- Dalteparin sodium
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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.
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]
Tinzaparin sodium is the only low molecular weight heparin shown to be safe in critically ill people with renal failure at both treatment and prophylaxis dose levels.[3]. Heparins are cleared by the kidneys, but studies have shown that dalteparin does not accumulate even if kidney function is reduced.[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.
- ^ Nagge J, Crowther M, Hirsch J (2002). "Is Impaired Renal Function a Contraindication to the Use of Low-Molecular-Weight Heparin?". Arch Intern Med. 162 (22): 2605–2609. doi:10.1001/archinte.162.22.2605. PMID 12456233.
- ^ 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.
Categories:- Heparins
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