At my facility if a patient is on a heparin drip, the 1st dose of lovenox is given while the drip is still running and then the drip is turned off 2 hours later. At least that's how we did it with my last patient who was on a heparin drip.# 1 5.VT/PE? Heparin is started for immediate anticoagulation and if the patient will need to be on long term anticoagulation, lovenox can be used (usually it's one dose) before the heparin is discontinued and coumadin is started, and the until therapetic PT/INR is achieved.