DALTEPARIN (Systemic)

Some commonly used brand names are:

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 bloodclots form in the blood vessels of the legs. These blood clots can travelto the lungs and can become lodged in the blood vessels of the lungs, causinga condition called pulmonary embolism. Dalteparin is used for several daysafter abdominal surgery, while you are unable to walk. It is during this timethat blood clots are most likely to form. Dalteparin also may be used forother conditions as determined by your doctor.

Dalteparin is available only with your doctor's prescription, in the followingdosage 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 willdo. This is a decision you and your doctor will make. For dalteparin, thefollowing should be considered:

Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to dalteparin or heparin. Also tell your health care professionalif you are allergic to any other substances, such as foods, especially porkor 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 inanimals.

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

Children?Studies on this medicine have been done only in adultpatients, and there is no specific information comparing use of dalteparinin children with use in other age groups.

Older adults?This medicine has been tested and has not been shownto cause different side effects or problems in older people than it does inyounger adults.

Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. When you are usingdalteparin, it is especially important that your health care professionalknow 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 dalteparinmay increase the risk of bleeding

Other medical problems?The presence of other medicalproblems may affect the use of dalteparin. Make sure you tell your doctorif 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 heparinbefore and had a reaction to either of them called thrombocytopenia (a lowplatelet count in the blood), or if new blood clots formed while you werereceiving the medicine.

• In addition, tell your doctor if you have recentlyhad medical surgery. This may increase the risk of serious bleedingwhen you are taking dalteparin.

Proper Use of This Medicine

If you areusing dalteparin at home, your health care professional will teach you howto inject yourself with the medicine. Be sure to followthe directions carefully. Check with your health care professional if youhave any problems using the medicine.

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

Dosing?The dose of dalteparin will be different fordifferent patients. Follow your doctor's orders or thedirections on the label. The following information includes only theaverage 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 pulmonaryembolism (lung clots):
    • Adults? The dose will be determined by your doctor, based onyour 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 weightinjected under the skin (but no more than 10,000 IU) given every 12 hoursfor 5 to 8 days. Unless your doctor recommends otherwise, aspirin should begiven 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 assoon as possible. However, if it is almost time for your next dose, skip themissed dose and go back to your regular dosing schedule. Do not double doses.

Storage?To store this medicine:

• 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 surethat any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

Tell all your medical doctors and dentists that you are usingthis medicine.

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

• Bruising or bleeding, especially bleeding that is hard to stop. (Bleedinginside the body sometimes appears as bloody or black, tarry stools or causesfaintness.)
• Back pain; burning, pricking, tickling, or tingling sensation; legweakness; numbness; paralysis; or problems with bowel or bladder function.

Side Effects of This Medicine

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

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

More common

Less common

Rare

Other side effects not listed abovemay also occur in some patients. If you notice any other effects, check withyour doctor.