Dalteparin

Tell your doctor you use Dalteparin before you have any type of spinal puncture or epidural/spinal anesthesia. Patients who have these procedures while they use Dalteparin are at risk of developing a blood clot on or near the spinal cord. This could result in long-term or permanent paralysis.

The risk is increased in patients who have an indwelling epidural catheter, traumatic or repeated epidural or spinal puncture, a history of a deformed spine or spinal surgery, and in patients who use medicines that may affect blood clotting such as warfarin, aspirin, platelet inhibitors (eg, clopidogrel), and nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen, naproxen).

If you have a spinal puncture or epidural/spinal anesthesia while you use Dalteparin , tell your doctor immediately if you notice any signs or symptoms of nerve problems, such as numbness or tingling, muscle weakness, or paralysis.

           Dalteparin is used for:

Preventing blood clots in patients who have certain illnesses or who will be having certain types of surgeries. It is also used along with aspirin to prevent certain problems caused by heart attacks or unstable angina (chest pain). It is also used to reduce the recurrence of blood clots in certain cancer patients. It may also be used for other conditions as determined by your doctor.

Dalteparin is a low molecular weight heparin (LMWH). It works by blocking the formation of blood clots.

Do NOT use Dalteparin if:

you are allergic to any ingredient in Dalteparin

you are allergic to heparin, benzyl alcohol, or pork products

you have active severe high blood pressure, major bleeding, or a history of low platelets or bleeding problems due to the use of heparin

you are receiving Dalteparin for unstable chest pain or heart attack and will be receiving local anesthesia

Contact your doctor or health care provider right away if any of these apply to you.

Before using Dalteparin :

Some medical conditions may interact with Dalteparin . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding

if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

if you have allergies to medicines, foods, or other substances

if you have a history of kidney problems, liver problems, stomach or intestinal problems (eg, ulcers), stroke, or vision problems caused by diabetes or high blood pressure

if you have inflammation of the heart due to a bacterial infection, or severe, uncontrolled high blood pressure

if you have a bleeding disorder, a history of brain bleeding or blood conditions, or von Willebrand disease

if you have recently had or are scheduled to have brain, spine, or eye surgery, an epidural catheter, or a spinal puncture

if you are taking medicines that affect platelets (eg, aspirin, clopidogrel, ticlopidine)

Some MEDICINES MAY INTERACT with Dalteparin . Tell your health care provider if you are taking any other medicines, especially any of the following:

Activated protein C, anticoagulants (eg, warfarin), dextran, dipyridamole, direct factor XA inhibitors (eg, rivaroxaban), direct thrombin inhibitors (eg, dabigatran), injectable cephalosporins (eg, cephazolin), injectable penicillins (eg, ampicillin), NSAIDs (eg, ibuprofen, ketorolac, naproxen), platelet inhibitors (eg, clopidogrel, ticlopidine), salicylates (eg, aspirin), sulfinpyrazone, or thrombolytics (eg, streptokinase) because the risk of side Use Dalteparin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Dalteparin is usually administered as an injection at your doctor's office, hospital, or clinic. If you are using Dalteparin at home, carefully follow the injection procedures taught to you by your health care provider.

Do not use Dalteparin if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.

Dalteparin should be given while sitting or lying down.

Use the proper technique taught to you by your doctor. Inject deep under the skin, NOT into muscle.

Dalteparin may be injected in a U-shape around the navel, the upper outer thigh, or the upper outer section of the buttock. The injection site should be changed daily. When injection around the navel or thigh is used, a fold of skin must be held by the thumb and forefinger while the injection is given. The entire needle should be injected at a 45- to 90-degree angle.

Fixed dose syringes - To ensure delivery of the full dose, do not expel the air bubble from the prefilled syringe before injection. Hold the syringe assembly by the open sides of the device. Remove the needle shield. Insert the needle into the injection area. Depress the plunger of the syringe while holding the finger flange until the entire dose remaining in the syringe has been given. The needle guard will not be activated unless the entire dose has been given. Remove the needle from the patient. Let go of the plunger and allow the syringe to move up inside the device until the entire needle is guarded. Discard the assembly in approved containers.

Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.

If you miss a dose of Dalteparin , contact your doctor immediately.

Ask your health care provider any questions you may have about how to use Dalteparin .

Important safety information:

Dalteparin may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.

Tell your doctor or dentist that you take Dalteparin before you receive any medical or dental care, emergency care, or surgery.

Before you begin taking any new prescription or nonprescription medicine, check the label to see if it has aspirin or ibuprofen in it. If it does or you are not sure, contact your doctor or pharmacist.

Some forms of Dalteparin contain benzyl alcohol. Do not use medicine with benzyl alcohol in NEWBORNS or INFANTS. It may cause serious and sometimes fatal side effects. If you have questions, check with your doctor or pharmacist.

If you have ever had an allergic reaction to benzyl alcohol, ask your doctor or pharmacist if your medicine has benzyl alcohol in it.

Dalteparin may affect certain lab tests, including liver enzyme tests. Be sure your doctor and lab personnel know you are using Dalteparin .

Lab tests, including complete blood cell counts (eg, platelet counts) and tests for blood in the stool, may be performed while you use Dalteparin . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Use Dalteparin with caution in the ELDERLY; they may be more sensitive to its effects, especially bleeding.

Dalteparin should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.

PREGNANCY and BREAST-FEEDING: Dalteparin may contain the preservative benzyl alcohol, which can cause harm to the fetus. If you become pregnant, use a formulation without this preservative. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Dalteparin while you are pregnant. Dalteparin is found in breast milk. If you are or will be breast-feeding while you are using Dalteparin , check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Dalteparin :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Mild bleeding, bruising, irritation, pain, redness, or swelling at the injection site.

                       Store Dalteparin at room temperature, between 66 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Keep Dalteparin out of the reach of children and away from pets.