Dalteparin injection

Dalteparin is used in combination with aspirin to prevent serious or life-threatening complications from angina (chest pain) and heart attacks. Dalteparin is also used to prevent deep vein thrombosis (DVT; a blood clot, usually in the leg), which can lead to pulmonary embolism (PE; a blood clot in the lung), in people who are on bedrest or who are having hip replacement, knee replacement, or abdominal surgery. It is also used treat or prevent DVT and PE in people who have cancer. Dalteparin is in a class of medications called anticoagulants ('blood thinners'). It works by decreasing the clotting ability of the blood.

Dalteparin is also sometimes used to help prevent serious or life-threatening complications from stroke. It is also sometimes used to help prevent strokes or blood clots in people who have atrial fibrillation (a condition in which the heart beats irregularly, increasing the chance of clots forming in the body, and possibly causing strokes) or in people with heart valves. Talk to your doctor about the risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Unless your doctor tells you otherwise, continue your normal diet.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are receiving dalteparin injection.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

• Fragmin^®

Dalteparin is a low molecular weight heparin (LMWH) similar to enoxaparin (Lovenox) and tinzaparin. Dalteparin is used to treat or prevent blood clots and their complications (deep vein thrombosis or DVT and pulmonary embolism or PE). Deep vein thrombosis is the formation of blood clots in veins deep in a muscle, most often in the legs. Deep vein thrombosis may lead to pulmonary embolism, a condition in which a piece of the clot (the embolus) breaks loose and travels through the veins to the lung. In the lung the clot blocks an artery and prevents the part of the lung that is supplied by the artery from working normally. If the artery that is blocked is a large artery, the embolus can cause sudden death. Patients undergoing hip replacement and other major surgery are at increased risk of deep vein thrombosis and pulmonary embolism. Dalteparin, like other LMWHs is derived from breaking heparin into smaller units. Dalteparin prevents clot formation by accelerating the breakdown of clotting factors Xa and IIa (thrombin) by antithrombin III. Unfractionated heparin, unlike LMWHs, also breaks down clotting factors IX, XI, XII, and plasmin. Unlike heparin, the effect of dalteparin does not need to be monitored with blood tests. The FDA approved dalteparin in December 1994.

The most frequent adverse reactions are:

• bleeding,
• drop in platelet count,
• bruising,
• pain at injection site, and
• increase in certan factors inliver function tests.

An immune reaction resulting in a drop in platelets and clotting (heparin-induced thrombocytopenia) is very rare, and significantly lower than with heparin use. LMWHs should be avoided in patients with epidural or spinal punctures as there is significant risk of spinal or epidural hematomas resulting in paralysis.

Combining dalteparin with other blood thinning agents may increase the risk of severe bleeding. Dalteparin should not be combined with urokinase or other anticoagulants such as apixaban (Eliquis), dabigatran (Pradaxa) and rivaroxaban (Xarelto). Therapy should be monitored when used with platelet inhibitors (such as aspirin and clopidogrel [Plavix]), serotonin reuptake inhibitors (such as sertraline [Zoloft] and fluoxetine [prozac, Sarafem, Prozac Weekly]), and nonsteroidal anti-inflammatory drugs (such as ibuprofen). Dalteparin may increase potassium levels, so caution with and monitoring of potassium levels is advised with drugs such as ACE inhibitors (for example, lisinopril [Zestril, Prinivil]), angiotensin II receptor blockers (for example, losartan [Cozaar]), and other drugs like aliskiren, spironolactone (Aldactone), eplerenone, and potassium salts.