SC (Adults): Abdominal surgery —2500 IU 1–2 hr before surgery, then once daily for 5–10 days; high-risk patients undergoing abdominal surgery —5000 IU evening before surgery, then once daily for 5–10 days or 2500 IU 1–2 hr before surgery, another 2500 IU 12 hour later, then 5000 IU daily for 5–10 days; hip replacement surgery —2500 IU within 2 hr before surgery, another 2500 IU evening of the day of surgery≥6 hr after first dose, then 5000 IU daily for 5–10 days (if surgery is in the evening omit second dose day of surgery) or 5000 IU evening before surgery, then 5000 IU daily for 5–10 days. medical patients with severely restricted mobility: 5000 IU for 12 to 14 days.
SC (Adults): 120 IU/kg (not to exceed 10,000 IU) q 12 hr with concurrent aspirin .
Systemic Anticoagulation (Unlabeled)
SC (Adults): 200 IU/kg once daily or 100 IU/kg twice daily.
Active major bleeding; history of heparin-induced thrombocytopenia or heparin-induced thrombocytopenia with thrombosis; as treatment for unstable angina of non–Q-wave MI or prolonged VTE prophylaxis in patients undergoing epidural/neuraxial anesthesia; hypersensitivity to heparin or pork products or to any component of the product.
Use Cautiously in:
Patients with severe renal or hepatic impairment.
Retinopathy (hypertensive or diabetic).
Spinal or epidural anesthesia.
Geri: Geriatric patients (risk of bleeding may be , consider age-related in renal function and body weight).
OB, Pedi: Pregnancy, lactation, or children (safety not established; products containing benzyl alcohol should not be used in neonates).
Exercise Extreme Caution in:
Spinal/epidural anesthesia or spinal puncture (increased risk of spinal/epidural hematoma that may lead to long-term or permanent paralysis).
The risk of severe bleeding may be increased. Close clinical and laboratory monitoring (aPTT and/or anti-Xa) is indicated during coadministration of dalteparin and antithrombin. Adjust the dose of dalteparin accordingly. Reduced doses of dalteparin are recommended when coadministered with antithrombin III.
SSRIs (eg, fluoxetine)
The risk of severe bleeding may be increased. Carefully monitor the coagulation status of the patient and observe the patient for bleeding. Adjust therapy as needed.