Dalteparin Brand Name– Fragmin
What is Dalteparin
Dalteparin is a subcutaneously administered low molecular weight heparin used for deep vein thrombosis (DVT) prophylaxis, treatment of venous thromboembolism (VTE), and prophylaxis of ischemic complications in unstable angina and non-Q-wave myocardial infarction (MI).
Like enoxaparin, dalteparin consists of smaller heparin molecules than unfractionated heparin (UFH), with the majority of molecules ranging in size from 2,000 to 9,000 daltons (14% to 26% are more than 8,000 daltons).
Compared with UFH, dalteparin has an improved bioavailability after subcutaneous injection and a more predictable anticoagulant response.
Dalteparin also has a longer half-life than UFH and therefore, can be dosed less frequently. Dalteparin has been shown to be superior to warfarin in preventing DVT after total hip replacement surgery.
Dalteparin has also been shown to be effective in treating unstable coronary artery disease.
The FRISC trial (the low-Molecular Weight Heparin (Fragmin) During Instability in Coronary Artery Disease Trial) showed that dalteparin decreased the risk of death or acute myocardial infarction (AMI) by 36% as compared to aspirin alone.
In an additional trial (The Fragmin in Unstable Coronary Artery Disease Trial, FRIC), dalteparin was as effective as intravenous heparin in preventing death or AMI in the acute phase after unstable angina or non-Q wave MI.
Indications
- acute myocardial infarction
- antiphospholipid antibody syndrome
- cerebral thromboembolism
- coronary artery thrombosis prophylaxis
- deep venous thrombosis (DVT)
- deep venous thrombosis (DVT) prophylaxis
- periprocedural anticoagulation
- pulmonary embolism
- pulmonary embolism prophylaxis
- thrombosis prophylaxis
- unstable angina
Side Effects
- alopecia
- anaphylactoid reactions
- bleeding
- bullous rash
- disseminated intravascular coagulation (DIC)
- elevated hepatic enzymes
- fever
- GI bleeding
- hematoma
- hematuria
- injection site reaction
- intracranial bleeding
- maculopapular rash
- osteoporosis
- pruritus
- rash
- retroperitoneal bleeding
- skin necrosis
- spinal hematoma
- subdural hematoma
- thrombocytopenia
- thrombosis
Monitoring Parameters
- anti-Xa activity
- hemoglobin/hematocrit
- platelet count
- stool guaiac
- urinalysis
Contraindications
- anticoagulant therapy
- bleeding
- breast-feeding
- coagulopathy
- dental disease
- dental work
- diabetic retinopathy
- endocarditis
- epidural anesthesia
- geriatric
- GI bleeding
- hemophilia
- heparin hypersensitivity
- heparin-induced thrombocytopenia (HIT)
- hepatic disease
- hypertension
- infants
- intramuscular injections
- lumbar puncture
- neonates
- peptic ulcer disease
- porcine protein hypersensitivity
- pregnancy
- prosthetic heart valves
- renal disease
- renal failure
- renal impairment
- scoliosis
- spinal anesthesia
- stroke
- surgery
- thrombocytopenia
- thrombolytic therapy
Interactions
- Abciximab
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- Anagrelide
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- Vortioxetine
- Warfarin
