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Identification
NameDalteparin
Accession NumberDB06779
TypeSmall Molecule
GroupsApproved
DescriptionDalteparin, 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.
Structure
Thumb
Synonyms
Daltepariininatrium
Dalteparin sodium
Dalteparin sodná sůl
Dalteparin Sodyum
Dalteparin-nátrium
Dalteparina sódica
Daltéparine sodique
Dalteparinnatrium
Dalteparino natrio druska
Dalteparinum Natricum
Dalteparyna sodowa
Heparin Fragment KABI 2165
Tedelparin
External Identifiers
  • Kabi-2165
Approved Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Fragmininjection25000 [iU]/mLsubcutaneousPfizer Laboratories Div Pfizer Inc2015-04-01Not applicableUs
Fragmininjection2500 [iU]/.2mLsubcutaneousPfizer Laboratories Div Pfizer Inc2015-04-01Not applicableUs
Fragmininjection25000 [iU]/mLsubcutaneousEisai Inc.1994-12-22Not applicableUs
Fragmininjection12500 [iU]/.5mLsubcutaneousEisai Inc.1994-12-22Not applicableUs
Fragmininjection12500 [iU]/.5mLsubcutaneousPfizer Laboratories Div Pfizer Inc2015-04-01Not applicableUs
Fragmininjection10000 [iU]/.4mLsubcutaneousEisai Inc.1994-12-22Not applicableUs
Fragmininjection5000 [iU]/.2mLsubcutaneousPfizer Laboratories Div Pfizer Inc2015-04-01Not applicableUs
Fragmininjection5000 [iU]/.2mLsubcutaneousEisai Inc.1994-12-22Not applicableUs
Fragmininjection15000 [iU]/.6mLsubcutaneousEisai Inc.1994-12-22Not applicableUs
Fragmininjection15000 [iU]/.6mLsubcutaneousPfizer Laboratories Div Pfizer Inc2015-04-01Not applicableUs
Fragmininjection10000 [iU]/mLsubcutaneousEisai Inc.1994-12-22Not applicableUs
Fragmininjection7500 [iU]/.3mLsubcutaneousPfizer Laboratories Div Pfizer Inc2015-04-01Not applicableUs
Fragmininjection7500 [iU]/.3mLsubcutaneousEisai Inc.1994-12-22Not applicableUs
Fragmininjection18000 [iU]/.72mLsubcutaneousEisai Inc.1994-12-22Not applicableUs
Fragmininjection18000 [iU]/.72mLsubcutaneousPfizer Laboratories Div Pfizer Inc2015-04-01Not applicableUs
Fragmininjection10000 [iU]/mLsubcutaneousEisai Inc.1994-12-22Not applicableUs
Fragmininjection10000 [iU]/mLsubcutaneousPfizer Laboratories Div Pfizer Inc2015-04-01Not applicableUs
Fragmininjection2500 [iU]/.2mLsubcutaneousEisai Inc.1994-12-22Not applicableUs
Fragmin 10000 Iu(anti-XA)/0.4mlsolution10000 unitintravenous; subcutaneousPfizer Canada Inc2011-02-01Not applicableCanada
Fragmin 10000 Iu(anti-XA)/mlsolution10000 unitintravenous; subcutaneousPfizer Canada Inc1995-12-31Not applicableCanada
Fragmin 12500 Iu(anti-XA)/0.5mlsolution12500 unitintravenous; subcutaneousPfizer Canada Inc2011-02-01Not applicableCanada
Fragmin 15000 Iu(anti-XA)/0.6mlsolution15000 unitintravenous; subcutaneousPfizer Canada Inc2011-02-01Not applicableCanada
Fragmin 18000 Iu(anti-XA)/0.72mlsolution18000 unitintravenous; subcutaneousPfizer Canada Inc2011-02-01Not applicableCanada
Fragmin 2500 Iu(anti-factor Xa)/mlsolution2500 unitintravenous; subcutaneousPfizer Canada Inc2012-07-25Not applicableCanada
Fragmin 2500 Iu(anti-XA)/0.2mlsolution2500 unitintravenous; subcutaneousPfizer Canada Inc1995-12-31Not applicableCanada
Fragmin 25000 Iu(anti-XA)/mlsolution25000 unitintravenous; subcutaneousPfizer Canada Inc1997-11-27Not applicableCanada
Fragmin 3500 Iu(anti-factor Xa)/0.28mlsolution3500 unitintravenous; subcutaneousPfizer Canada Inc2015-03-25Not applicableCanada
Fragmin 5000 Iu(anti-XA)/0.2mlsolution5000 unitintravenous; subcutaneousPfizer Canada Inc1995-12-31Not applicableCanada
Fragmin 7500 Iu(anti-XA)/0.3mlsolution7500 unitintravenous; subcutaneousPfizer Canada Inc2011-02-01Not applicableCanada
Fragmin Inj.-liq 2500 Iu(anti-XA)/mlliquid2500 unitintravenous; subcutaneousPharmacia & Upjohn Inc1995-12-312002-07-30Canada
Approved Generic Prescription ProductsNot Available
Approved Over the Counter ProductsNot Available
Unapproved/Other Products Not Available
International Brands
NameCompany
BoxolPharmacia
EurodalGland
LigoframinPfizer
Low LiquemineRoche
Brand mixturesNot Available
SaltsNot Available
Categories
UNIIS79O08V79F
CAS number9041-08-1
WeightNot Available
Chemical FormulaNot Available
InChI KeyNot Available
InChINot Available
IUPAC NameNot Available
SMILESNot Available
Taxonomy
ClassificationNot classified
Pharmacology
IndicationDalteparin is used as a prophylaxis for deep-vein thrombosis and pulmonary embolisms in patients undergoing general surgery (e.g., abdominal, gynecologic, urologic), and in patients with acute medical conditions (e.g. cancer, bed rest, heart failure, severe lung disease). It is also used in patients who have severely restricted mobility, which poses a risk for thromboembolic complications. Dalteparin is also used concomitantly with aspirin and/or other therapy (e.g., nitrates, β-adrenergic blockers, clopidogrel, platelet glycoprotein [GP] IIb/IIIa-receptor inhibitors) to reduce the risk of acute cardiac ischemic events. The patients who undergo this treatment combination have unstable angina or non-ST-segment elevation/non-Q-wave myocardial infarction (i.e., non-ST-segment elevation acute coronary syndromes). It is also used in the prevention of clotting during hemodialysis and hemofiltration in connection with acute renal failure or chronic renal insufficiency.
