance should pay. The only thing that they might suggest is switching to Haparin (because it’s cheaper). They also might want you to get it from a mail order pharmacy like Precision RX.

  2. I dont think it is too late at all. As to your insurance, some have clauses that if you were already on a med for a pregnancy that, even if they normally dont cover it, they will cover it through that pregnancy. Same thing with an OB: if the doctor is out of network, they will still cover them through your pregnancy. Not all ins co’s do that, but some will.

  3. I’m so glad you took initiative an asked for another opinion. I don’t know much about Lovenox, but I’m keeping my fingers crossed for you that it’s the answer!

    I’m so sorry about Baby Bug. I know you’ll always miss those you lost.

    Argh, I hope the cavity doesn’t get worse! When do you start taking the Lovenox? Are the injections easy to take?

  4. I tested positive for lupus anticoagulant while pregnant, and then negative 8 weeks later. I’m also on Lovenox. Both my hematologist and MFM thought it made sense given my history. (Although my MFM did decide to put me on a higher dose than recommended by my hematologist!)

    My MFM wanted me to start once there was a heartbeat, usually around 6w4d, so you sound right on track!

    As for insurance, my insurance (BCBS) has a lifetime max. on Lovenox – like, 14 days or something stupid! I maxed it out last time I was in the hospital. So my dr. had to send in a request for prior authorization. I have fought with my insurance every step of the way thus far. . . . but, surprisingly, it was approved, no problems!

    The only hicup was that it took a few days to process, and I wanted to start the Lovenox asap!, So the pharmacist agreed to fill a partial perscription (5 syringes) and I just ate the cost of that. It’s too bad, but it was worth it for the peace of mind.

    Oh, and the injections might suck at first 😦 I’ve found it really helpful to use the sides of my stomach, as far away from my belly button as possible!

    GL, and feel free to email me with any questions 🙂

  5. it’s not too late, just start now, today!!!

  6. I do not know anything about lovenox – just stopping by to give you some support and ((hugs)) – and hoping, hoping that this is it. I hope the tooth feels better.

  7. Thank you SO much for the advice. I feel better about not having started at 13dpo now. Littlebluebird, you helped me feel less crazy. I feel like I’m being “unncessary” since the LA came back negative, but your doctor ordered the same stuff so I’m not crazy! 🙂 Arminta, I hope I don’t get switched to heparin, I’ve heard that’s tougher to take for some reason, I will be with the same ins company (BCBS) but with ad ifferent employer.

  8. I wish I had advice to add to your Lovenox questions. But I just wanted to tell you I’m thiking of you. And sending very warm thoughts your way.

  9. I agree with everyone else. Most people probably barely realize they’re pregnant at 13dpo, so 16dpo is totally fine to start taking the lovenox. I’m pretty sure you can inject it anywhere you’ve got a layer of fat under the skin, but usually they suggest stomach or thighs (like for fertility meds). I’m sure the pharmacist and the package insert can tell you more. I don’t think there are many side effects from the kind of dose you’re probably on.
    I don’t get why they won’t do dental work on you now. The little bit of local anesthetic they’d have to use couldn’t possibly harm the kid. Hopefully they won’t use mercury in fillings, or anything else toxic. Seems a little strange.

    • I have no idea why they won’t do dental work. They said they can do fillings but they said the medication wasn’t safe at this stage fo the pregnancy. I might ask for a second opinion, but its better safe than sorry I Guess and now I’ll remain paranoid. Thanks for your well advice on lovenox!

  10. It’s not too late at all.

    I took lovenox during the first half of my pregnancy on the advice of my RE and OBGYN despite never having had a miscarriage. I too had some weird blood results, nothing concrete but six or seven different tests that came back as low positives.

    I discontinued use at 18w because of placenta previa(high risk of bleeding).

    When my OB had me see a hematologist about it he told me the same thing that yours told you, he didn’t think I needed it. He said, “I wouldn’t have started you on it at all unless you’d had an ‘event’ or miscarriage”.

    My one bit of advice, I found the needles were a bit dull(maybe I was just used to follistim)so I used ice before and after.

