Low Molecular Weight Heparin Dalteparin Sodium Injection Prefilled Syringes PFS Anticoagulant

Low Molecular Weight Heparin Dalteparin Sodium Injection Prefilled Syringes PFS Anticoagulant

Product : Dalteparin Sodium Injection Pre-filled Syringe

Specification : PFS, 0.6ml/7500IU, 0.4ml/5000IU, 0.2ml/2500IU

Standard : In - house

Packing : 2’s/box

Description :

Dalteparin, a low molecular weight heparin (LMWH) prepared by nitrous acid degradation of unfractionated heparin of porcine intestinal mucosa origin, is an anticoagulant. It is composed of strongly acidic sulphated polysaccharide chains with an average molecular weight of 5000 and about 90% of the material within the range of 2000-9000. LMWHs have a more predictable response, a greater bioavailability, and a longer anti-Xa half life than unfractionated heparin. Dalteparin can also be safely used in most pregnant women. Low molecular weight heparins are less effective at inactivating factor IIa due to their shorter length compared to unfractionated heparin.

Indications and Dosages :

➤➤To prevent ischemic complications in patients who receive aspirin as part of treatment for unstable angina and non–Q-wave MI

subcutaneous injection

Adults. 120 international units/kg every 12 hr with aspirin (75 to 165 mg daily) until patient is stable, usually 5 to 8 days. Maximum: 10,000 international units/dose.

➤➤To prevent blood clots in patients undergoing hip replacement surgery

subcutaneous injection

Adults. Initial: 2,500 international units 1 to 2 hr before surgery, repeated in 8 to 12 hr and again 8 to 12 hr later. Maintenance: 5,000 international units every morning for 5 to 10 days postoperatively or until patient is fully ambulatory. Alternate: 5,000 international units the evening before surgery; then 5,000 international units daily (starting the next evening) for 5 to 10 days or until patient is fully ambulatory.

➤➤To prevent blood clots in patients undergoing abdominal surgery who are at risk for thromboembolic complications

subcutaneous injection

Adults. 2,500 international units daily, starting 1 to 2 hr before surgery and repeated for 5 to 10 days. For patients at high risk (those with cancer), 5,000 international units the evening before surgery, repeated daily for 5 to 10 days; or 2,500 international units 1 to 2 hr before surgery followed by 2,500 international units 12 hr later and then 5,000 international units daily for 5 to 10 days.

➤➤To prevent blood clots in patients with severe mobility restrictions during acute

illness

subcutaneous injection

Adults. 5,000 international units daily.

➤➤To treat symptomatic venous thromboembolism and prevent recurrence in patients with cancer

subcutaneous injection

Adults. 200 international units/kg (not to exceed 18,000 international units) once daily for 30 days. Then 150 international units/kg once daily for 5 more mo.

Pharmacodynamics :

Dalteparin has an antithrombin binding site that is essential for high affinity binding to the plasma protein antithrombin (ATIII). Anti-Xa activity of plasma is used as both as an estimate of clotting activity, and as a basis to determine dosage. Its use should be avoided in patients with a creatinine clearance less than 20mL/min. In these patients, unfractionated heparin should only be used. As for monitoring, active partial thromboplastin time (aPTT) will only increase at high doses of low molecular weight heparins (LMWH). Therefore, monitoring aPTT is not recommended. However, anti-Xa activity can be measured to monitor the efficacy of the LMWH.

Mechanism of action :

Dalteparin potentiates the activity of ATIII, inhibiting the formation of both factor Xa and thrombin. The main difference between dalteparin and unfractionated heparin (UH) is that dalteparin preferentially inactivates factor Xa. As a result, only a slight increase in clotting time [(i.e. activated partial thomboplastin time (APTT)] is observed relative to UH. For this same reason, APTT is not used to monitor the effects of dalteparin except as an indicator for overdosage.