PharmacodynamicsDalteparin 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 actionDalteparin 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.
Related Articles
AbsorptionAlmost completely absorbed after subcutaneous (sc) doses, with a bioavialability of about 87%.
Volume of distribution

3 litres

Protein bindingLess than unfractionated heparin, which is more than 90%.
Metabolism

Liver and the reticulo-endothelial system are the sites of biotransformation. They are partially metabolized by desulphatation and depolymerization.

Route of eliminationAfter 4 hours, about 20% is seen in urine. Most of the remainder is found in the liver, gastrointestinal tract and kidney. The kidneys are the major site of dalteparin excretion (approximately 70% based on animal studies).
Half lifeTerminal Half life: Intravenous - 2 hours. Subcutaneous - 3-5hours
Clearance

Excreted via kidneys. The plasma clearance rate is 33 mL/min.

ToxicityOverdosage: hemorrhagic complications. Adverse Drug Reaction: (common) osteopenia with extended use; mild, reversible non-immunological thrombocytopenia; transient elevation of liver transaminases; alopecia. (uncommon): severe immunologically-mediated heparin-induced thrombocytopenia; anaphylactic reactions; skin rash, skin necrosis; retroperitoneal hemorrhage; angioedema
Affected organismsNot Available
PathwaysNot Available
SNP Mediated EffectsNot Available
SNP Mediated Adverse Drug ReactionsNot Available
ADMET
Predicted ADMET features
PropertyValueProbability
Human Intestinal AbsorptionNot AvailableNot Available
Blood Brain BarrierNot AvailableNot Available
Caco-2 permeableNot AvailableNot Available
P-glycoprotein substrateNot AvailableNot Available
P-glycoprotein inhibitor INot AvailableNot Available
P-glycoprotein inhibitor IINot AvailableNot Available
Renal organic cation transporterNot AvailableNot Available
CYP450 2C9 substrateNot AvailableNot Available
CYP450 2D6 substrateNot AvailableNot Available
CYP450 3A4 substrateNot AvailableNot Available
CYP450 1A2 substrateNot AvailableNot Available
CYP450 2C9 inhibitorNot AvailableNot Available
CYP450 2D6 inhibitorNot AvailableNot Available
CYP450 2C19 inhibitorNot AvailableNot Available
CYP450 3A4 inhibitorNot AvailableNot Available
CYP450 inhibitory promiscuityNot AvailableNot Available
Ames testNot AvailableNot Available
CarcinogenicityNot AvailableNot Available
BiodegradationNot AvailableNot Available
Rat acute toxicityNot AvailableNot applicable
hERG inhibition (predictor I)Not AvailableNot Available
hERG inhibition (predictor II)Not AvailableNot Available
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )
Pharmacoeconomics
ManufacturersNot Available
PackagersNot Available
Dosage forms
FormRouteStrength
Injectionsubcutaneous10000 [iU]/mL
Injectionsubcutaneous10000 [iU]/.4mL
Injectionsubcutaneous12500 [iU]/.5mL
Injectionsubcutaneous15000 [iU]/.6mL
Injectionsubcutaneous18000 [iU]/.72mL
Injectionsubcutaneous2500 [iU]/.2mL
Injectionsubcutaneous25000 [iU]/mL
Injectionsubcutaneous5000 [iU]/.2mL
Injectionsubcutaneous7500 [iU]/.3mL
Solutionintravenous; subcutaneous10000 unit
Solutionintravenous; subcutaneous12500 unit
Solutionintravenous; subcutaneous15000 unit
Solutionintravenous; subcutaneous18000 unit
Solutionintravenous; subcutaneous2500 unit
Solutionintravenous; subcutaneous25000 unit
Solutionintravenous; subcutaneous3500 unit
Solutionintravenous; subcutaneous5000 unit
Solutionintravenous; subcutaneous7500 unit
Liquidintravenous; subcutaneous2500 unit
PricesNot Available
PatentsNot Available
Properties
StateSolid
Experimental PropertiesNot Available
Predicted PropertiesNot Available
Spectra
Mass Spec (NIST)Not Available
Spectra
Spectrum TypeDescriptionSplash Key
References
Synthesis ReferenceNot Available
General References
  1. King DJ, Kelton JG: Heparin-associated thrombocytopenia. Ann Intern Med. 1984 Apr;100(4):535-40. [PubMed:6367579 ]
  2. Bell WR, Royall RM: Heparin-associated thrombocytopenia: a comparison of three heparin preparations. N Engl J Med. 1980 Oct 16;303(16):902-7. [PubMed:6997743 ]
  3. Ockelford PA, Patterson J, Johns AS: A double-blind randomized placebo controlled trial of thromboprophylaxis in major elective general surgery using once daily injections of a low molecular weight heparin fragment (Fragmin). Thromb Haemost. 1989 Dec 29;62(4):1046-9. [PubMed:2559484 ]
