Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Fragmin (Dalteparin).
Bleeding: The most serious risk associated with Fragmin (Dalteparin) is bleeding in any tissue or organ. It is extremely important to have regular blood tests as recommended by your doctor to ensure proper levels of clotting.
If you experience bleeding gums, bleeding from the mouth, bleeding from the anus or vagina, or you notice blood in your urine, contact your doctor as soon as possible. If you have an increased risk of bleeding you should be closely monitored by your doctors while taking Fragmin (Dalteparin).
Blood counts: While you are taking Fragmin (Dalteparin), your doctor will also be monitoring your blood cell counts, including a platelet count. If your platelet level drops very suddenly, you may have to stop Fragmin (Dalteparin) and switch to another type of medication. Make sure to tell your doctor if you have had any problems with low platelets or platelet defects in the past.
Body weight: The safety and effectiveness of Fragmin (Dalteparin) for people of high weight (e.g., over 120 kg) and low weight (e.g., under 46 kg) have not been fully established. If you have a high or low body weight, discuss with your doctor how Fragmin (Dalteparin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fragmin (Dalteparin), and whether any special monitoring is needed.
Heart problems: Blood clots have occurred for people with prosthetic heart valves using low molecular weight heparins. People with unstable coronary artery disease may be at increased risk of bleeding. If you have a history of heart disease or have prosthetic heart valves your doctor should closely monitor your condition while you are taking Fragmin (Dalteparin).
Kidney problems: The kidneys remove much of Fragmin (Dalteparin) from your body. People with decreased kidney function or kidney disease may experience increased side effects of Fragmin (Dalteparin) as a result of the medication building up in the body. If you have reduced kidney function or kidney disease, discuss with your doctor how Fragmin (Dalteparin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fragmin (Dalteparin), and whether any special monitoring is needed.
Liver problems: People with liver problems may be at an increased risk for bleeding. If you have decreased liver function or liver disease, discuss with your doctor how Fragmin (Dalteparin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fragmin (Dalteparin), and whether any special monitoring is needed.
Osteoporosis: Other medications in the heparin family have been reported to encourage the development of osteoporosis. If you have osteoporosis or are at risk for developing osteoporosis, discuss with your doctor how Fragmin (Dalteparin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fragmin (Dalteparin), and whether any special monitoring is needed.
Potassium levels: Increases in blood levels of potassium occur for a small percentage of people taking medications in the heparin family, including Fragmin (Dalteparin). This may be more likely to happen if you have diabetes or chronic kidney failure, or if you are taking potassium sparing diuretics. Your doctor may want to monitor your potassium levels. If you experience unexplained nausea, fatigue, muscle weakness, or tingling sensations, contact your doctor.
Stomach or intestinal ulcers: Fragmin (Dalteparin) increases the risk of unwanted bleeding. If you have a history of stomach or intestinal ulcers, discuss with your doctor how Fragmin (Dalteparin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fragmin (Dalteparin), and whether any special monitoring is needed. People with active stomach or intestinal ulcers should not use Fragmin (Dalteparin).
Surgery: The risk of bleeding while using low molecular weight heparin may be greater in knee surgery than other orthopedic surgeries. Your doctor will weigh the potential risks and benefits to decide whether low molecular weight heparins will be used during surgery.
There have been cases of spinal bleeding and blood clots when Fragmin (Dalteparin) is used along with spinal or epidural anesthesia. These spinal blood clots may lead to long-term or permanent paralysis. The risk is greater with higher treatment doses of Fragmin (Dalteparin) than with deep vein thrombosis prevention doses. The risk is also greater for people who are taking other medications that affect blood such as Naproxen or Ibuprofen, or other anticoagulants. If you notice a sudden inability to move your body or sudden back pain or tenderness, get medical help immediately.
Pregnancy: Fragmin (Dalteparin) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Fragmin (Dalteparin), contact your doctor immediately.
If you do use Fragmin (Dalteparin) while you are pregnant, your doctor should closely monitor you because of an increased risk of bleeding. Pregnant women who have artificial heart valves also need to be closely monitored by their doctors if they use Fragmin (Dalteparin) because of a higher risk of developing clots in their heart valves.
Pregnant women should not use Fragmin (Dalteparin) from multidose vials containing benzyl alcohol as a preservative.
Breast-feeding: It is not known if Fragmin (Dalteparin) passes into breast milk. If you are a breast-feeding mother and are taking Fragmin (Dalteparin), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using Fragmin (Dalteparin) have not been established for children.
Seniors: Seniors may be at an increased risk of bleeding while using Fragmin (Dalteparin). Your doctor may adjust your dose, especially if you weigh less than 45 kg or have decreased kidney function.
