Dalteparin sodium

Dalteparin sodium
Clinical data
Trade names	Fragmin
AHFS/Drugs.com	Monograph
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%
Elimination half-life	3-5 hours subcutaneous; 2.1-2.3 hours IV
Excretion	Renal
Identifiers
CAS Number	9041-08-1 ;
DrugBank	DB06779;
ChemSpider	none;
UNII	12M44VTJ7B;
KEGG	D03353;
ECHA InfoCard	100.110.590

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. 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.[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]

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.[4]

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. Cite journal requires |journal= (help)
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.
"FDA approves first anticoagulant (blood thinner) for pediatric patients to treat potentially life-threatening blood clots, PM FDA, May 16, 2019". fda.gov. Retrieved 17 May 2019.

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[1] 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.

[2] 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. Cite journal requires |journal= (help)

[3] 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.

[4] "FDA approves first anticoagulant (blood thinner) for pediatric patients to treat potentially life-threatening blood clots, PM FDA, May 16, 2019". fda.gov. Retrieved 17 May 2019.