  4. Hartl P, Brucke P, Dienstl E, Vinazzer H: Prophylaxis of thromboembolism in general surgery: comparison between standard heparin and Fragmin. Thromb Res. 1990 Feb 15;57(4):577-84. [PubMed:2158151 ]
  5. Monreal M, Lafoz E, Salvador R, Roncales J, Navarro A: Adverse effects of three different forms of heparin therapy: thrombocytopenia, increased transaminases, and hyperkalaemia. Eur J Clin Pharmacol. 1989;37(4):415-8. [PubMed:2557219 ]
  6. Holmer E, Soderberg K, Bergqvist D, Lindahl U: Heparin and its low molecular weight derivatives: anticoagulant and antithrombotic properties. Haemostasis. 1986;16 Suppl 2:1-7. [PubMed:3744129 ]
  7. Malm K, Dahlback B, Arnljots B: Low-molecular-weight heparin (dalteparin) effectively prevents thrombosis in a rat model of deep arterial injury. Plast Reconstr Surg. 2003 Apr 15;111(5):1659-66. [PubMed:12655212 ]
  8. Tincani E, Mannucci C, Casolari B, Turrini F, Crowther MA, Prisco D, Cenci AM, Bondi M: Safety of dalteparin for the prophylaxis of venous thromboembolism in elderly medical patients with renal insufficiency: a pilot study. Haematologica. 2006 Jul;91(7):976-9. Epub 2006 Jun 1. [PubMed:16757417 ]
  9. Schmid P, Brodmann D, Fischer AG, Wuillemin WA: Study of bioaccumulation of dalteparin at a prophylactic dose in patients with various degrees of impaired renal function. J Thromb Haemost. 2009 Apr;7(4):552-8. doi: 10.1111/j.1538-7836.2009.03292.x. Epub 2009 Jan 19. [PubMed:19175499 ]
  10. Abe W, Ikejima K, Lang T, Okumura K, Enomoto N, Kitamura T, Takei Y, Sato N: Low molecular weight heparin prevents hepatic fibrogenesis caused by carbon tetrachloride in the rat. J Hepatol. 2007 Feb;46(2):286-94. Epub 2006 Oct 25. [PubMed:17166617 ]
  11. Frydman A: Low-molecular-weight heparins: an overview of their pharmacodynamics, pharmacokinetics and metabolism in humans. Haemostasis. 1996;26 Suppl 2:24-38. [PubMed:8707165 ]
  12. Samama MM, Gerotziafas GT: Comparative pharmacokinetics of LMWHs. Semin Thromb Hemost. 2000;26 Suppl 1:31-8. [PubMed:11011804 ]
  13. Rey E, Rivard GE: Prophylaxis and treatment of thromboembolic diseases during pregnancy with dalteparin. Int J Gynaecol Obstet. 2000 Oct;71(1):19-24. [PubMed:11044537 ]
External Links
ATC CodesB01AB04
AHFS Codes
  • 20:12.04.16
PDB EntriesNot Available
FDA labelNot Available
MSDSNot Available
Interactions
Drug Interactions
Drug
AbciximabAbciximab may increase the anticoagulant activities of Dalteparin.
AceclofenacAceclofenac may increase the anticoagulant activities of Dalteparin.
AcenocoumarolAcenocoumarol may increase the anticoagulant activities of Dalteparin.
Acetylsalicylic acidAcetylsalicylic acid may increase the anticoagulant activities of Dalteparin.
AdapaleneAdapalene may increase the anticoagulant activities of Dalteparin.
AliskirenDalteparin may increase the hyperkalemic activities of Aliskiren.
AllylestrenolThe therapeutic efficacy of Dalteparin can be decreased when used in combination with Allylestrenol.
AlprostadilAlprostadil may increase the anticoagulant activities of Dalteparin.
AlteplaseAlteplase may increase the anticoagulant activities of Dalteparin.
AltrenogestThe therapeutic efficacy of Dalteparin can be decreased when used in combination with Altrenogest.
ALX-0081ALX-0081 may increase the anticoagulant activities of Dalteparin.
AmilorideDalteparin may increase the hyperkalemic activities of Amiloride.
Aminosalicylic AcidAminosalicylic Acid may increase the anticoagulant activities of Dalteparin.
AnagrelideAnagrelide may increase the anticoagulant activities of Dalteparin.
AncrodAncrod may increase the anticoagulant activities of Dalteparin.
AnistreplaseAnistreplase may increase the anticoagulant activities of Dalteparin.
AntipyrineAntipyrine may increase the anticoagulant activities of Dalteparin.
Antithrombin III humanDalteparin may increase the anticoagulant activities of Antithrombin III human.
ApixabanApixaban may increase the anticoagulant activities of Dalteparin.
ApremilastApremilast may increase the anticoagulant activities of Dalteparin.
AprotininThe therapeutic efficacy of Dalteparin can be decreased when used in combination with Aprotinin.
ArdeparinArdeparin may increase the anticoagulant activities of Dalteparin.
ArgatrobanArgatroban may increase the anticoagulant activities of Dalteparin.
AstaxanthinAstaxanthin may increase the anticoagulant activities of Dalteparin.
