Dalteparin, Injectable Solution

Other warnings

• Low platelet levels warning: This drug can decrease your body’s count of platelets (blood cells that help blood clot). This raises your risk of bleeding.
• Bleeding warning: This drug raises your risk of bleeding. This may occur as nosebleeds, increased bruising, increased bleeding from cuts, or bleeding from your gums after brushing or flossing. It could also occur as blood in your urine, or blood in your stool (could appear bright red, dark red, or black and tarry). If you notice these symptoms, call your doctor.
• Recent surgery warning: If you’ve had recent surgery (within the last six months) on your brain, spine, or eyes, your risk of bleeding is increased while you take this drug. Talk with your doctor about whether this drug is safe for you.

Dalteparin is a prescription drug. It comes in the form of an injectable solution. It’s given by subcutaneous injection (an injection below the skin). This drug is self-injectable. This means you or a caregiver can inject the medication.

Dalteparin is available as the brand-name drug Fragmin. It’s not available as a generic drug.

This drug may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it’s used

Dalteparin is a blood thinner. It helps to:

• prevent complications related to unstable angina (chest pain) or heart attack
• prevent deep vein thrombosis (blood clots in the deep veins of your legs or arms) during abdominal surgery or hip replacement surgery
• prevent deep vein thrombosis (blood clots the deep veins of your legs or arms) during abdominal surgery or hip replacement surgery
• prevent blood clots in the deep veins of your arms and legs when you aren’t able to move very much due to severe illness
• treat venous thrombosis (blood clots in your veins) if you have cancer

How it works

Dalteparin belongs to a class of drugs called low molecular weight heparin (LMWH). A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Dalteparin works by blocking a particular protein in your body that causes clotting. This helps keep blood clots from forming. If you have a blood clot, this drug will stop it from getting worse while your body breaks down the clot on its own.

Dalteparin injectable solution doesn’t cause drowsiness, but it can cause other side effects.

More common side effects

The more common side effects that can occur with dalteparin include:

• a swelling filled with blood at the injection site
• increased bruising or bleeding
• longer bleeding from cuts or scrapes

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Bleeding. Your risk is higher if you have or develop a low platelet count. Symptoms can include:
  • a swelling filled with blood in the spine, with symptoms of:
    • tingling
    • numbness in the legs
    • muscle weakness
  • increased nosebleeds
  • increased gum bleeding after brushing or flossing
  • coughing up blood
  • vomiting blood
  • blood in your urine
  • blood in your stools (may be bright red, dark red, or black and tarry)
  • increased bruising
  • dark red spots under your skin
• Gasping syndrome in premature infants. Symptoms can include:
  • trouble breathing
• Increased liver enzymes (as shown in a test by your doctor). Symptoms can include:
  • pain in the abdomen (stomach area)
  • nausea or vomiting
  • yellowing of your skin or the whites of your eyes
• Allergic reactions. Symptoms can include:
  • itching
  • rash
  • fever
  • hives (itchy welts)
  • reaction at the injection site, including redness, swelling, or itching
  • trouble breathing

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Dalteparin injectable solution can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with dalteparin are listed below.

Interactions that increase your risk of side effects

Taking dalteparin with certain medications raises your risk of side effects from dalteparin. Examples of these drugs include:

• Platelet inhibitors, such as prasugrel, ticagrelor, dipyridamole, or clopidogrel.
  • When used with dalteparin, these drugs raise your risk of dangerous bleeding.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin*, ibuprofen, or naproxen.
  • When used with dalteparin, these drugs raise your risk of dangerous bleeding.
• Oral anticoagulants, such as warfarin or dabigatran.
  • When used with dalteparin, these drugs raise your risk of dangerous bleeding.

* Your doctor may prescribe dalteparin with aspirin if you’re being treated for chest pain or a heart attack.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Allergy warning

This drug can cause a severe allergic reaction. Symptoms can include:

• trouble breathing
• swelling of your throat or tongue
• itching
• rash
• fever
• reaction at the site of injection, such as redness, swelling, or itching
• hives (itchy welts)

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Alcohol interaction warning

Dalteparin raises your risk of bleeding. Having drinks that contain alcohol while taking this drug increases that risk. If you drink alcohol, talk to your doctor. You may need to be monitored for signs of bleeding.

Warnings for people with certain health conditions

For people with a history of spinal surgery or defect: If you have medications injected into your epidural space (in the spine), or have a procedure that involves puncture of your spinal column, this drug raises your risk of bleeding in this area. If you have a spinal defect or have had recent spinal surgery, your risk is higher. This blood buildup can lead to serious movement problems, including paralysis in part or most of your body. These problems can be permanent.

For people with major bleeding: If you currently have serious bleeding, do not use this drug.

For people with a history of drug-induced low platelet count: If you’ve had a low platelet count caused by use of the drug heparin, do not use this drug.

For people with allergy to heparin or pork: Do not use this drug if you’ve had a reaction to the drug heparin or to pork.

For people with current or past heart problems: If you have a history of certain heart problems, your risk of bleeding is increased when taking this drug. These problems include:

• uncontrolled high blood pressure
• infection in your heart

For people with a history of stroke: Your risk of bleeding is increased when taking this drug.

For people with severe kidney or liver problems: Your risk of bleeding is increased when taking this drug. Talk with your doctor about whether this drug is safe for you.

For people with eye problems: If you have eye problems caused by high eye pressure or diabetes, your risk of bleeding is increased when taking this drug. Talk with your doctor about whether this drug is safe for you.

