Dalteparin Sodium Injection (patient information)

IMPORTANT WARNING
If you have epidural or spinal anesthesia or a spinal puncture while taking a 'blood thinner' such as dalteparin, you are at risk for internal bleeding that could cause you to become paralyzed.

Tell your doctor if you are taking abciximab (ReoPro); anagrelide (Agrylin); other anticoagulants ('blood thinners') such as warfarin (Coumadin); aspirin, ibuprofen (Advil, Motrin, or Nuprin), indomethacin (Indocin), ketoprofen (Actron, Orudis), naproxen (Aleve, Anaprox, Naprosyn), or other nonsteroidal anti-inflammatory drugs (NSAIDs); cilostazol (Pletal); clopidogrel (Plavix); dipyridamole (Persantine); eptifibatide (Integrilin); sulfinpyrazone (Anturane); ticlopidine (Ticlid); and tirofiban (Aggrastat).

If you experience any of the following symptoms, call your doctor immediately: numbness, tingling, leg weakness or paralysis, and loss of control over your bladder or bowels. Talk to your doctor about the risk of taking dalteparin.

About your treatment
Your doctor has ordered dalteparin sodium, an anticoagulant ('blood thinner'), to prevent harmful blood clots from forming. The drug will be injected under the skin (subcutaneously) once a day. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Your health care provider (doctor, nurse, or pharmacist) may measure the effectiveness and side effects of your treatment using laboratory tests and physical examinations. It is important to keep all appointments with your doctor and the laboratory. The length of treatment depends on how you respond to the medication.

Precautions
Before administering dalteparin:


 * tell your doctor and pharmacist if you are allergic to dalteparin, heparin, enoxaparin (Lovenox), any other drugs, or pork products.
 * tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially those listed in the IMPORTANT WARNING section and vitamins.
 * tell your doctor if you have or have ever had liver or kidney disease or diabetes.
 * tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking dalteparin, call your doctor.

Administering your medication
Before you administer dalteparin, look at the solution closely. It should be clear and free of floating material. Observe the solution container to make sure there are no leaks. Do not use the solution if it is discolored, if it contains particles, or if the container leaks. Use a new solution, but show the damaged one to your health care provider.

It is important that you use your medication exactly as directed. Do not change your dosing schedule without talking to your health care provider.

Minor Side Effects
Dalteparin may cause side effects. Tell your health care provider if the following symptom is severe or does not go away:


 * upset stomach

Severe Side Effects
If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor or health care provider immediately:


 * unusual bleeding
 * vomiting or spitting up blood or brown material that resembles coffee grounds
 * bloody or black, tarry stools
 * blood in urine
 * red or dark-brown urine
 * easy bruising
 * excessive menstrual bleeding
 * fever
 * dizziness or lightheadedness

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

Storing your medication
Your health care provider will probably give you several days supply of dalteparin at a time. You will be told to store it at room temperature.

Store your medication only as directed. Make sure you understand what you need to store your medication properly.

Keep your supplies in a clean, dry place when you are not using them, and keep all medications and supplies out of reach of children. Your health care provider will tell you how to throw away used needles, syringes, tubing, and containers to avoid accidental injury.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Signs of infection
If you are receiving dalteparin under your skin, you need to know the symptoms of a catheter-related infection (an infection where the needle enters your skin). If you experience any of these effects near the infusion site, tell your health care provider as soon as possible:


 * tenderness
 * warmth
 * irritation
 * drainage
 * redness
 * swelling
 * pain

Brand names

 * Fragmin®