Dalteparin

LMWH·Haematology - Anticoagulants & Haemostatics

VTE prophylaxis, treatment of DVT/PE, ACS (NSTEMI/STEMI)

PBSLMWHFragminPre-filled syringes (2500, 5…S4+1

Prophylaxis

5000 U OD

Half-life

3-5 h

Bleeding Risk

HIGH

Renal Adj.

DOSE RED.

Rapid Summary

Overview

Low Molecular Weight Heparin (LMWH). Highly similar to Enoxaparin. Used for VTE prophylaxis and treatment. Dosed in 'Units' rather than 'mg'.

Maximum Dose

Max 200 IU/kg per day (Therapeutic weight-based dosing).

Clinical Focus

Like Enoxaparin, it relies on the kidneys for clearance. High risk of fatal bleeding if full doses are given in severe CKD.

Bottom Line

Dalteparin is a low-molecular-weight heparin for VTE prophylaxis and treatment, but requires dose adjustment in renal impairment and anti-Xa monitoring in extremes of weight.

Formulation & Access

Brand Names

Fragmin

Parenteral

Pre-filled syringes (2500, 5000, 7500, 10000, 12500, 15000, 18000 IU) for SC injection.

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

VTE prophylaxis, treatment of DVT/PE, ACS (NSTEMI/STEMI).

Clinical Place

Direct alternative to Enoxaparin. Often chosen based on hospital contract/formulary preference.

Quick reference

Class & Role

LMWH — Low Molecular Weight Heparin (LMWH).

Route / Formulation

Pre-filled syringes (2500, 5000, 7500, 10000, 12500, 15000, 18000 IU) for SC injection. (Fragmin)

Usual Dose & Max

SC 5000 IU OD. Max 200 IU/kg per day (Therapeutic weight-based dosing).

Key Indication Doses

VTE Prophylaxis (Medical/Surgical): SC 5000 IU OD. Therapeutic VTE/PE/ACS: SC 200 IU/kg OD OR 100 IU/kg BD. Renal Impairment: If eGFR < 30, reduce prophylaxis dose to 2500 IU OD. For therapeutic dosing, switch to unfractionated heparin or monitor Anti-Xa levels strictly.

Best Uses

Dalteparin is a low-molecular-weight heparin for VTE prophylaxis and treatment, but requires dose adjustment in renal impairment and anti-Xa monitoring in extremes of weight.

Avoid / Cautions

Active major bleeding, history of HIT, planned epidural insertion/removal within 12-24 hours. Pregnancy Category C. (Does not cross placenta, safe and standard in pregnancy).

Key Risks

Haematological: Haemorrhage. HIGH — Heparin-Induced Thrombocytopenia (HIT), though slightly less risk than unfractionated heparin. Neurological: Epidural/Spinal hematoma (can cause permanent paralysis if given too close to an epidural block/removal).

Key Interactions

Other anticoagulants, high-dose Aspirin, NSAIDs (Massive bleeding risk).

Monitoring

Monitor FBC (platelets) on days 4-14 to screen for HIT. Check eGFR. Routine aPTT/INR monitoring is useless. Use Anti-Xa levels for monitoring in obesity/pregnancy.

Clinical Pearl

Never administer a therapeutic dose of Dalteparin within 24 hours of an epidural insertion or removal. The resultant hematoma will compress the spinal cord and cause paraplegia.

Access

Fragmin

Brand: Fragmin

Dalteparin

LMWH·Haematology - Anticoagulants & Haemostatics

VTE prophylaxis, treatment of DVT/PE, ACS (NSTEMI/STEMI)

PBSLMWHFragminPre-filled syringes (2500, 5…S4+1

Prophylaxis

5000 U OD

Half-life

3-5 h

Bleeding Risk

HIGH

Renal Adj.

DOSE RED.

Rapid Summary

Overview

Low Molecular Weight Heparin (LMWH). Highly similar to Enoxaparin. Used for VTE prophylaxis and treatment. Dosed in 'Units' rather than 'mg'.

Maximum Dose

Max 200 IU/kg per day (Therapeutic weight-based dosing).

Clinical Focus

Like Enoxaparin, it relies on the kidneys for clearance. High risk of fatal bleeding if full doses are given in severe CKD.

Bottom Line

Dalteparin is a low-molecular-weight heparin for VTE prophylaxis and treatment, but requires dose adjustment in renal impairment and anti-Xa monitoring in extremes of weight.

Formulation & Access

Brand Names

Fragmin

Parenteral

Pre-filled syringes (2500, 5000, 7500, 10000, 12500, 15000, 18000 IU) for SC injection.

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

VTE prophylaxis, treatment of DVT/PE, ACS (NSTEMI/STEMI).

Clinical Place

Direct alternative to Enoxaparin. Often chosen based on hospital contract/formulary preference.

Quick reference

Class & Role

LMWH — Low Molecular Weight Heparin (LMWH).

Route / Formulation

Pre-filled syringes (2500, 5000, 7500, 10000, 12500, 15000, 18000 IU) for SC injection. (Fragmin)

Usual Dose & Max

SC 5000 IU OD. Max 200 IU/kg per day (Therapeutic weight-based dosing).

Key Indication Doses

Best Uses

Dalteparin is a low-molecular-weight heparin for VTE prophylaxis and treatment, but requires dose adjustment in renal impairment and anti-Xa monitoring in extremes of weight.

Avoid / Cautions

Active major bleeding, history of HIT, planned epidural insertion/removal within 12-24 hours. Pregnancy Category C. (Does not cross placenta, safe and standard in pregnancy).

Key Risks

Key Interactions

Other anticoagulants, high-dose Aspirin, NSAIDs (Massive bleeding risk).

Monitoring

Monitor FBC (platelets) on days 4-14 to screen for HIT. Check eGFR. Routine aPTT/INR monitoring is useless. Use Anti-Xa levels for monitoring in obesity/pregnancy.

Clinical Pearl

Never administer a therapeutic dose of Dalteparin within 24 hours of an epidural insertion or removal. The resultant hematoma will compress the spinal cord and cause paraplegia.

Access

Fragmin

Brand: Fragmin