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dalteparin

Generic Name: dalteparin (dall ta PEH rin)
Brand Names: Fragmin

What is dalteparin?

Dalteparin is an anticoagulant (blood thinner). Dalteparin prevents the formation of blood clots.

Dalteparin is used to prevent blood clot formation in patients at risk who are undergoing abdominal surgery or hip replacement surgery, and those who are on bed rest due to illness. Dalteparin is also used in the treatment of certain types of angina and heart attacks, and to prevent complications of blood clots in patients who are also taking aspirin.

Dalteparin may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about dalteparin?

There is a risk of bleeding in the spinal or epidural space, possibly resulting in paralysis, when dalteparin is used along with spinal or epidural anesthesia or spinal puncture. This risk may be increased by the use of indwelling epidural catheters or by the concomitant use of drugs that affect blood clotting.

What should I discuss with my healthcare provider before using dalteparin?

• have a very low level of platelets in your blood,

• have uncontrolled active bleeding,

• have an allergy to pork products, or

• cannot have accurate blood testing done prior to and during dosing.

Before using dalteparin, tell your doctor if you

• have bacterial endocarditis,

• have high blood pressure that is not being controlled,

• need to have surgery or another invasive procedure,

• have hemophilia or another blood disorder,

• have a stomach ulcer,

• have eye problems due to diabetes or high blood pressure,

• have liver disease, or

• have kidney disease.

You may not be able to use dalteparin, or you may require a dosage adjustment or special monitoring during therapy if you have any of the conditions listed above.

How should I use dalteparin?

Use dalteparin exactly as directed by your doctor. If you do not understand these directions, ask your doctor, nurse, or pharmacist to explain them to you.

Dalteparin must be used as a subcutaneous (under the skin) injection.

Your doctor or nurse will give you detailed instructions on how to prepare, inject, and store dalteparin. Dalteparin can be injected into the fat of the stomach (in a U-shape around the bellybutton); the upper, outer area of the thighs; or the upper, outer part of the buttocks. Follow your doctor"s instructions.

The injection site should be varied daily.

Sit or lie down before receiving an injection. When injecting into the stomach or upper thigh, lift a fold of skin using the thumb and forefinger. Insert the needle completely into the fold (or buttock) at a 45 to 90 degree angle.

It is important to use dalteparin regularly to get the most benefit.

Do not use any medication that is discolored or that has particles in it.

Your doctor may want you to have blood tests or other medical evaluations during treatment with dalteparin to monitor progress and side effects.

What happens if I miss a dose?

Use the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and use only the next regularly scheduled dose. Do not use a double dose of this medication.

Notify your doctor if you miss a dose of dalteparin.

What happens if I overdose?

Symptoms of an overdose may include unusual bleeding from wounds or injection sites; nosebleeds; black, bloody, or tarry stools; blood in the urine; and easy bruising or bleeding.

What should I avoid while using dalteparin?

Dalteparin side effects

• an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

• any prolonged or unexplained bleeding;

• pain, warmth, or redness in an arm or leg, or difficulty breathing, which could indicate a blood clot; or

• ulceration at the injection site.

Other less serious side effects may be more likely to occur. Continue to use dalteparin and notify your doctor if you experience

• mild pain, redness, or warmth at the injection site;

• rash or itching; or

• fever.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect dalteparin?

There is a risk of bleeding in the spinal or epidural space, possibly resulting in paralysis, when dalteparin is used along with spinal or epidural anesthesia or spinal puncture. This risk may be increased by the use of indwelling epidural catheters or by the concomitant use of drugs that affect blood clotting.

• aspirin,

• ibuprofen (Motrin, Advil, Nuprin, and others), ketoprofen (Orudis KT, Orudis, Oruvail), naproxen (Aleve, Naprosyn, Anaprox, and others), indomethacin (Indocin), diclofenac (Cataflam, Voltaren), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), ketorolac (Toradol), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), tolmetin (Tolectin), or any other nonsteroidal anti-inflammatory medication;

• warfarin (Coumadin);

• aspirin and dipyridamole (Aggrenox);

• ticlopidine (Ticlid) or clopidogrel (Plavix); or

• dipyridamole (Persantine).

The drugs listed above may increase the effects of dalteparin, which could be dangerous. You may not be able to take dalteparin, or you may require a dosage adjustment or special monitoring during your treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with dalteparin. Talk to your doctor and pharmacist before using any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

• Your pharmacist has additional information about dalteparin written for health professionals that you may read.

What does my medication look like?

Dalteparin is available with a prescription under the brand name Fragmin. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ("Multum") is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum"s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum"s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.