AzapropazoneAzapropazone may increase the anticoagulant activities of Dalteparin.
AzelastineAzelastine may increase the anticoagulant activities of Dalteparin.
Azilsartan medoxomilDalteparin may increase the hyperkalemic activities of Azilsartan medoxomil.
BalsalazideBalsalazide may increase the anticoagulant activities of Dalteparin.
BatroxobinBatroxobin may increase the anticoagulant activities of Dalteparin.
BazedoxifeneBazedoxifene may decrease the anticoagulant activities of Dalteparin.
BecaplerminBecaplermin may increase the anticoagulant activities of Dalteparin.
BemiparinBemiparin may increase the anticoagulant activities of Dalteparin.
BenazeprilDalteparin may increase the hyperkalemic activities of Benazepril.
BenoxaprofenBenoxaprofen may increase the anticoagulant activities of Dalteparin.
BeraprostBeraprost may increase the anticoagulant activities of Dalteparin.
BivalirudinBivalirudin may increase the anticoagulant activities of Dalteparin.
BromfenacBromfenac may increase the anticoagulant activities of Dalteparin.
CanagliflozinDalteparin may increase the hyperkalemic activities of Canagliflozin.
CandesartanDalteparin may increase the hyperkalemic activities of Candesartan.
CandoxatrilDalteparin may increase the hyperkalemic activities of Candoxatril.
CangrelorCangrelor may increase the anticoagulant activities of Dalteparin.
CaptoprilDalteparin may increase the hyperkalemic activities of Captopril.
CarprofenCarprofen may increase the anticoagulant activities of Dalteparin.
CastanospermineCastanospermine may increase the anticoagulant activities of Dalteparin.
CelecoxibCelecoxib may increase the anticoagulant activities of Dalteparin.
CertoparinDalteparin may increase the anticoagulant activities of Certoparin.
ChloroquineChloroquine may increase the anticoagulant activities of Dalteparin.
ChlorotrianiseneChlorotrianisene may decrease the anticoagulant activities of Dalteparin.
CilazaprilDalteparin may increase the hyperkalemic activities of Cilazapril.
CilostazolCilostazol may increase the anticoagulant activities of Dalteparin.
Citric AcidCitric Acid may increase the anticoagulant activities of Dalteparin.
ClonixinClonixin may increase the anticoagulant activities of Dalteparin.
ClopidogrelClopidogrel may increase the anticoagulant activities of Dalteparin.
CollagenaseThe risk or severity of adverse effects can be increased when Dalteparin is combined with Collagenase.
Conjugated Equine EstrogensConjugated Equine Estrogens may decrease the anticoagulant activities of Dalteparin.
D-LimoneneD-Limonene may increase the anticoagulant activities of Dalteparin.
Dabigatran etexilateDabigatran etexilate may increase the anticoagulant activities of Dalteparin.
DanaparoidDanaparoid may increase the anticoagulant activities of Dalteparin.
DasatinibDasatinib may increase the anticoagulant activities of Dalteparin.
DeferasiroxThe risk or severity of adverse effects can be increased when Dalteparin is combined with Deferasirox.
DefibrotideDefibrotide may increase the anticoagulant activities of Dalteparin.
Deoxycholic AcidThe risk or severity of adverse effects can be increased when Dalteparin is combined with Deoxycholic Acid.
DesirudinDalteparin may increase the anticoagulant activities of Desirudin.
DesmoteplaseDesmoteplase may increase the anticoagulant activities of Dalteparin.
DesogestrelThe therapeutic efficacy of Dalteparin can be decreased when used in combination with Desogestrel.
DextranDalteparin may increase the anticoagulant activities of Dextran.
Dextran 40Dalteparin may increase the anticoagulant activities of Dextran 40.
Dextran 70Dalteparin may increase the anticoagulant activities of Dextran 70.
Dextran 75Dalteparin may increase the anticoagulant activities of Dextran 75.
DiclofenacDiclofenac may increase the anticoagulant activities of Dalteparin.
DicoumarolDicoumarol may increase the anticoagulant activities of Dalteparin.
DienestrolDienestrol may decrease the anticoagulant activities of Dalteparin.
DienogestThe therapeutic efficacy of Dalteparin can be decreased when used in combination with Dienogest.
DiethylstilbestrolDiethylstilbestrol may decrease the anticoagulant activities of Dalteparin.
DiflunisalDiflunisal may increase the anticoagulant activities of Dalteparin.
DipyridamoleDipyridamole may increase the anticoagulant activities of Dalteparin.
DitazoleDitazole may increase the anticoagulant activities of Dalteparin.
DrospirenoneThe therapeutic efficacy of Dalteparin can be decreased when used in combination with Drospirenone.
Drotrecogin alfaDrotrecogin alfa may increase the anticoagulant activities of Dalteparin.
DroxicamDroxicam may increase the anticoagulant activities of Dalteparin.
DydrogesteroneThe therapeutic efficacy of Dalteparin can be decreased when used in combination with Dydrogesterone.
Edetic AcidEdetic Acid may increase the anticoagulant activities of Dalteparin.
EdoxabanEdoxaban may increase the anticoagulant activities of Dalteparin.
EnalaprilDalteparin may increase the hyperkalemic activities of Enalapril.
EnalaprilatDalteparin may increase the hyperkalemic activities of Enalaprilat.
EnoxaparinEnoxaparin may increase the anticoagulant activities of Dalteparin.
EpinastineEpinastine may increase the anticoagulant activities of Dalteparin.
