Makindo Medical Notes

ℹ️ About

Always check the BNF link here 📖 for the most up-to-date prescribing advice.

• Dalteparin is a low molecular weight heparin (LMWH) widely used in VTE prevention and treatment, and in acute coronary syndromes.

⚙️ Mode of Action

• Potentiates antithrombin III, leading to inhibition of Factor Xa and to a lesser degree Factor IIa (thrombin).
• Results in reduced fibrin formation → anticoagulant effect 🩸.

💊 Indications & Dose

💡 For cancer-associated thrombosis, extended LMWH therapy (often 6 months or more) is commonly recommended.

⚠️ Interactions

• Increased bleeding risk with NSAIDs, antiplatelets, anticoagulants, SSRIs.

🔎 Cautions

• Renal or hepatic impairment — accumulation risk, especially in renal failure 🧪.
• Monitor potassium — risk of hyperkalaemia.
• Use with caution in elderly and low body weight patients.

🚫 Contraindications

• Active bleeding or bleeding disorders.
• Severe uncontrolled hypertension.
• History of heparin-induced thrombocytopenia (HIT).
• Recent trauma, surgery involving CNS, eyes, or ears.

❗ Side Effects

• Haemorrhage (major risk) 🩸.
• Thrombocytopenia, including HIT (rare but serious).
• Hyperkalaemia ⚡.
• Pain or bruising at injection site.
• Osteoporosis with long-term use.

📚 References

• BNF — Dalteparin
• ESC / ACCP guidelines on VTE prevention & treatment

📝 Revisions

• Expanded dosing indications; added cautions and long-term side effects.