Description: Anticoagulant, Low Molecular Weight Heparin
“Alert: Black Box Warning
Epidural or spinal hematomas may occur in patients who are anticoagulated with low molecular weight heparins (LMWHs) or heparinoids and are receiving neuraxial anesthesia or undergoing spinal puncture. These hematomas may result in long-term or permanent paralysis. Consider these risks when scheduling patients for spinal procedures. “
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Dalteparin, Fragmin is low molecular weight heparin that inhibits both factor Xa and factor IIa (thrombin), the antithrombotic effect of Dalteparin, Fragmin is characterized by a higher ratio of anti-Factor Xa to anti-Factor IIa activity (ratio = 4).
Indications For Use
Anticoagulant for hemolysis and hemofiltration, Non-ST elevation acute coronary syndrome, venous thromboembolism prophylaxis, venous thromboembolism treatment in patients with active cancer
Before starting Dalteparin, Fragmin makes sure your physician is aware of any allergies or medications you currently take. Dalteparin, Fragmin because of its anticoagulant activity can cause bleeding at the site of injection, use with extreme caution in patients at increased risk of bleeding; risk factors include bacterial endocarditis; congenital or acquired bleeding disorders; active ulcerative or angiodysplastic GI diseases; severe uncontrolled hypertension; hemorrhagic stroke; or use shortly after brain, spinal, or ophthalmology surgery; in patients treated concomitantly with other drugs known to cause bleeding (eg, platelet inhibitors, selective serotonin reuptake inhibitors); recent GI bleeding or ulceration; thrombocytopenia or platelet defects; hypertensive or diabetic retinopathy; or in patients undergoing invasive procedures. Discontinue if bleeding occurs; use is contraindicated with active major bleeding. Cases of thrombocytopenia including thrombocytopenia with thrombosis have occurred when using Dalteparin, Fragmin. Monitor platelet counts closely. Use is contraindicated in patients with a history of heparin-induced thrombocytopenia (HIT) or HIT with thrombosis.
Subcutaneous: Can be dosed at 5000 units or calculated by kg/unit/hour infusion rate depending on an indication and patient condition.
Pharmacist Tips On Using
How to Take: Inject subcutaneously not intramuscularly. May inject in a U-shape to the area surrounding the navel, the upper outer side of the thigh, or the upper outer quadrangle of the buttock. Use thumb and forefinger to lift up a fold of skin when injecting in the navel area or thigh. Insert entire needle length at a 45- to a 90-degree angle. Do not expel air bubbles from the prefilled syringe prior to injection. Air bubbles (and extra solution, if applicable) may be expelled from graduated syringes. In order to minimize bruising, do not rub the injection site. Rotate injection sites daily.
Thrombocytopenia, hemorrhage, bruising at the injection site, major hemorrhage, wound hematoma, elevated liver enzymes, pain at the injection site, epistaxis. The patient should monitor for weakness, dizziness, unexplained edema, black tarlike stool, what appears to be coffee grounds in vomit, major unexplained bruising, minor cuts that do not stop bleeding, blood when brushing teeth, etc. These are signs of over anticoagulation or an internal bleed in which case immediate medical attention is required.
Note this is not a complete list of side effects for Dalteparin, Fragmin only common ones.
Frequently Asked Questions
Why would my doctor give this to me if it can cause me to have a potentially fatal bleed, is it safe?
Your physician has found that given your medical conditions the reduction of risk of a major clot resulting in a heart attack or stroke far outweighs the increased risk of a bleed. Every medication does have risks however the training of your medical team has established that the benefits outweigh said risks based on their many years of experience, schooling, training, and available clinical data.