Dalteparin Sodium

Indications
 Subcutaneous
Pulmonary embolism
Adult: 200 units/kg daily as a single dose or in 2 divided doses in high-risk patients. Max: 18,000 units daily.
Subcutaneous
Deep vein thrombosis
Adult: 200 units/kg daily as a single dose or in 2 divided doses in high-risk patients. Max: 18,000 units daily.
Subcutaneous
Prophylaxis of venous thromboembolism during surgical procedures
Adult: High-risk thrombosis: 2500 units given 1-2 hr before and 8-12 hr after the procedure followed by 5000 units daily. May continue dosage for up to 5 wk following hip replacement therapy. Moderate-risk thrombosis: 2500 units given 1-2 hr before the procedure followed by 2500 units once daily for 5-7 days or until the patient is fully ambulant.
Subcutaneous
Unstable angina
Adult: 120 units/kg every 12 hr continued for 5-8 days with concomitant low-dose of aspirin. Max: 10,000 units every 12 hr.
Max Dosage: 10,000 u every 12 hrs.
Intravenous
Prophylaxis of clotting in extracorporeal circulation in haemodialysis or haemofiltration
Adult: 30-40 units/kg via IV inj, followed by an IV infusion of 10-15 units/kg/hr. A single dose of 5000 units may be given for haemodialysis or haemofiltration session lasting <4 hr. For patients at high risk of bleeding complications or who are in acute renal failure: 5-10 units/kg via IV inj followed by an infusion of 4-5 units/kg/hr.

Special Populations: Prevention of clotting in the extracorporeal circulation during haemodialysis or haemofiltration: Adult: with chronic renal insufficiency: 30-40 units/kg body wt IV Inj followed by 10-15 units/kg/hr infusion. Haemodialysis or haemofiltration session <4 hrs: 5000 u as a single dose. Acute renal insufficiency or patients at high-risk: 5-10 units/kg body wt IV Inj followed by 4-5 units/kg body weight/hr IV infusion.
Contraindications
 Hypersensitivity. Active major bleeding, severe coagulation disorders; lumbar puncture; sympathetic block; brain, spinal cord, eye or ear surgery; severe hypertension.
Warnings / Precautions
 Preexisting thrombocytopenia, recent childbirth, DM, subacute bacterial endocarditis, pericarditis, recent lumbar puncture, vasculitis. Monitor coagulation time. Hepatic or renal dysfunction; high doses; osteoporosis; familial antithrombin III deficiency; elderly; children; platelet count and stool occult blood test recommended during treatment; GI ulceration. Pregnancy and lactation.
Adverse Reactions
 Hypersensitivity reactions; thrombocytopenia; inj site pain and tenderness; ecchymoses; haematoma. Prolonged use may lead to alopecia and osteoporosis
Potentially Fatal: Severe haemorrhage.
Overdose Reactions
 Prolongation of the aPTT. Prolonged clotting time induced by dalteparin may be neutralised by protamine, but the anti-Factor Xa activity is only neutralised to about 25-50%. As protamine has an inhibitory effect on primary haemostasis, it should be used only in an emergency. 1 mg of protamine inhibits the effect of 100 IU (anti-Factor Xa) of dalteparin.
Drug Interactions
 Increased risk of hyperkalaemia when used with potassium sparing drugs such as ACE inhibitors.
Potentially Fatal: Oral anticoagulants, platelet inhibitors and NSAIDs may increase risk of haemorrhage.
See Below for More dalteparin sodium Drug Interactions
Lab Interactions
 Dalteparin-induced transaminases may interfere with interpretation of LFT results and diagnosis of MI, liver disease and pulmonary embolism.
Mechanism of Actions
 Dalteparin sodium is a low molecular weight heparin analogue which inhibits factor Xa more than factor IIa (thrombin).
Absorption: Almost completely absorbed from the GI tract (oral); peak plasma concentrations after 4 hr.
Excretion: Via kidneys; prolonged in renal impairment. Elimination half-life: 2 hr (IV), 3-5 hr (SC).
Storage Conditions
 Intravenous: Store below 25°C. Subcutaneous: Store below 25°C.
ATC Classification
 B01AB04 - dalteparin ; Belongs to the class of heparin group. Used in the treatment of thrombosis.
Storage
 Intravenous: Store below 25°C. Subcutaneous: Store below 25°C.
Available As
  • Dalteparin Sodium 10000 iu
  • Dalteparin Sodium 2500 iu
  • Dalteparin Sodium 5000 iu
  • Dalteparin Sodium 7500 iu

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