    Also if your insurance won’t cover lovenox you can take heparin instead which is much cheaper and there is a generic. Just be warned the heparin is twice a day and a larger volume, but if it saves you $1000 a month….

    Good luck!

    • Thanks sooooo much for letting me know a similar thing happened to you regarding conflicting opinions. I feel much better about using lovenox and I feel a bit mnore at ease knowing there is a cheaper alternative.

  11. hey, I’m praying that you’ll get to also have a photo progression of your growing belly.

  12. Hi sweet Kate,
    Hang in there love, you’re doing all the right things– I agree with your wonderful commenters– not too late, all will be ok– take this a moment at a time. You can check with the benefits person at the new company to get a clue about future coverage– there is almost always a ‘medically necessary’ clause or process.

    Hope you are a little less scared, and feeling a little less crazy, but I don’t blame you for being however you are– this is so hard and so so so potentially ongoingly (my new word) wonderful–

    sending love

  13. sending prayers and good thoughts that all is well, and that everything works well with the lovenox.

    btw, congrats on your little bean.

  14. Thanks everyone for your prayers and well wishes. I am super nervous. . . I guess that’s only normal but I wish I could shake it.

  15. Coming to from LFCA. I was on Lovenox until about 34 weeks pregnant. The doctor will pull the meds towards the end of your pregnancy to prevent extreme blood loss during labor/delivery. I think you are fine if you start taking it now. I had a bit of a delay as well between finding out I was pregnant and starting Lovenox. I can’t speak to your insurance issues, since my plan at the time covered most of the cost. It is an incredibly expensive drug, but I was told not to use heparin as it was not deemed best for pregnant women. Also, the hematologist recommended I take a supplement for Calcium and Vitamin D since the Lovenox can mess with your bone density. Like you, my hematologist did not think it necessary to take the Lovenox (I was diagnosed with a Protein S deficiency), but my RE and OB did, so I went with their advice. If nothing else, it will not hurt you or your pregnancy.

    The injections were the bain of my existence for quite some time. There were some very nasty bruises and sometimes the injections themselves were painful (they are not pH balanced like many other drugs). I used my stomach until my belly got too big, and them moved to my upper thighs.

    Also, one last word of advice. I used ice initially both before and after the injection, which caused more bruising in my experience. The RN told me to stop icing prior to the injection, and that seemed to help. Your experience may be different. Good luck and sending positive vibes your way.

  16. I too took Lovenox, but only after a DVT was discovered. My doctors declined to do any blood testing after one loss. I tested positive for lupus anticoagulant after I was pregnant and negative while I was pregnant. I found icing helped before and after to minimize the pain and bruising.

    Feel blessed, at the dosages I needed it was $3,000 a month and not covered by insurance fully. I had to switch to heparin because we couldn’t afford it. Next time as per the OB, MFM and Hematologist, I am to start Lovenox when I start trying to get pregnant – no waiting until a positive test. Best of luck to you, I hope the pain subsides!

  17. I used lovenox for my last FET. Starting from transfer day (theoretically 16dpo) up until 8 weeks. Who knows if if made a difference, but I’m now at 25 weeks! 🙂 I used ice before and after, but I don’t think it made much difference in the bruising. Maybe helped a little with the stinging. I did switch from injecting in my belly to the tops of my (chubby) thighs, because I felt the rubbing of my pants on my belly was making the bruising worse.

    Re the cost, I have two full boxes of lovenox that I would be happy to send you. I’d hate to see it go to waste. You can email me at dorasblog at gmail.

  18. hi, reading some of your concerns, i just wanted to relieve some of your thoughts on this lovenox. My wife and i have lost a healthy baby born at 21 week, she was not developed enough to survive outside the womb at 21 weeks but she had placental abruption because of clotting from the factor v. thank god we went to a specialist who found this out through testing. our original obgyn accounted it to her fibroids which we found out was total BS. she is now 38 weeks and we are expecting our first child any day now. i credit this to her taking 81mg of asprin daily, and 80mg of lovenox daily. these blood thinners help with clotting in the placenta. So please listen to your doctors and begin this treatment after 12 weeks or so and have lots of beutiful babies

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