Regarding Lovenox and tPA, Lovenox (enoxaparin) at full dose (1 mg/kg q
12 hours) is equivalent anticoagulation to full dose unfractionated
heparin or warfarin, and would definitely be a
contraindication to tPA. Monitoring its effect requires a
Factor Xa level, not rapidly available in most hospitals. Lovenox at DVT
prevention dose, e.g. 40 mg sc daily, is much less clearly a
contraindication. It is thought equivalent to sc heparin at 5000 units q
8-12 hours. There is no published information of which I am aware and it would be up to practioner whether to go ahead with alteplase
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