II. Indications
- Venous Thromboembolism (DVT, PE) prophylaxis
- Venous Thromboembolism treatment (off-label)
- Acute Coronary Syndrome (off-label)
III. Mechanism
IV. Dosing: Adult DVT Prophylaxis
- Low risk
- Initial: 2500 IU SQ 1-2 hours before surgery
- Later: 2500 IU daily for 5-10 days
- High risk (e.g. hip surgery, Thrombophilia risk, pregnancy, medical patients with reduced mobility)
- Initial: 5000 IU SQ the evening before surgery or on medical admission
- Later: 5000 IU SQ daily for 5-10 days (up to 12 to 14 days for medical patients with restricted mobility patients)
V. Dosing: Adult Treatment
- VTE (DVT/PE) in active cancer (prolonged Anticoagulation)
- Initial first month: 200 units/kg SC daily
- Next 5 months: 150 units/kg SC daily
- Maximum: 18,000 units/day
-
Venous Thromboembolism (DVT, PE) treatment (off-label)
- Dalteparin 200 units/kg SQ daily or 100 to 120 units/kg SC every 12 hours
-
Unstable Angina
- Administer with Aspirin daily
- Dalteparin 120 units/kg (max 10,000 units) every 12 hours
- Renal impairement (GFR <30 ml/min)
- Target anti-Xa level 0.5 to 1.5 units/ml
- For 3 to 4 doses, recheck anti-Xa level 4 to 6 hours after dose
VI. Dosing; Child (over age 4 weeks old)
-
Venous Thromboembolism (DVT, PE) treatment
- Age 1 month to 2 years:
- Dalteparin 150 units/kg SQ every 12 hours
- Age 2 to 8 years
- Dalteparin 125 units/kg SQ every 12 hours
- Age 8 to 17 years
- Dalteparin 100 units/kg SQ every 12 hours
- Age 1 month to 2 years:
VII. Safety
- Use in pregnancy when benefit outweighs the risk
- Considered safe in Lactation
VIII. Efficacy
IX. Resources
X. References
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- Miano (2018) Chest 153(1):133-42 +PMID: 28823757 [PubMed]
- Worley (2008) J Spinal Cord Med 31(4):379-87 +PMID: 18959355 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| Definition (NCI_NCI-GLOSS) | A drug used to prevent blood clots from forming or to treat blood clots that have formed in patients with cancer or other conditions. Dalteparin is a type of anticoagulant. |
| Definition (NCI) | A low molecular weight, synthetic heparin. As an anticoagulant/antithrombotic agent, dalteparin binds to antithrombin and enhances the inhibition of Factor Xa. Compared to unfractionated heparins, the use of dalteparin is associated with lower incidences of osteoporosis and heparin-induced thrombocytopenia. (NCI04) |
| Definition (MSH) | A low-molecular-weight fragment of heparin, prepared by nitrous acid depolymerization of porcine mucosal heparin. The mean molecular weight is 4000-6000 daltons. It is used therapeutically as an antithrombotic agent. (From Merck Index, 11th ed) |
| Definition (PDQ) | A low molecular weight, synthetic heparin. As an anticoagulant/antithrombotic agent, dalteparin binds to antithrombin and enhances the inhibition of Factor Xa. Compared to unfractionated heparins, the use of dalteparin is associated with lower incidences of osteoporosis and heparin-induced thrombocytopenia. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=43290&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=43290&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1453" NCI Thesaurus) |
| Concepts | Pharmacologic Substance (T121) , Carbohydrate (T118) |
| MSH | D017985 |
| SnomedCT | 108986009, 372563008 |
| Swedish | Dalteparin |
| Czech | dalteparin, tedelparin |
| Finnish | Tedelpariini |
| Russian | DALTEPARIN, TEDELPARIN, ТЕДЕЛПАРИН, ДАЛТЕПАРИН |
| Japanese | フラグミン, テデルパリン, ダルテパリンナトリウム, ダルテパリン |
| English | Dalteparin [Chemical/Ingredient], dalteparin, DALTEPARIN, Dalteparin (product), Dalteparin (substance), DAL, Dalteparin, Tedelparin |
| Polish | Dalteparyna, Tedelparyna |
| Spanish | dalteparina (producto), dalteparina (sustancia), dalteparina, Dalteparina, Tedelparina |
| German | Dalteparin, Tedelparin |
| Portuguese | Dalteparina, Tedelparina |
| Italian | Tedelparina, Dalteparina |
| French | Tedelparine, Daltéparine |
Ontology: Fragmin (C0917726)
| Concepts | Pharmacologic Substance (T121) , Carbohydrate (T118) |
| MSH | D017985 |
| English | Fragmine, Pfizer Brand of Dalteparin Sodium, fragmin, Fragmin |
| Czech | Fragmin |
| French | Fragmin |