EpirizoleEpirizole may increase the anticoagulant activities of Dalteparin.
EplerenoneDalteparin may increase the hyperkalemic activities of Eplerenone.
EpoprostenolEpoprostenol may increase the anticoagulant activities of Dalteparin.
EpoprostenolThe risk or severity of adverse effects can be increased when Dalteparin is combined with Epoprostenol.
EprosartanDalteparin may increase the hyperkalemic activities of Eprosartan.
EptifibatideEptifibatide may increase the anticoagulant activities of Dalteparin.
EstradiolEstradiol may decrease the anticoagulant activities of Dalteparin.
EstriolEstriol may decrease the anticoagulant activities of Dalteparin.
EstroneEstrone may decrease the anticoagulant activities of Dalteparin.
EtanerceptEtanercept may increase the anticoagulant activities of Dalteparin.
Ethinyl EstradiolEthinyl Estradiol may decrease the anticoagulant activities of Dalteparin.
Ethyl biscoumacetateDalteparin may increase the anticoagulant activities of Ethyl biscoumacetate.
EtodolacEtodolac may increase the anticoagulant activities of Dalteparin.
EtofenamateEtofenamate may increase the anticoagulant activities of Dalteparin.
EtonogestrelThe therapeutic efficacy of Dalteparin can be decreased when used in combination with Etonogestrel.
EtoricoxibEtoricoxib may increase the anticoagulant activities of Dalteparin.
Evening primrose oilEvening primrose oil may increase the anticoagulant activities of Dalteparin.
exisulindexisulind may increase the anticoagulant activities of Dalteparin.
FenbufenFenbufen may increase the anticoagulant activities of Dalteparin.
FenoprofenFenoprofen may increase the anticoagulant activities of Dalteparin.
FibrinolysinFibrinolysin may increase the anticoagulant activities of Dalteparin.
FloctafenineFloctafenine may increase the anticoagulant activities of Dalteparin.
FlunixinFlunixin may increase the anticoagulant activities of Dalteparin.
FlurbiprofenFlurbiprofen may increase the anticoagulant activities of Dalteparin.
Fondaparinux sodiumFondaparinux sodium may increase the anticoagulant activities of Dalteparin.
ForasartanDalteparin may increase the hyperkalemic activities of Forasartan.
FosinoprilDalteparin may increase the hyperkalemic activities of Fosinopril.
GenisteinGenistein may decrease the anticoagulant activities of Dalteparin.
GestodeneThe therapeutic efficacy of Dalteparin can be decreased when used in combination with Gestodene.
HeminHemin may increase the anticoagulant activities of Dalteparin.
HeparinHeparin may increase the anticoagulant activities of Dalteparin.
HexestrolHexestrol may decrease the anticoagulant activities of Dalteparin.
HirulogHirulog may increase the anticoagulant activities of Dalteparin.
HMPL-004HMPL-004 may increase the anticoagulant activities of Dalteparin.
Hydroxyprogesterone caproateThe therapeutic efficacy of Dalteparin can be decreased when used in combination with Hydroxyprogesterone caproate.
Ibritumomab tiuxetanThe risk or severity of adverse effects can be increased when Dalteparin is combined with Ibritumomab tiuxetan.
IbrutinibThe risk or severity of adverse effects can be increased when Ibrutinib is combined with Dalteparin.
IbudilastIbudilast may increase the anticoagulant activities of Dalteparin.
IbuprofenIbuprofen may increase the anticoagulant activities of Dalteparin.
IbuproxamIbuproxam may increase the anticoagulant activities of Dalteparin.
IcatibantIcatibant may increase the anticoagulant activities of Dalteparin.
Icosapent ethylIcosapent ethyl may increase the anticoagulant activities of Dalteparin.
IfenprodilIfenprodil may increase the anticoagulant activities of Dalteparin.
IloprostIloprost may increase the anticoagulant activities of Dalteparin.
IloprostThe risk or severity of adverse effects can be increased when Dalteparin is combined with Iloprost.
IndomethacinIndomethacin may increase the anticoagulant activities of Dalteparin.
IndoprofenIndoprofen may increase the anticoagulant activities of Dalteparin.
IrbesartanDalteparin may increase the hyperkalemic activities of Irbesartan.
IsoxicamIsoxicam may increase the anticoagulant activities of Dalteparin.
KebuzoneKebuzone may increase the anticoagulant activities of Dalteparin.
KetoprofenKetoprofen may increase the anticoagulant activities of Dalteparin.
KetorolacKetorolac may increase the anticoagulant activities of Dalteparin.
LeflunomideLeflunomide may increase the anticoagulant activities of Dalteparin.
LepirudinLepirudin may increase the anticoagulant activities of Dalteparin.
LevonorgestrelThe therapeutic efficacy of Dalteparin can be decreased when used in combination with Levonorgestrel.
LimaprostThe risk or severity of adverse effects can be increased when Limaprost is combined with Dalteparin.
LisinoprilDalteparin may increase the hyperkalemic activities of Lisinopril.
LornoxicamLornoxicam may increase the anticoagulant activities of Dalteparin.
LosartanDalteparin may increase the hyperkalemic activities of Losartan.
LoxoprofenLoxoprofen may increase the anticoagulant activities of Dalteparin.
LumiracoxibLumiracoxib may increase the anticoagulant activities of Dalteparin.
Magnesium salicylateMagnesium salicylate may increase the anticoagulant activities of Dalteparin.
MasoprocolMasoprocol may increase the anticoagulant activities of Dalteparin.
