Dangerous Drug: Dalteparin Sodium(dahl’ tep ah rin)
Fragmin
PREGNANCY CATEGORY B
Drug Classes
Anticoagulant
Antithrombotic
Low–molecular-weight heparin
Therapeutic Actions
Low–molecular-weight heparin that inhibits thrombus and clot formation by blocking factor Xa, factor IIa, preventing the formation of clots.
Indications
Treatment of unstable angina and non–Q-wave MI for the prevention of complications in patients on aspirin or standard therapy
Prevention of DVT, which may lead to pulmonary embolism, following abdominal or hip replacement surgery
Extended treatment of symptomatic venous thromboembolism, DVT, or pulmonary embolism to reduce the recurrence of venous thromboembolism in patients with cancer
Unlabeled uses: Systemic anticoagulation in venous and arterial thromboembolic complications; prophylaxis of DVT in situations that may lead to PE
Contraindications and Cautions
Contraindicated with hypersensitivity to dalteparin, heparin, pork products, or benzyl alcohol; severe thrombocytopenia; uncontrolled bleeding; use of unstable angina dosage in patients undergoing regional anesthesia; pregnancy.
Use cautiously with lactation; history of GI bleed; severe hepatic or renal impairment; recent childbirth or surgery; history of heparin-induced thrombocytopenia; severe and uncontrolled hypertension, spinal tap, spinal/epidural anesthesia.
Available Forms
Injection (prefilled syringes)—2,500 international units/0.2 mL, 5,000 international units/0.2 mL, 7,500 international units/0.3 mL, 10,000 international units/mL, 10,000 international units/0.4 mL, 12,500 international units/0.5 mL, 15,000 international units/0.6 mL, 18,000 international units/0.72 mL
Dosages
Adults
Unstable angina: 120 international units/kg subcutaneously every 12 hr with aspirin therapy for 5–8 days; not to exceed 10,000 international units every 12 hr.
DVT prophylaxis, abdominal surgery: 2,500 international units subcutaneously given 1–2 hr before surgery and repeated once daily for 5–10 days after surgery; high-risk patients, 5,000 international units subcutaneously starting the evening before surgery; then daily for 5–10 days.
Hip replacement surgery: 5,000 international units subcutaneously the evening before surgery or 2,500 international units within 2 hr before surgery or 2,500 international units 4–8 hr after surgery; then, 5,000 international units subcutaneously each day for 5–10 days or up to 14 days.
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