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Precautions and Warnings With Dalteparin

You may not be able to use dalteparin safely if you have certain medical conditions, such as stomach ulcers or kidney disease. Being aware of these and other dalteparin precautions and warnings can help ensure a safe treatment process. To make your treatment even safer, make sure your healthcare provider has a list of all your current medications and any medical conditions you have.

What Should I Tell My Healthcare Provider?

Talk with your healthcare provider prior to using dalteparin sodium (Fragmin®) if you have:
 
  • A bleeding disorder (not a clotting disorder)
  • Intestinal or stomach ulcers or bleeding
  • Bleeding in the brain
  • An aneurysm
  • A bacterial infection of the endocardium (the inner layer of the heart)
  • Had a negative reaction to heparin
  • Kidney disease, such as kidney failure
  • Had recent brain, eye, or spinal surgery
  • High blood pressure
  • Diabetic retinopathy (an eye condition)
  • Any allergies, including allergies to foods, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
  • Breastfeeding
  • Pregnant or thinking of becoming pregnant.
     
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
 

Specific Precautions and Warnings With Dalteparin

Some warnings and precautions to be aware of prior to using this anticoagulant include the following:
 
  • As with all "blood thinners," one of the most serious side effects of dalteparin is internal bleeding, which can be fatal. Let your healthcare provider know if you develop any signs of bleeding, such as:
     
    • Easy bruising
    • Cuts or scrapes that are slow to stop bleeding
    • Black, tarry stools; bright-red blood in the stool; or vomiting of blood (signs of gastrointestinal bleeding)
    • Signs of bleeding in the brain, such as vision or speech changes, weakness or numbness in an arm or leg, or a severe headache.
 
  • There have been reports of spinal or epidural hematoma in people who had spinal, epidural, or caudal anesthesia (or spinal punctures) while on dalteparin. This is a serious problem that can sometimes cause long-term or permanent paralysis. Each case must be evaluated on an individual basis, but you may not be a candidate for these types of anesthesia or procedures if you are using dalteparin.
     
  • Make sure your healthcare provider knows if you have kidney disease, diabetic retinopathy, uncontrolled high blood pressure, recent ulcers of the digestive tract, or any obvious bleeding. Extra care must be taken in such situations.
     
  • Dalteparin should be used with extreme caution in people with bacterial endocarditis, bleeding disorders (that increase the risk of bleeding), active stomach or intestinal ulcers, bleeding in the brain, or who have recently had brain, spinal, or eye surgery.
     
  • Dalteparin may interact with a number of other medications (see Drug Interactions With Dalteparin for more information).
     
  • As with other heparin-like drugs, dalteparin can cause low blood platelets (thrombocytopenia). In many cases, this is mild and causes no other problems. Rarely, though, a severe reaction known as heparin-induced thrombocytopenia (HIT) may occur. This dangerous problem can cause excessive clotting, loss of limbs, and even death.
     
  • Dalteparin multi-dose vials contain benzyl alcohol, a preservative that can be dangerous to premature newborns. Because benzyl alcohol may cross the placenta, pregnant women should generally avoid using dalteparin multi-dose vials. This is not a problem with the single-dose syringes.
     
  • Dalteparin passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Fragmin and Breastfeeding).
     
  • Dalteparin is considered a pregnancy Category B medication. This means that it is probably safe for use during pregnancy, although the full risks are currently unknown (see Fragmin and Pregnancy).
     
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Dalteparin Drug Information

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