Enoxaparin and/or Minocycline in Acute Stroke

Enoxaparin is a low molecular weight heparin (average molecular weight 4,500 daltons, vs. 12,000 to 15,000 daltons for unfractionated heparin) administered subcutaneously and intravenously. It is a marketed drug FDA-approved in various clinical situations for: the prevention and treatment of deep vein thrombosis; and in the treatment of acute myocardial infarction. Minocycline is an orally administered antibiotic of the tetracycline class. It is a marketed drug FDA-approved for the treatment of various bacterial and rickettsial infections. Both medications have been found to be neuroprotective in experimental stroke models. Minocycline has shown promise in a human acute stroke study. This study is designed to investigate two logistically simple treatment regimens, singly or in combination, employing these medications for acute ischemic stroke: 1. pulsed intravenous (iv) administration of enoxaparin initiated within 6 hours and completed by 24 hours after stroke onset; and 2. oral minocycline treatment once daily for five days. The goal of treatment is neuroprotection: the limitation of the loss of brain tissue that follows ischemic stroke.