Dalteparin

Dalteparin is used along with aspirin to help prevent blood vessel problems in people with certain types of angina (chest pain) or heart attack.

Dalteparin is used to prevent a type of blood clot known as deep vein thrombosis (DVT) in people who have had a hip replacement or stomach surgery, or who cannot move as usual during or after a hospital stay. A DVT can lead to blood clots in the lungs (PE, pulmonary embolism).

Dalteparin is also used to prevent a blood clot from returning in adults with cancer and in children who are at least 1 month old.

Dalteparin is not used to treat an active blood clot (DVT or PE).

Dalteparin may also be used for reasons not mentioned in this medication guide.

You should not use dalteparin if you have uncontrolled or active bleeding, have had low levels of platelets in your blood, or have had a blood clot caused by heparin or similar medicines.

Dalteparin can cause a very serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural). Inform any doctor who treats you that you are using dalteparin.

Some drugs can increase your risk of bleeding when used with dalteparin. Inform your doctor about all other medicines you are using.

You should not use this medicine if you are allergic to it, or if you have:

• an allergy to heparin, or pork products;
• to undergo a spinal procedure and need to receive treatment for a certain type of heart attack or angina (chest pain) or to keep a blood clot from coming back;
• active or uncontrolled bleeding; or
• a history of low levels of platelets in your blood or blood clots caused by heparin or similar medicines.

Dalteparin can cause a serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural). This type of blood clot could cause long-term or permanent paralysis.

Dalteparin can make it easier for you to bleed, even from a minor injury. Call your doctor if you have bleeding that will not stop.

Tell your doctor if you have or have ever had:

• an allergy to latex;
• a genetic spinal defect, or any other condition affecting your spine;
• a thin tube (catheter) placed in your back to give you certain medicine;
• a spinal surgery;
• recently had a spinal tap or epidural anesthesia;
• a history of difficult or repeated spinal taps;
• a planned surgery, dental work, or any other medical procedure;
• a bleeding or blood clotting disorder;
• take certain other medicines that can increase bleeding risk;
• a stomach ulcer, or a stomach or intestinal bleeding disorder;
• hemorrhagic stroke, severe or uncontrolled high blood pressure;
• eye problems caused by diabetes or high blood pressure (retinopathy);
• low levels of platelets in your blood;
• an infection of the lining of your heart (also called bacterial endocarditis);
• kidney disease; or
• severe liver disease.

Dalteparin may contain an ingredient that can cause serious side effects or death in very young or premature babies. Do not give this medicine to a child without medical advice.

It is not known if dalteparin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. Having a blood clot during pregnancy may cause complications or medical problems in the mother. The benefit of treating a blood clot may outweigh any risks to the baby.

Ask a doctor if it is safe to breastfeed while using this medicine.

Get emergency medical help if you have signs of an allergic reaction: hives, difficulty breathing, swelling of your face, lips, tongue, or throat.

Seek emergency medical attention or tell your doctor right away if you have symptoms of a spinal blood clot: back pain, numbness, tingling, muscle weakness in your lower body, or loss of bladder or bowel control.

Dalteparin can cause you to bleed more easily. Also call your doctor at once if you have signs of bleeding such as:

• bleeding that will not stop (nosebleeds, bleeding gums, abnormal vaginal bleeding);
• easy bruising, unusual bleeding, purple or red spots under your skin;
• bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
• urine that looks red, pink, or brown; or
• headache, weakness, dizziness, or feeling like you might pass out.

Common side effects of dalteparin may include:

• bleeding;
• low levels of platelets in your blood;
• bruising, swelling, warmth, redness, pain, or bleeding where an injection was given; or
• abnormal liver function tests.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Dalteparin is injected under the skin. A healthcare provider may give you this injection or may teach you how to properly use dalteparin by yourself.

Dalteparin is usually given once or twice per day. Follow your doctor's dosing instructions very carefully.

In certain cases, doses are based on weight. Your dose may change if you gain or lose weight.

Your healthcare provider will show you where to inject dalteparin. Do not inject into the same place two times in a row. Choose a different place on your body each time you give an injection.

Prepare an injection only when you are ready to give it. Call your pharmacist if the medicine looks cloudy, has changed colors or has particles in it. Ask your doctor or pharmacist if you don't understand how to use an injection.

Throw away a prefilled syringe or single-use vial after one use, even if there is still medicine left inside.

Do not reuse a needle, single-use vial, or syringe. Place them in a puncture-proof "sharps" container and dispose of it following state or local laws. Keep out of the reach of children and pets.

You may need frequent medical tests.

If you need surgery, dental work, or a medical procedure, tell the surgeon or dentist ahead of time that you are using dalteparin. You may need to stop using the medicine for a short time.

Some dalteparin vials may be used more than once, you may store these vials at room temperature for up to 2 weeks. Discard any unused medicine after 2 weeks. Be sure you know what type of vial you have (single-use or multi-use). Ask your pharmacist if you have any questions.

Store at room temperature away from moisture and heat. Follow all other storage instructions provided with dalteparin. Your healthcare provider can provide more information about how to store this medicine.

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose may cause excessive bleeding.

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, Advil, Aleve, Motrin, and others. Using an NSAID with dalteparin may cause you to bruise or bleed easily.

Avoid activities that may increase your risk of bleeding or injury. Use extra care while shaving or brushing your teeth.

Tell your doctor about all your other medicines, especially:

• medicine used to prevent blood clots--alteplase, clopidogrel, dipyridamole, ticlopidine, and others;
• a blood thinner--warfarin, Coumadin, Jantoven, apixaban, rivaroxaban, dabigatran and others; or
• NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may affect dalteparin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.