In HIT, all heparin must be stopped and a non-heparin anticoagulant started. Argatroban, a direct thrombin inhibitor, is the agent indicated for HIT (fondaparinux and bivalirudin are other alternatives).

• Enoxaparin is a heparin (LMWH) and is contraindicated in HIT.
• Warfarin is started only once the platelet count has recovered above 150,000, never as initial therapy.