Dalteparin

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5B. ANTI-COAGULANTS in 5. HEMATOLOGICAL SYSTEM
DALTEPARIN
LOW-MOLECULAR-WEIGHT HEPARIN | ANTI-COAGULANT
PK: A: Complete (SC) D: (Vd) 40-60 mL/kg E: Urine

Indications & Dose: DEEP VEIN THROMBOSIS/PULMONARY EMBOLISM SC Adult 200U/kg/day as 1 or 2 divided doses, max 18, 000U/day, In cancer patients: 200U/kg/day 30 days followed by 150U/kg/day up to 5 months | POST-OPERATIVE VENOUS THROMBOEMBOLISM Prophylactic therapy SC Adult Hip-Replacement Surgery: 5, 000U 10-14h before surgery followed by second dose of 5, 000U 4-8h after surgery or later if hemostasis has not been achieved, continue with 5, 000U/day throughout the postoperative period for 5-10 days or 2, 500U within 2h before surgery, followed by 2, 500U 4-8h after surgery or later if hemostasis has not been achieved followed by 5000U/day throughout the postoperative period for 5 days. High-risk patients: 5000U/day 12h before surgery or 12-24h postoperatively continued up to 28-35 days postoperatively, Hip-Fracture Surgery: 5, 000U/day before or after surgery for 10 days (or 28-35 days postoperatively in high risk patients) , Knee-Replacement Surgery: 5, 000U/day initiated either preoperatively/postoperatively 10 days, Abdominal surgery: 5, 000U 8-12h prior to surgery followed by 5, 000U/day throughout the postoperative period for 5-10 days | TO REDUCE RISK OF ISCHEMIC COMPLICATIONS SC Adult Unstable angina/NSTEMI: 120U/kg BID, max 10, 000U along with aspirin (if no contraindications) 5-8 days | VENOUS THROMBOEMBOLIC EVENT DURING PREGNANCY Acute Long-term therapy SC Adult 200U/kg daily in 1 or 2 divided doses, continued postpartum for at least 6 wk with warfarin | VENOUS THROMBOEMBOLISM Prophylactic therapy SC Adult Acutely ill medical patients with severely restricted mobility: 5, 000U/day 12-14 days

Contra: Hypersensitivity, active major bleeding, unstable angina, MI, acute venous thromboembolism, IM/IV route of administration, thrombocytopenia, hypersensitivity to heparin/pork products, cerebrovascular disorders, bacterial endocarditis, severe HTN

Precautions: Hypersensitivity to methylparaben/ propylparaben, history of heparin-induced thrombocytopenia, renal impairment, children

ADR: Serious: Thrombocytopenia, spinal/epidural hematomas, spinal puncture/neuraxial anesthesia, paralysis, GI bleeding, Others: Wound hematoma, pain at inj site, inj site hematoma, skin necrosis, thrombosis

DDI: Serious antiplatelet increases in hemorrhagic risk, Ketorolac prolongs bleeding time

Monitor: CBC including platelet count, stool occult blood tests, PT