Chemistry:Dalteparin sodium
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| Clinical data | |
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| Trade names | Fragmin |
| AHFS/Drugs.com | Monograph |
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| Routes of administration | Subcutaneous |
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| Pharmacokinetic data | |
| Bioavailability | 81-93% |
| Elimination half-life | 3-5 hours subcutaneous; 2.1-2.3 hours IV |
| Excretion | Kidney |
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Dalteparin is a low molecular weight heparin. It is marketed as Fragmin. Like other low molecular weight heparins, dalteparin is used for prophylaxis or treatment of deep vein thrombosis and pulmonary embolism to reduce the risk of a stroke or heart attack.[2] Dalteparin acts by potentiating the activity of antithrombin III, inhibiting formation of both Factor Xa and thrombin.[3] It is normally administered by self-injection.
The CLOT study, published in 2003, showed that in patients with malignancy and acute venous thromboembolism (VTE), dalteparin was more effective than warfarin in reducing the risk of recurrent embolic events.[4] Dalteparin is not superior to unfractionated heparin in preventing blood clots.[5]
Heparins are cleared by the kidneys, but studies have shown that dalteparin does not accumulate even if kidney function is reduced.[6] Approximately 70% of dalteparin is excreted through kidneys based on animal studies.[7]
In May 2019, the U.S. Food and Drug Administration (FDA) approved Fragmin injection to reduce the recurrence of symptomatic VTE in pediatric patients one month of age and older.[8] It is on the World Health Organization's List of Essential Medicines.[9]
References
- ↑ 1.0 1.1 "Dalteparin (Fragmin) Use During Pregnancy". 27 November 2019. https://www.drugs.com/pregnancy/dalteparin.html.
- ↑ Dalteparin - Subcutaneous Injection, HealthLinkBC | https://www.healthlinkbc.ca/medications/fdb0271
- ↑ Pfizer Medical Information: Fragmin Pharmacodynamics | https://www.pfizermedicalinformation.ca/en-ca/fragmin/action-and-clinical-pharmacology#
- ↑ "Low-molecular-weight heparin versus a Coumadin for the prevention of recurrent venous thromboembolism in patients with cancer". N Engl J Med 349 (2): 146–53. 2003. doi:10.1056/NEJMoa025313. PMID 12853587.
- ↑ The PROTECT Investigators for the Canadian Critical Care Trials Group and the Australian and New Zealand Intensive Care Society Clinical Trials Group (2011). "Dalteparin versus unfractionated heparin in critically ill patients". New England Journal of Medicine 364 (14): 1305–1314. doi:10.1056/NEJMoa1014475. PMID 21417952.
- ↑ "Prophylaxis against deep vein thrombosis in critically ill patients with severe renal insufficiency with the low-molecular-weight heparin dalteparin". Arch Intern Med 168 (16): 1805–1812. 2008. doi:10.1001/archinte.168.16.1805. PMID 18779469.
- ↑ Pfizer Medication Information: Fragmin Pharmacokinetics | https://www.pfizermedicalinformation.ca/en-ca/fragmin/action-and-clinical-pharmacology#
- ↑ "FDA approves first anticoagulant (blood thinner) for pediatric patients to treat potentially life-threatening blood clots, PM FDA, May 16, 2019". U.S. Food and Drug Administration (FDA). https://www.fda.gov/news-events/press-announcements/fda-approves-first-anticoagulant-blood-thinner-pediatric-patients-treat-potentially-life-threatening.
- ↑ World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. 2021. WHO/MHP/HPS/EML/2021.02.
External links
- "Dalteparin sodium". Drug Information Portal. U.S. National Library of Medicine. https://druginfo.nlm.nih.gov/drugportal/name/dalteparin%20sodium.
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