For people with bleeding disorders: If you have certain bleeding disorders, your risk of bleeding is increased when taking this drug. These disorders include a low count of platelets (blood cells that help your blood to clot), or platelets that don’t work right. Talk with your doctor about whether this drug is safe for you.

For people with stomach ulcers or recent stomach bleeding: Your risk of bleeding is increased when taking this drug. Talk with your doctor about whether this drug is safe for you.

Warnings for other groups

For pregnant women: Studies have shown no clear link between the use of dalteparin and negative effects on a fetus. However, the potential for negative effects on a fetus cannot be ruled out.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used in pregnancy if clearly needed.

Also, this drug may contain benzyl alcohol. This preservative can cause gasping syndrome in premature infants. Gasping syndrome causes trouble breathing and can lead to death. If you’re pregnant and need to take this drug, your doctor should prescribe the version of this drug that does not contain benzyl alcohol.

For women who are breastfeeding: This drug may pass into breast milk and cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects such as bleeding.

If you’re over the age of 65 years and either weigh less than 99 pounds (45 kg) or have kidney problems, you’re at increased risk of bleeding while taking this drug.

For children: This medication has not been studied in children. It should not be used in people younger than 18 years.

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how you react to the first dose

Drug forms and strengths

Brand: Fragmin

• Form: Single-dose prefilled syringe
• Strengths: 2,500 IU/0.2 mL, 5,000 IU/0.2 mL, 7,500 IU/0.3 mL, 12,500 IU/0.5 mL, 15,000 IU/0.6 mL, 18,000 IU/0.72 mL

• Form: Single-dose prefilled syringe
• Strengths: 10,000 IU/mL

• Form: Multiple-dose vial
• Strengths: 95,000 IU/3.8 mL

Dosage for prevention of complications related to unstable angina or heart attack

Adult dosage (ages 18 to 64 years)

Your dosage will be based on your weight.

• Typical dosage: 120 IU/kg every 12 hours along with aspirin (75–165 mg per day).
• Typical length of therapy: 5 to 8 days.
• Maximum dosage: 10,000 IU per injection.

Child dosage (ages 0 to 17 years)

This medication has not been studied in children. It should not be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects such as bleeding.

Your doctor may start you on a lower dosage or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for prevention of deep vein thrombosis during abdominal or hip replacement surgery

Adult dosage (ages 18 to 64 years)

• Typical dosage: The typical dosage of dalteparin varies depending on when your doctor would like to start therapy and on your risk for clots. Your doctor will determine the best dosage for you.
• Typical length of therapy: 5 to 10 days.

Child dosage (ages 0 to 17 years)

This medication has not been studied in children. It should not be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects such as bleeding.

Your doctor may start you on a lower dosage or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for prevention of deep vein thrombosis in people with limited movement due to severe illness

Adult dosage (ages 18 to 64 years)

• Typical dosage: 5,000 IU once daily.
• Typical length of therapy: 12 to 14 days.
• Maximum dosage: 10,000 IU per injection.

Child dosage (ages 0 to 17 years)

This medication has not been studied in children. It should not be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects such as bleeding.

Your doctor may start you on a lower dosage or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for treatment of venous thrombosis in people with cancer

Your dosage will be based on your weight.

Adult dosage (ages 18 to 64 years)

• Typical dosage: 200 IU/kg once daily for the first 30 days. After that, 150 IU/kg once daily for months 2 to 6.
• Typical length of therapy: Up to 6 months.
• Maximum dosage: 18,000 IU daily.

Child dosage (ages 0 to 17 years)

This medication has not been studied in children. It should not be used in children younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects such as bleeding.

Your doctor may start you on a lower dosage or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Dalteparin injectable solution is used for short-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: You may have blood clots or other serious complications.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include severe bleeding.

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: You may not feel different when this drug is working. However, be sure to keep taking it as your doctor prescribed.

Keep these considerations in mind if your doctor prescribes dalteparin for you.

General

• Take this drug at the time(s) recommended by your doctor.

Storage

• Store this drug at room temperature between 68°F and 77°F (20°C and 25°C).
• Keep this drug away from light.
• Don’t store this medication in moist or damp areas, such as bathrooms.
• After using the multiple-dose vial for the first time, you can store it for up to two weeks. After that time, you should throw it away.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t harm your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

Your doctor or pharmacist can tell you how to properly inject this drug. Here are a few tips:

• Inject this drug while sitting or lying down.
• Do not inject this drug into a muscle. You can inject it into the following areas:
  • the area around your belly button
  • the upper outer area of your thighs
  • the upper area of your buttocks
• Change your injection site daily.
• Do not mix this drug with other injections.

Clinical monitoring

You and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

• Platelet count: Blood tests can check the number of platelets in your blood. If your platelet count is low, your doctor may lower your dosage of this drug to reduce bleeding risk. They may even stop your use of this drug.
• Kidney problems: If you have kidney problems, your doctor will monitor your kidney function to see if you need a lower dosage of this drug. If you have cancer, your doctor may also monitor your blood levels of a protein called anti-Xa. Knowing your anti-Xa levels can help your doctor decide the best dosage of this drug for you. Your levels of this protein are checked using blood tests. These tests are usually done four to six hours after your third or fourth dose of this drug.
• Complications from epidural anesthesia: If you take this drug and have epidural anesthesia (pain medication given by needle into your spine), your doctor may monitor you for certain symptoms. These symptoms can be a sign of nerve problems. They include:
  • back pain
  • numbness or weakness in the legs
  • loss of control of the bladder or bowels

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.

Hidden costs

You may need to have blood tests during your treatment with this drug. The cost of these tests will depend on your insurance coverage.

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor may need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.