Meclofenamic acidMeclofenamic acid may increase the anticoagulant activities of Dalteparin.
MedrogestoneThe therapeutic efficacy of Dalteparin can be decreased when used in combination with Medrogestone.
Medroxyprogesterone acetateThe therapeutic efficacy of Dalteparin can be decreased when used in combination with Medroxyprogesterone acetate.
Mefenamic acidMefenamic acid may increase the anticoagulant activities of Dalteparin.
Megestrol acetateThe therapeutic efficacy of Dalteparin can be decreased when used in combination with Megestrol acetate.
MeloxicamMeloxicam may increase the anticoagulant activities of Dalteparin.
MesalazineMesalazine may increase the anticoagulant activities of Dalteparin.
MestranolMestranol may decrease the anticoagulant activities of Dalteparin.
MetamizoleMetamizole may increase the anticoagulant activities of Dalteparin.
MilrinoneMilrinone may increase the anticoagulant activities of Dalteparin.
MoexiprilDalteparin may increase the hyperkalemic activities of Moexipril.
Mycophenolate mofetilMycophenolate mofetil may increase the anticoagulant activities of Dalteparin.
Mycophenolic acidMycophenolic acid may increase the anticoagulant activities of Dalteparin.
NabumetoneNabumetone may increase the anticoagulant activities of Dalteparin.
NadroparinDalteparin may increase the anticoagulant activities of Nadroparin.
NaftifineNaftifine may increase the anticoagulant activities of Dalteparin.
NaproxenNaproxen may increase the anticoagulant activities of Dalteparin.
NCX 4016NCX 4016 may increase the anticoagulant activities of Dalteparin.
NepafenacNepafenac may increase the anticoagulant activities of Dalteparin.
Niflumic AcidNiflumic Acid may increase the anticoagulant activities of Dalteparin.
NimesulideNimesulide may increase the anticoagulant activities of Dalteparin.
NintedanibThe risk or severity of adverse effects can be increased when Dalteparin is combined with Nintedanib.
NorethisteroneThe therapeutic efficacy of Dalteparin can be decreased when used in combination with Norethisterone.
ObinutuzumabThe risk or severity of adverse effects can be increased when Dalteparin is combined with Obinutuzumab.
OlmesartanDalteparin may increase the hyperkalemic activities of Olmesartan.
OlopatadineOlopatadine may increase the anticoagulant activities of Dalteparin.
OlsalazineOlsalazine may increase the anticoagulant activities of Dalteparin.
Omacetaxine mepesuccinateThe risk or severity of adverse effects can be increased when Dalteparin is combined with Omacetaxine mepesuccinate.
OmapatrilatDalteparin may increase the hyperkalemic activities of Omapatrilat.
Omega-3 fatty acidsOmega-3 fatty acids may increase the anticoagulant activities of Dalteparin.
OrgoteinOrgotein may increase the anticoagulant activities of Dalteparin.
OtamixabanOtamixaban may increase the anticoagulant activities of Dalteparin.
OxaprozinOxaprozin may increase the anticoagulant activities of Dalteparin.
OxyphenbutazoneOxyphenbutazone may increase the anticoagulant activities of Dalteparin.
PaliferminThe serum concentration of Palifermin can be increased when it is combined with Dalteparin.
ParecoxibParecoxib may increase the anticoagulant activities of Dalteparin.
ParnaparinParnaparin may increase the anticoagulant activities of Dalteparin.
Pentosan PolysulfatePentosan Polysulfate may increase the anticoagulant activities of Dalteparin.
PentoxifyllinePentoxifylline may increase the anticoagulant activities of Dalteparin.
PerindoprilDalteparin may increase the hyperkalemic activities of Perindopril.
PhenindionePhenindione may increase the anticoagulant activities of Dalteparin.
PhenprocoumonPhenprocoumon may increase the anticoagulant activities of Dalteparin.
PhenylbutazonePhenylbutazone may increase the anticoagulant activities of Dalteparin.
PimecrolimusPimecrolimus may increase the anticoagulant activities of Dalteparin.
PirfenidonePirfenidone may increase the anticoagulant activities of Dalteparin.
PiroxicamPiroxicam may increase the anticoagulant activities of Dalteparin.
PlasminPlasmin may increase the anticoagulant activities of Dalteparin.
Polyestradiol phosphatePolyestradiol phosphate may decrease the anticoagulant activities of Dalteparin.
PrasugrelPrasugrel may increase the anticoagulant activities of Dalteparin.
ProgesteroneThe therapeutic efficacy of Dalteparin can be decreased when used in combination with Progesterone.
PropacetamolPropacetamol may increase the anticoagulant activities of Dalteparin.
Protein CDalteparin may increase the anticoagulant activities of Protein C.
ProtocatechualdehydeDalteparin may increase the anticoagulant activities of Protocatechualdehyde.
PTC299PTC299 may increase the anticoagulant activities of Dalteparin.
QuinaprilDalteparin may increase the hyperkalemic activities of Quinapril.
QuinestrolQuinestrol may decrease the anticoagulant activities of Dalteparin.
RamiprilDalteparin may increase the hyperkalemic activities of Ramipril.
RescinnamineDalteparin may increase the hyperkalemic activities of Rescinnamine.
ResveratrolResveratrol may increase the anticoagulant activities of Dalteparin.
ReteplaseReteplase may increase the anticoagulant activities of Dalteparin.
ReviparinDalteparin may increase the anticoagulant activities of Reviparin.
RidogrelRidogrel may increase the anticoagulant activities of Dalteparin.
