Dalteparin

Administration

• Type: Anticoagulant (Low molecular weight heparin)
• Dosage Forms:
• Routes of Administration: Subcutaneous
• Common Trade Names: Fragmin

Adult Dosing

• PE/DVT treatment: 200 units/kg SC q24h, max 18,000 units
• VTE prophylaxis: 2500-5000 units subQ daily

Pediatric Dosing

Safety/efficacy not established

• PE/DVT treatment: 129 +/- 43 units/kg subQ daily, adjust dose to goal anti-Xa activity 0.5-1 unit/mL 4-6 hours after injection
• VTE prophylaxis: 92 +/- 52 units/kg subQ daily

Special Populations

• Pregnancy Rating: B
• Lactation risk: Infant risk cannot be ruled out
• Renal dosing:
• Hepatic dosing:

Contraindications

• Allergy to class/drug
• Active major bleeding
• History of heparin-induced thrombocytopenia
• Use for VTE prophylaxis or to treat NSTEMI/UA in patients undergoing neuraxial or epidural anesthesia

Adverse Reactions

Serious

• Major bleeding: epidural hematoma, spinal hematoma, intracranial hemorrhage, subdural hemorrhage, hemorrhagic stroke, intrauterine hemorrhage
• Thrombocytopenia
• Paralysis

Common

• Injection site hematoma, pain, irritation

Pharmacology

• Half-life: 3-5h
• Metabolism:
• Excretion: Renal

Mechanism of Action

• Low-molecular weight heparin: binds antithrombin and inhibits coagulation Factor Xa and thrombin

See Also

• Low molecular weight heparin, unfractionated heparin
• Anticoagulant reversal for life-threatening bleeds