Daily Medication Pearl: Dalteparin Sodium (Fragmin)

Medication Pearl of the Day: Dalteparin Sodium (Fragmin)

Indication: Fragmin is a low molecular weight heparin (LMWH) indicated for prophylaxis of ischemic complications of unstable angina and non-Q-wave myocardial infarction, prophylaxis of deep vein thrombosis (DVT) in abdominal surgery, hip replacement surgery or medical patients with severely restricted mobility during acute illness, and extended treatment of symptomatic venous thromboembolism (VTE) to reduce the recurrence of VTE in adult patients with cancer.

Explanations:

• Dosing: Unstable angina: 120 international units (IU)/kg, DVT dosing could be from 2500 to 5000 IU
• Dosage forms: Injection: 2500 IU/0.2 mL, 5000 IU/0.2 mL, 7500 IU/0.3 mL, 12,500 IU/0.5 mL, 15,000 IU/0.6 mL, and 18,000 IU/0.72 mL
  • Single-dose prefilled syringes: 10,000 IU/mL
  • Single-dose graduated syringes: 95,000 IU/3.8 mL (25,000 IU/mL) multiple-dose vials
• Adverse events (AEs): Most common AEs (>1%) are bleeding (including hemorrhage), thrombocytopenia (type 1), hematoma at the injection site, pain at the injection site, and transient elevation of transaminases.
• Mechanism of action: Dalteparin is a low molecular weight heparin with antithrombotic properties. It acts by enhancing the inhibition of Factor Xa and thrombin by antithrombin. In humans, dalteparin potentiates preferentially the inhibition of coagulation Factor Xa, only slightly affecting the activated partial thromboplastin time.

Reference: label (fda.gov)