Dalteparin sodium
An anticoagulant medication
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Dalteparin sodium is a low molecular weight heparin (LMWH) used as an anticoagulant to prevent and treat deep vein thrombosis (DVT) and pulmonary embolism (PE). It is also used in patients with unstable angina and myocardial infarction (heart attack) to prevent complications. Dalteparin is administered by subcutaneous injection and works by inhibiting factor Xa and thrombin, which are key components in the coagulation cascade.
Mechanism of Action
Dalteparin sodium functions by enhancing the activity of antithrombin III, a natural inhibitor of coagulation factors. By binding to antithrombin III, dalteparin accelerates the inactivation of factor Xa and, to a lesser extent, thrombin. This action reduces the formation of fibrin, a protein essential for blood clot formation, thereby exerting its anticoagulant effect.
Clinical Uses
Dalteparin is primarily used in the following clinical scenarios:
- Prevention of Venous Thromboembolism (VTE): It is used in patients undergoing surgery, particularly orthopedic procedures, to prevent the formation of blood clots.
- Treatment of Deep Vein Thrombosis and Pulmonary Embolism: Dalteparin is effective in treating existing DVT and PE, reducing the risk of further clotting.
- Acute Coronary Syndrome: In patients with unstable angina or non-Q-wave myocardial infarction, dalteparin helps prevent further cardiac events.
- Cancer-associated Thrombosis: Dalteparin is often used in patients with cancer to manage and prevent thromboembolic events.
Administration and Dosage
Dalteparin is administered via subcutaneous injection. The dosage varies depending on the indication:
- For VTE prophylaxis in surgical patients, a typical dose is 2500 to 5000 IU once daily.
- For treatment of DVT or PE, the dose is often weight-based, typically 200 IU/kg once daily.
- In acute coronary syndrome, the dosing regimen may vary based on clinical guidelines.
Side Effects
Common side effects of dalteparin include:
- Bleeding: As with all anticoagulants, there is a risk of bleeding, which can be serious or life-threatening.
- Thrombocytopenia: A decrease in platelet count, known as heparin-induced thrombocytopenia (HIT), can occur.
- Injection Site Reactions: Patients may experience pain, bruising, or irritation at the injection site.
Contraindications
Dalteparin should not be used in patients with:
- Active major bleeding
- Severe thrombocytopenia
- Known hypersensitivity to dalteparin or other heparin products
Monitoring
While routine monitoring of anticoagulation levels is not typically required with dalteparin, certain patients may need monitoring of anti-factor Xa levels, especially those with renal impairment or at high risk of bleeding.
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