Low molecular weight heparin (LMWH)
Dalteparin sodium
Brand names: Fragmin
Adult dose
Dose: VTE prophylaxis: 5,000 units SC OD; Treatment: 200 units/kg SC OD or 100 units/kg SC BD; Cancer-associated VTE: 200 units/kg/day month 1, then 150 units/kg/day
Route: Subcutaneous
Frequency: OD–BD
Clinical pearls
- NICE NG89/NG158
- CLOT trial (cancer-associated VTE) underpinned LMWH preference; DOACs now alternative per ISTH
- RCOG GTG 37a/37b — pregnancy LMWH
Contraindications
- Active major bleeding
- Severe thrombocytopenia
- Recent intracranial/spinal surgery
- HIT history (use alternative)
- CrCl <15
Side effects
- Bleeding
- HIT
- Hyperkalaemia
- Injection-site reactions
- Osteoporosis (long-term)
Interactions
- Anticoagulants/antiplatelets/NSAIDs
- ACEi/ARB (hyperkalaemia)
Monitoring
- FBC (HIT)
- Renal function
- Anti-Xa in pregnancy / extreme weights / renal
- Bleeding
Reference: BNF; NICE NG89; NICE NG158; RCOG GTG 37a; BSH; https://bnf.nice.org.uk/drugs/dalteparin-sodium/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Endotracheal Tube Depth and Tidal Volume Calculator · Airway Management
- IMPROVE VTE Risk Score for Medical Patients · VTE Risk
- Corrected Sodium (Hyperglycaemia) · Electrolytes
- BMI + Metabolic Risk Assessment · Obesity
- Ideal & Adjusted Body Weight · Body Composition
- Weight-Based Levothyroxine Dose Calculator · Thyroid
Drugs
Pathways
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO