Dalteparin (patient information)

Overview
Dalteparin (dal-TE-pa-rin) is used to prevent deep venous thrombosis, a condition in which harmful blood clots form in the blood vessels of the legs. These blood clots can travel to the lungs and can become lodged in the blood vessels of the lungs, causing a condition called pulmonary embolism. Dalteparin is used for several days after abdominal surgery, while you are unable to walk. It is during this time that blood clots are most likely to form. Dalteparin also may be used for other conditions as determined by your doctor.

In the U.S.

 * Fragmin

In Canada

 * Fragmin

Category

 * Anticoagulant
 * antithrombotic

Description
Dalteparin (dal-TE-pa-rin) is used to prevent deep venous thrombosis, a condition in which harmful blood clots form in the blood vessels of the legs. These blood clots can travel to the lungs and can become lodged in the blood vessels of the lungs, causing a condition called pulmonary embolism. Dalteparin is used for several days after abdominal surgery, while you are unable to walk. It is during this time that blood clots are most likely to form. Dalteparin also may be used for other conditions as determined by your doctor.

Dalteparin is available only with your doctor's prescription, in the following dosage form:


 * Parenteral
 * Injection (U.S. and Canada)

Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For dalteparin, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to dalteparin or heparin. Also tell your health care professional if you are allergic to any other substances, such as foods, especially pork or pork products, preservatives, or dyes.

Pregnancy—Dalteparin has not been studied in pregnant women. However, it has not been shown to cause birth defects or other problems in animals.

Breast-feeding—It is not known whether this medicine passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are using this medicine and who wish to breast-feed should discuss this with their doctor.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of dalteparin in children with use in other age groups.

Older adults—This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are using dalteparin, it is especially important that your health care professional know if you are taking any of the following:


 * Aspirin or
 * Inflammation or pain medicine, except narcotics, or
 * Ticlopidine—Using any of these medicines together with dalteparin may increase the risk of bleeding

Other medical problems—The presence of other medical problems may affect the use of dalteparin. Make sure you tell your doctor if you have any other medical problems, especially:


 * Bleeding problems or
 * Eye problems caused by diabetes or high blood pressure or
 * Heart infection or
 * High blood pressure (hypertension) or
 * Kidney disease or
 * Liver disease or
 * Stomach or intestinal ulcer (active) or
 * Stroke—The risk of bleeding may be increased
 * Also, tell your doctor if you have received dalteparin or heparin before and had a reaction to either of them called thrombocytopenia (a low platelet count in the blood), or if new blood clots formed while you were receiving the medicine.
 * In addition, tell your doctor if you have recently had medical surgery . This may increase the risk of serious bleeding when you are taking dalteparin.

Proper Use
If you are using dalteparin at home, your health care professional will teach you how to inject yourself with the medicine. Be sure to follow the directions carefully. Check with your health care professional if you have any problems using the medicine.

Put used syringes in a puncture-resistant, disposable container, or dispose of them as directed by your health care professional.

Dosing—The dose of dalteparin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of dalteparin. If your dose is different, do not change it unless your doctor tells you to do so.


 * For injection dosage form:
 * For prevention of deep venous thrombosis (leg clots) and pulmonary embolism (lung clots):
 * Adults— The dose will be determined by your doctor, based on your condition.
 * Children—Use and dose must be determined by your doctor.


 * For prevention of blood clots after unstable angina (chest pain) or non-Q-wave myocardial infarction (a type of heart attack)
 * Adults—120 International Units (IU) per kilogram of body weight injected under the skin (but no more than 10,000 IU) given every 12 hours for 5 to 8 days. Unless your doctor recommends otherwise, aspirin should be given 75 to 165 milligrams daily.
 * Children—Use and dose must be determined by your doctor.

Missed dose—If you miss a dose of this medicine, use it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

 * Keep out of the reach of children.
 * Store away from heat and direct light.
 * Keep the medicine from freezing. Do not refrigerate.
 * Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions
Tell all your medical doctors and dentists that you are using this medicine.

Check with your doctor immediately if you notice any of the following side effects:


 * Bruising or bleeding, especially bleeding that is hard to stop. (Bleeding inside the body sometimes appears as bloody or black, tarry stools or causes faintness.)
 * Back pain; burning, pricking, tickling, or tingling sensation; leg weakness; numbness; paralysis; or problems with bowel or bladder function.

Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Stop using this medicine and check with your doctor immediately if any of the following side effects occur:

More common
Deep, dark purple bruise, pain, or swelling at place of injection

Less common
Bleeding of gums; coughing up blood; difficulty in breathing or swallowing; dizziness; headache; increased menstrual flow or vaginal bleeding; nosebleeds; paralysis; prolonged bleeding from cuts; red or dark brown urine; red or black, tarry stools; shortness of breath; unexplained pain, swelling, or discomfort, especially in the chest, abdomen, joints, or muscles; unusual bruising; vomiting of blood or coffee ground-like material; weakness

Rare
Back pain; bleeding from mucous membranes; bluish or black discoloration, flushing, or redness of skin; burning, pricking, tickling, or tingling sensation; coughing; feeling faint; fever; leg weakness; numbness; problems with bowel or bladder function; skin rash (which may consist of pinpoint, purple-red spots), hives, or itching; sloughing of skin at place of injection; swelling of eyelids, face, or lips; tightness in chest or wheezing

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.