Dalteparin sodium

Dalteparin sodium
Clinical data
Trade names	Fragmin
AHFS/Drugs.com	International Drug Names
Pregnancy category	AU: C US: B (No risk in non-human studies)
Routes of administration	subcutaneous
ATC code	B01AB04 (WHO)
Legal status
Legal status	US: ℞-only
Pharmacokinetic data
Bioavailability	81-93%
Biological half-life	3-5 hours subcutaneous; 2.1-2.3 hours IV
Excretion	Renal
Identifiers
CAS Number	9041-08-1^Y
DrugBank	DB06779
ChemSpider	none
UNII	12M44VTJ7B^Y
KEGG	D03353
ECHA InfoCard	100.110.590

Dalteparin is a low molecular weight heparin. It is marketed as Fragmin by Pfizer Inc. Like other low molecular weight heparins, dalteparin is used for prophylaxis or treatment of deep vein thrombosis and pulmonary embolism. It is normally administered by self-injection.

The CLOT study, published in 2003, showed that in patients with malignancy and acute venous thromboembolism, dalteparin was more effective than warfarin in reducing the risk of recurrent embolic events.^[1] Dalteparin is not superior to unfractionated heparin in preventing blood clots.^[2]

Heparins are cleared by the kidneys, but studies have shown that dalteparin does not accumulate even if kidney function is reduced.^[3]

References

↑ Lee AY, Levine MN, Baker RI, Bowden C, Kakkar AK, Prins M, Rickles FR, Julian JA, Haley S, Kovacs MJ, Gent M (2003). "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. 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". doi:10.1056/NEJMoa1014475.
↑ Douketis J, Cook D, Meade M, et al. (2008). "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. doi:10.1001/archinte.168.16.1805. PMID 18779469.

Antithrombotics (thrombolytics, anticoagulants and antiplatelet drugs) (B01)

Antiplatelet drugs

Glycoprotein IIb/IIIa inhibitors	Abciximab Eptifibatide Orbofiban Roxifiban Sibrafiban^§ Tirofiban

ADP receptor/P2Y₁₂ inhibitors	Thienopyridines Clopidogrel Prasugrel Ticlopidine Nucleotide/nucleoside analogs Cangrelor Elinogrel Ticagrelor

Prostaglandin analogue (PGI2)	Beraprost Iloprost Prostacyclin Treprostinil

COX inhibitors	Acetylsalicylic acid/Aspirin^# Aloxiprin Carbasalate calcium Indobufen Triflusal

Thromboxane inhibitors	Thromboxane synthase inhibitors Dipyridamole (+ aspirin) Picotamide Terbogrel Receptor antagonists Terbogrel Terutroban^§

Phosphodiesterase inhibitors	Cilostazol Dipyridamole Triflusal

Other	Cloricromen Ditazole Vorapaxar

Anticoagulants

Vitamin K antagonists
(inhibit II, VII, IX, X)

Factor Xa inhibitors
(with some II inhibition)

Heparin group/ glycosaminoglycans/ (bind antithrombin)	Low molecular weight heparin Bemiparin Certoparin Dalteparin Enoxaparin Nadroparin Parnaparin Reviparin Tinzaparin^‡ Oligosaccharides Fondaparinux Idraparinux^§ Heparinoids Danaparoid Dermatan sulfate Sulodexide

Direct Xa inhibitors ("xabans")	Apixaban Betrixaban^† Darexaban^§ Edoxaban Otamixaban^§ Rivaroxaban

Direct thrombin (IIa) inhibitors

Other

Thrombolytic drugs/
fibrinolytics

Non-medicinal

^#WHO-EM
^‡Withdrawn from market
Clinical trials:
- ^†Phase III
- ^§Never to phase III

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