RivaroxabanDalteparin may increase the anticoagulant activities of Rivaroxaban.
RofecoxibRofecoxib may increase the anticoagulant activities of Dalteparin.
RosiglitazoneRosiglitazone may increase the anticoagulant activities of Dalteparin.
SalicylamideSalicylamide may increase the anticoagulant activities of Dalteparin.
Salicylic acidSalicylic acid may increase the anticoagulant activities of Dalteparin.
SalsalateSalsalate may increase the anticoagulant activities of Dalteparin.
SaprisartanDalteparin may increase the hyperkalemic activities of Saprisartan.
SaralasinDalteparin may increase the hyperkalemic activities of Saralasin.
SCH-530348SCH-530348 may increase the anticoagulant activities of Dalteparin.
SelexipagSelexipag may increase the anticoagulant activities of Dalteparin.
SeratrodastSeratrodast may increase the anticoagulant activities of Dalteparin.
SevofluraneSevoflurane may increase the anticoagulant activities of Dalteparin.
SpiraprilDalteparin may increase the hyperkalemic activities of Spirapril.
SpironolactoneDalteparin may increase the hyperkalemic activities of Spironolactone.
SRT501SRT501 may increase the anticoagulant activities of Dalteparin.
StreptokinaseStreptokinase may increase the anticoagulant activities of Dalteparin.
SugammadexSugammadex may increase the anticoagulant activities of Dalteparin.
SulfasalazineSulfasalazine may increase the anticoagulant activities of Dalteparin.
SulindacSulindac may increase the anticoagulant activities of Dalteparin.
SulodexideSulodexide may increase the anticoagulant activities of Dalteparin.
SuprofenSuprofen may increase the anticoagulant activities of Dalteparin.
Synthetic Conjugated Estrogens, ASynthetic Conjugated Estrogens, A may decrease the anticoagulant activities of Dalteparin.
Synthetic Conjugated Estrogens, BSynthetic Conjugated Estrogens, B may decrease the anticoagulant activities of Dalteparin.
TasosartanDalteparin may increase the hyperkalemic activities of Tasosartan.
TelmisartanDalteparin may increase the hyperkalemic activities of Telmisartan.
TemocaprilDalteparin may increase the hyperkalemic activities of Temocapril.
TenecteplaseTenecteplase may increase the anticoagulant activities of Dalteparin.
TenoxicamTenoxicam may increase the anticoagulant activities of Dalteparin.
TepoxalinTepoxalin may increase the anticoagulant activities of Dalteparin.
TeriflunomideTeriflunomide may increase the anticoagulant activities of Dalteparin.
TesmilifeneTesmilifene may increase the anticoagulant activities of Dalteparin.
Tiaprofenic acidTiaprofenic acid may increase the anticoagulant activities of Dalteparin.
TiboloneTibolone may increase the anticoagulant activities of Dalteparin.
TicagrelorTicagrelor may increase the anticoagulant activities of Dalteparin.
TiclopidineTiclopidine may increase the anticoagulant activities of Dalteparin.
TinzaparinTinzaparin may increase the anticoagulant activities of Dalteparin.
TipranavirTipranavir may increase the anticoagulant activities of Dalteparin.
TirofibanTirofiban may increase the anticoagulant activities of Dalteparin.
Tolfenamic AcidTolfenamic Acid may increase the anticoagulant activities of Dalteparin.
TolmetinTolmetin may increase the anticoagulant activities of Dalteparin.
TositumomabThe risk or severity of adverse effects can be increased when Dalteparin is combined with Tositumomab.
TrandolaprilDalteparin may increase the hyperkalemic activities of Trandolapril.
TranilastTranilast may increase the anticoagulant activities of Dalteparin.
TrapidilTrapidil may increase the anticoagulant activities of Dalteparin.
TreprostinilTreprostinil may increase the anticoagulant activities of Dalteparin.
TreprostinilThe risk or severity of adverse effects can be increased when Dalteparin is combined with Treprostinil.
TriamtereneDalteparin may increase the hyperkalemic activities of Triamterene.
TriflusalTriflusal may increase the anticoagulant activities of Dalteparin.
Trisalicylate-cholineTrisalicylate-choline may increase the anticoagulant activities of Dalteparin.
UrokinaseUrokinase may increase the anticoagulant activities of Dalteparin.
ValdecoxibValdecoxib may increase the anticoagulant activities of Dalteparin.
ValsartanDalteparin may increase the hyperkalemic activities of Valsartan.
Vitamin EVitamin E may increase the anticoagulant activities of Dalteparin.
VorapaxarThe risk or severity of adverse effects can be increased when Vorapaxar is combined with Dalteparin.
WarfarinWarfarin may increase the anticoagulant activities of Dalteparin.
XimelagatranXimelagatran may increase the anticoagulant activities of Dalteparin.
ZaltoprofenZaltoprofen may increase the anticoagulant activities of Dalteparin.
ZeranolZeranol may decrease the anticoagulant activities of Dalteparin.
ZileutonZileuton may increase the anticoagulant activities of Dalteparin.
ZomepiracZomepirac may increase the anticoagulant activities of Dalteparin.
Food Interactions
  • Herbs (anticoagulant/antiplatelet properties such as ginseng, ginkgo, ginger, garlic)

Targets

Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
potentiator
General Function:
Serine-type endopeptidase inhibitor activity
Specific Function:
Most important serine protease inhibitor in plasma that regulates the blood coagulation cascade. AT-III inhibits thrombin, matriptase-3/TMPRSS7, as well as factors IXa, Xa and XIa. Its inhibitory activity is greatly enhanced in the presence of heparin.
