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Generic Name: dalteparin (DAL te PAR in)
Brand Names: Fragmin

What is dalteparin?

Dalteparin is an anticoagulant (blood thinner) that prevents the formation of blood clots.

Dalteparin is used to treat or prevent blood clots in the veins, arteries, or lung that can be caused by cancer or certain heart conditions. Dalteparin is also used before surgery to reduce the risk of blood clots.

Dalteparin may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about dalteparin?

Before you receive dalteparin, tell your doctor if you have eye problems caused by diabetes or high blood pressure, an infection of your heart, uncontrolled high blood pressure, a bleeding or blood clotting disorder, stomach or intestinal bleeding, liver disease, or if you have ever had a blood cell problem caused by heparin.

What should I discuss with my healthcare provider before receiving dalteparin?

• uncontrolled bleeding;

• a severe lack of platelets in your blood;

• if you are having surgery with spinal or epidural anesthesia; or

• if you are allergic to pork products.

Before using dalteparin, tell your doctor if you are allergic to any drugs, or if you have:

• eye problems caused by diabetes or high blood pressure,

• an infection of the lining of your heart (also called bacterial endocarditis);

• uncontrolled high blood pressure;

• a bleeding or blood clotting disorder, such as hemophilia;

• stomach or intestinal bleeding or disorder;

• kidney disease;

• liver disease; or

• if you have ever had a blood cell problem after receiving heparin.

If you have any of these conditions, you may not be able to receive dalteparin, or you may need a dosage adjustment or special tests during treatment.

How should I use dalteparin?

Dalteparin is given as an injection under the skin of your stomach, upper thigh, or buttocks. Your doctor, nurse, or other healthcare provider will give you this injection. You may be given instructions on how to inject your medicine at home. Do not use this medicine at home if you do not fully understand how to give the injection and properly dispose of needles and syringes used in giving the medicine.

You should be sitting or lying down while receiving a dalteparin injection.

Use a different place on your body each time you give yourself an injection. Your doctor will show you the places on your body where you can safely inject dalteparin. Do not inject this medicine into the same place two times in a row.

If you are using a single-dose prefilled syringe, follow the injection instructions closely. Single-dose syringes come in two different types and the directions for use are not the same for each type.

Use each needle and syringe only one time. Throw away used needles and syringes in a puncture-proof container. If your medicine does not come with such a container, ask your pharmacist where you can get one. Keep this container out of the reach of children and pets. Your pharmacist can tell you how to properly dispose of the container.

To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Your kidney function may also need to be tested. Do not miss any scheduled visits to your doctor.

Do not use any medication that is discolored or that has particles in it. Call your doctor for a new prescription.

What happens if I miss a dose?

Use the medication as soon as you remember the missed dose. If it is almost time for your next dose, skip the missed dose and use the medicine at your next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Symptoms of a dalteparin overdose may include bruising, nosebleed, blood in your urine or stools, or any bleeding that will not stop.

What should I avoid while using dalteparin?

Dalteparin side effects

• easy bruising or bleeding, unusual weakness;

• any bleeding that will not stop;

• blood in your urine or stools, black or tarry stools;

• coughing up blood or vomit that looks like coffee grounds;

• bruising, bleeding, swelling, or skin changes where the medicine was injected;

• nausea, sweating, feeling light-headed, fainting;

• sudden numbness or weakness, especially on one side of the body;

• sudden headache, confusion, problems with vision, speech, or balance;

• pain or swelling in one or both legs; or

• trouble breathing.

Less serious side effects include mild pain, redness, or warmth where the medicine was injected.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect dalteparin?

Before receiving dalteparin, tell your doctor if you are using any of the following drugs:

• a blood thinner such as warfarin (Coumadin);

• other medications used to prevent blood clots, such as alteplase (Activase), anistreplase (Eminase), clopidogrel (Plavix), dipyridamole (Persantine), streptokinase (Kabikinase, Streptase), ticlopidine (Ticlid), and urokinase (Abbokinase);

• salicylates such as Disalcid, Doan's Pills, Dolobid, Salflex, Tricosal, and others; or

• NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), or piroxicam (Feldene).

These other drugs can also increase your risk of bleeding, and it is very important that you doctor knows if you are using any of them. You may not be able to receive dalteparin, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect dalteparin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your doctor of pharmacist has information about dalteparin written for health professionals that you may read.

What does my medication look like?

Dalteparin is available with a prescription under the brand name Fragmin. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.