Introduction
Clexane® is the trade name for the drug enoxaparin, which belongs to the group of so-called low molecular weight heparins. Two major groups of heparins can be roughly distinguished. In addition to low-molecular-weight heparins, these include unfractionated heparins.
Low molecular weight heparins have an anticoagulant effect by influencing normal blood clotting in the human body. They increase the effect of antithrombin III by a factor of a thousand and thus its anticoagulant effect on coagulation factors Xa and IIa, thereby inhibiting the coagulation cascade. The low-molecular-weight heparins are injected into fatty tissue.
Clexane® is available in different strengths. Ready-to-use syringes with 20mg, 40mg, 60mg, 80mg or 100mg Clexane® are used. The area of application varies according to the dose.
Clexane® 20 mg is used, for example, after surgery in patients with a low or medium risk of thrombosis. High doses of Clexane®, e.g. an 80 mg ready-to-use syringe, are used in cases of so-called deep vein thrombosis, i.e. the occlusion of a leg vein by a blood clot.
The use of heparins in general and of Clexane® in particular can lead to dangerous complications. A dangerous and frequent side effect of the therapy is a so-called heparin-induced thrombocytopenia. A distinction is made between a harmless type I and a dangerous type II, in which an antibody-mediated reaction takes place that can lead to blood clots.
Compatibility of Clexane and alcohol
When one speaks of alcohol, one usually means the drinking alcohol, which is also known as ethanol. Ethanol is an intoxicating and stimulant substance that is absorbed in the oral mucosa, stomach and small intestine after consumption. The absorption process takes about one hour, depending on the stomach filling.
The metabolism of low-molecular heparins as well as Clexane® takes place mainly via the kidneys. For this reason, they must not be administered in cases of severe renal insufficiency. Alcohol, on the other hand, is largely metabolized in the liver via the enzymes alcohol dehydrogenase and aldehyde dehydrogenase.
In addition, the so-called microsomal ethanol-oxidising system (MEOS) plays a role in the breakdown of alcohol, but to a lesser extent. Especially at higher alcohol concentrations the MEOS increases in importance, because it is precisely then that it becomes significantly more active. A small amount of alcohol is also excreted via respiration.
It can therefore be said that Clexane® and alcohol are not degraded via the same metabolic pathways and theoretically do not inhibit each other in their mutual degradation. In principle, however, drug interactions with alcohol can never be completely excluded and predicted. Therefore, the consumption of alcohol while taking Clexane® should be avoided.
Furthermore, drug interactions naturally also depend on the amount of alcohol consumed. Moderate, occasional and therefore low-risk alcohol consumption means the consumption of less than 12 grams of alcohol per day for women and less than 24 grams of alcohol per day for men, whereby no alcohol should be consumed on at least two days per week. 10 grams of alcohol corresponds approximately to a standard glass of sparkling wine (0.1l) or a standard glass of beer (0.25l).
In general, however, you should always ask your doctor for advice if you consume alcohol while taking medication such as Clexane®. Chronic alcohol abuse leads to fatty degeneration of the liver and eventually to scarring of the liver, known as cirrhosis. Since the liver is responsible for the production of coagulation factors in the body, long-term damage can lead to problems with blood clotting.
Consequently, a lack of clotting factors increases the risk of bleeding – life-threatening bleeding can occur. Consequently, no drugs that inhibit blood clotting should be used. This therefore also applies to the use of Clexane®.
In addition, the coordination and sense of balance decrease when drinking alcohol, which increases the risk of falling and, if anticoagulant drugs such as Clexane® are taken at the same time, the risk of very dangerous bleeding. Alcohol consumption should therefore be avoided.