Gene Name:
SERPINC1
Uniprot ID:
P01008
Molecular Weight:
52601.935 Da
References
  1. Frydman A: Low-molecular-weight heparins: an overview of their pharmacodynamics, pharmacokinetics and metabolism in humans. Haemostasis. 1996;26 Suppl 2:24-38. [PubMed:8707165 ]
  2. Rey E, Rivard GE: Prophylaxis and treatment of thromboembolic diseases during pregnancy with dalteparin. Int J Gynaecol Obstet. 2000 Oct;71(1):19-24. [PubMed:11044537 ]
Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
inhibitor
General Function:
Vascular endothelial growth factor receptor binding
Specific Function:
Growth factor active in angiogenesis, vasculogenesis and endothelial cell growth. Induces endothelial cell proliferation, promotes cell migration, inhibits apoptosis and induces permeabilization of blood vessels. Binds to the FLT1/VEGFR1 and KDR/VEGFR2 receptors, heparan sulfate and heparin. NRP1/Neuropilin-1 binds isoforms VEGF-165 and VEGF-145. Isoform VEGF165B binds to KDR but does not activ...
Gene Name:
VEGFA
Uniprot ID:
P15692
Molecular Weight:
27042.205 Da
References
  1. Norrby K, Nordenhem A: Dalteparin, a low-molecular-weight heparin, promotes angiogenesis mediated by heparin-binding VEGF-A in vivo. APMIS. 2010 Dec;118(12):949-57. doi: 10.1111/j.1600-0463.2010.02635.x. Epub 2010 Oct 12. [PubMed:21091776 ]
  2. Marchetti M, Vignoli A, Russo L, Balducci D, Pagnoncelli M, Barbui T, Falanga A: Endothelial capillary tube formation and cell proliferation induced by tumor cells are affected by low molecular weight heparins and unfractionated heparin. Thromb Res. 2008;121(5):637-45. Epub 2007 Aug 10. [PubMed:17692905 ]
  3. Takahashi H, Ebihara S, Okazaki T, Asada M, Sasaki H, Yamaya M: A comparison of the effects of unfractionated heparin, dalteparin and danaparoid on vascular endothelial growth factor-induced tumour angiogenesis and heparanase activity. Br J Pharmacol. 2005 Oct;146(3):333-43. [PubMed:16041398 ]
Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
inhibitor
General Function:
Serine-type endopeptidase inhibitor activity
Specific Function:
Inhibits factor X (X(a)) directly and, in a Xa-dependent way, inhibits VIIa/tissue factor activity, presumably by forming a quaternary Xa/LACI/VIIa/TF complex. It possesses an antithrombotic action and also the ability to associate with lipoproteins in plasma.
Gene Name:
TFPI
Uniprot ID:
P10646
Molecular Weight:
35014.835 Da
References
  1. Mousa SA: Low-molecular-weight heparins in thrombosis and cancer: emerging links. Cardiovasc Drug Rev. 2004 Summer;22(2):121-34. [PubMed:15179449 ]
  2. Naumnik B, Rydzewska-Rosolowska A, Mysliwiec M: Different effects of enoxaparin, nadroparin, and dalteparin on plasma TFPI during hemodialysis: a prospective crossover randomized study. Clin Appl Thromb Hemost. 2011 Oct;17(5):480-6. doi: 10.1177/1076029610376936. Epub 2010 Aug 3. [PubMed:20682597 ]
  3. Bendz B, Andersen TO, Sandset PM: Dose-dependent release of endogenous tissue factor pathway inhibitor by different low molecular weight heparins. Blood Coagul Fibrinolysis. 2000 Jun;11(4):343-8. [PubMed:10847421 ]
Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
inhibitor
General Function:
Sialic acid binding
Specific Function:
Ca(2+)-dependent receptor for myeloid cells that binds to carbohydrates on neutrophils and monocytes. Mediates the interaction of activated endothelial cells or platelets with leukocytes. The ligand recognized is sialyl-Lewis X. Mediates rapid rolling of leukocyte rolling over vascular surfaces during the initial steps in inflammation through interaction with PSGL1.
Gene Name:
SELP
Uniprot ID:
P16109
Molecular Weight:
90833.105 Da
References
  1. Rey E, Rivard GE: Prophylaxis and treatment of thromboembolic diseases during pregnancy with dalteparin. Int J Gynaecol Obstet. 2000 Oct;71(1):19-24. [PubMed:11044537 ]

Enzymes

Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Syndecan binding
Specific Function:
Endoglycosidase that cleaves heparan sulfate proteoglycans (HSPGs) into heparan sulfate side chains and core proteoglycans. Participates in extracellular matrix (ECM) degradation and remodeling. Selectively cleaves the linkage between a glucuronic acid unit and an N-sulfo glucosamine unit carrying either a 3-O-sulfo or a 6-O-sulfo group. Can also cleave the linkage between a glucuronic acid uni...
Gene Name:
HPSE
Uniprot ID:
Q9Y251
Molecular Weight:
61148.17 Da
References
  1. Takahashi H, Ebihara S, Okazaki T, Asada M, Sasaki H, Yamaya M: A comparison of the effects of unfractionated heparin, dalteparin and danaparoid on vascular endothelial growth factor-induced tumour angiogenesis and heparanase activity. Br J Pharmacol. 2005 Oct;146(3):333-43. [PubMed:16041398 ]
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Drug created on September 14, 2010 10:21 / Updated on August 17, 2016 12:24