Indications
Dalteparin Sodium is a low molecular weight heparin, a type of blood thinner (anticoagulant). It is used to prevent blood clots in the legs (deep vein thrombosis, DVT) and lungs (pulmonary embolism, PE) after surgery or during periods of reduced movement due to illness, to treat existing DVT and PE, to prevent clots in people with cancer, to prevent clotting in the dialysis circuit, and, with Aspirin, in unstable angina and some types of heart attack.
How It Works
Dalteparin boosts the action of antithrombin, a natural substance in the blood that switches off clotting factors, mainly factor Xa. This slows the formation of new clots and stops existing clots from growing, giving the body time to break them down.
Dosage and Administration
Dalteparin is given as an injection under the skin, usually into the abdomen, once or twice a day; in hospital it may also be given into a vein. The dose depends on the reason for use, body weight and kidney function, and is given exactly as prescribed. The first doses are given by a doctor or nurse; patients or carers may be trained to inject at home. Do not rub the injection site and do not expel the air bubble from a prefilled syringe.
Interactions
- Other medicines that affect clotting or bleeding increase the bleeding risk: Warfarin, Aspirin, Clopidogrel, Ticagrelor, NSAIDs such as Ibuprofen and Diclofenac, Rivaroxaban, Apixaban and SSRIs
- Medicines that raise potassium (such as Spironolactone, ACE inhibitors) may add to the risk of high potassium
Contraindications
- Allergy to Dalteparin, Heparin or pork products
- Present or past heparin-induced thrombocytopenia (a serious drop in platelets caused by heparin)
- Active major bleeding or a high risk of uncontrolled bleeding
- Recent bleeding in the brain, or recent brain, spine, eye or ear surgery
- Severe uncontrolled high blood pressure or bacterial endocarditis
- Treatment doses should not be used when a spinal or epidural anaesthetic is planned
Side Effects
Common effects include bruising, pain or a small lump at the injection site, minor bleeding (nose or gums), and raised liver enzymes. Less common effects include low platelets, high blood potassium, hair thinning and, with long-term use, bone thinning.
Get urgent medical help for any serious bleeding (vomiting blood, black or bloody stools, blood in urine, heavy bleeding that will not stop), a severe headache, sudden weakness or numbness, back pain with leg numbness after a spinal or epidural injection, or a severe allergic reaction.
Pregnancy and Lactation
Dalteparin does not cross the placenta and is commonly used in pregnancy when a blood thinner is needed, under specialist care. Multi-dose vials containing benzyl alcohol should be avoided in pregnancy. Only very small amounts pass into breast milk and it is generally considered compatible with breastfeeding.
Precautions and Warnings
Platelet counts are checked during treatment. Use with care in kidney or liver disease, stomach ulcers, low body weight, the elderly and those with bleeding disorders. Spinal or epidural anaesthesia while on Dalteparin can cause a spinal blood clot leading to paralysis, so timing is controlled by the doctor. Tell any doctor or dentist that you use a blood thinner. Never switch between different heparins unit for unit.
Overdose
Overdose can cause serious bleeding. Seek medical help at once; Protamine Sulfate can partly reverse its effect.
Therapeutic Class
Anticoagulant; low molecular weight heparin.
Storage
Store below 30°C, do not freeze, and keep out of the reach of children. Opened multi-dose vials should be used within the time stated on the pack.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.