Fragmin

Fragmin is a brand name for the anticoagulant dalteparin sodium, a low molecular weight heparin (LMWH). It inhibits clot formation mainly by potentiating antithrombin III, with a strong effect on factor Xa and a lesser effect on thrombin, producing an anticoagulant effect that is more predictable than unfractionated heparin.

Fragmin is used to prevent and treat thromboembolic disorders. Indications include the prevention of venous thromboembolism after certain surgical procedures (such as hip or knee replacement) and treatment of established deep vein thrombosis or pulmonary embolism. It is also used in some acute coronary syndromes as part of anticoagulation therapy when indicated. The exact dosing is weight-based and depends on the indication; regimens vary from prophylactic doses to higher therapeutic doses, often given by subcutaneous injection. In some settings, Fragmin may be used as part of a bridging strategy with warfarin.

Pharmacokinetics and administration are characterized by more predictable responses than unfractionated heparin, enabling outpatient use in many cases. Routine monitoring of anti-Xa activity is not required for most patients, but it may be used in certain populations (such as those with obesity, pregnancy, renal impairment, or very low body weight) to guide dosing. Pharmacovigilance is necessary for signs of bleeding or hypersensitivity.

Contraindications include active major bleeding, known hypersensitivity to dalteparin or heparin, and history of heparin-induced thrombocytopenia. Caution is advised in renal impairment, during pregnancy and lactation, in patients undergoing neuraxial procedures, or those with recent surgery or severe bleeding risk. Common adverse effects are bleeding, injection-site reactions, and thrombocytopenia; osteoporosis can occur with prolonged use. Protamine sulfate can partially reverse dalteparin’s effects.