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Dalteparin sodium
Dalteparin sodium (Fragmin)
Dalteparin sodium
(DAL-tih-pair-in)
Pregnancy Category: B Fragmin (Rx)

Classification: Anticoagulant, low molecular weight heparin

See Also: See also Heparins, Low Molecular Weight.

Action/Kinetics: Peak plasma levels: 4 hr. t1/2, SC: 3-5 hr. t1/2 increased in those with chronic renal insufficiency requiring hemodialysis.

Uses: To prevent deep vein thrombosis (DVT) in clients undergoing hip replacement or abdominal surgery who are at risk for thromboembolic complications (i.e., pulmonary embolism). High risk includes obesity, general anesthesia more than 30 min, malignancy, history of DVT or pulmonary embolism, age 40 and over. To prevent ischemic complications due to blood clot formation in life-threatening unstable angina and non-Q-wave MI in clients on concurrent aspirin therapy. Investigational: Systemic anticoagulation in venous and arterial thromboembolic complications.

Special Concerns: See also Heparins, Low Molecular Weight. Also, the multiple dose vial contains benzyl alcohol that has been associated with a fatal "gasping syndrome" in premature infants.

Side Effects: CV: Hemorrhage hematoma at injection site, wound hematoma, reoperation due to bleeding, postoperational transfusions. Hematologic: Thrombocytopenia. Hypersensitivity: Allergic reactions, including pruritus, rash, fever, injection site reaction, bulleous eruption, skin necrosis (rare), anaphylaxis. Miscellaneous: Pain at injection site.

How Supplied: Injection: 2,500 IU/0.2 mL, 5,000 IU/0.2 mL, 10,000 IU/mL

Dosage
•SC Only Prevention of DVT in abdominal surgery.
Adults: 2,500 IU each day starting 1-2 hr prior to surgery and repeated once daily for 5-10 days postoperatively. High-risk clients: 5,000 IU the night before surgery and repeated once daily for 5-10 days. In malignancy: 2,500 IU 1-2 hr before surgery followed by 2,500 IU 12 hr later and 5,000 IU once daily for 5-10 days.
Hip replacement surgery.
Adults: 2,500 IU within 2 hr before surgery with a second dose of 2,500 IU in the evening on the day of surgery (six or more hr after the first dose). If surgery occurs in the evening, omit the second dose on the day of surgery. On the first postoperative day, give 5,000 IU once daily for 5-10 days. Alternatively, can give 5,000 IU the evening before surgery, followed by 5,000 IU once daily for 5-10 days, starting the evening of the day of surgery.
Prevent ischemic complications in unstable angina/non-Q-wave MI.
Adults: 120 IU/kg, not to exceed 10,000 IU q 12 hr with concurrent PO aspirin (75-165 mg/day). Continue treatment until client is clinically stablized (usually 5-8 days).
Systemic anticoagulation.
200 IU/kg SC daily or 100 IU b.i.d.