Accession Number
Small Molecule

Dalteparin, 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.

  • alpha-heparin
Product Ingredients
IngredientUNIICASInChI Key
Dalteparin sodium12M44VTJ7BNot AvailableNot applicable
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
FragminInjection12500 [iU]/0.5mLSubcutaneousEisai Limited1994-12-222016-09-30Us
FragminInjection10000 [iU]/1mLSubcutaneousPfizer Laboratories Div Pfizer Inc2015-04-01Not applicableUs
FragminSolution15000 unitIntravenous; SubcutaneousPfizer Canada Ulc2011-02-01Not applicableCanada
FragminInjection7500 [iU]/0.3mLSubcutaneousPfizer Laboratories Div Pfizer Inc2015-04-01Not applicableUs
FragminInjection10000 [iU]/1mLSubcutaneousEisai Limited1994-12-222016-09-30Us
FragminSolution12500 unitIntravenous; SubcutaneousPfizer Canada Ulc2011-02-01Not applicableCanada
FragminSolution10000 unitIntravenous; SubcutaneousPfizer Canada Ulc2011-02-01Not applicableCanada
FragminSolution7500 unitIntravenous; SubcutaneousPfizer Canada Ulc2011-02-01Not applicableCanada
FragminSolution25000 unitIntravenous; SubcutaneousPfizer Canada Ulc1997-11-27Not applicableCanada
FragminSolution2500 unitIntravenous; SubcutaneousPfizer Canada Ulc1995-12-31Not applicableCanada
Additional Data Available
  • Application Number
    Application Number

    A unique ID assigned by the FDA when a product is submitted for approval by the labeller.

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  • Product Code
    Product Code

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International/Other Brands
Boxol (Pharmacia) / Eurodal (Gland) / Ligoframin (Pfizer) / Low Liquemine (Roche)
CAS number
Not Available
Chemical Formula
Not Available
InChI Key
Not Available
Not Available
Not Available
Not Available



Dalteparin 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.

Associated Conditions

Dalteparin 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 action

Dalteparin 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.

AVascular endothelial growth factor A
ATissue factor pathway inhibitor
Additional Data Available
Adverse Effects

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Almost completely absorbed after subcutaneous (sc) doses, with a bioavialability of about 87%.

Volume of distribution

3 litres

Protein binding

Less than unfractionated heparin, which is more than 90%.


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

Route of elimination

After 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 life

Terminal Half life: Intravenous - 2 hours. Subcutaneous - 3-5hours


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


Overdosage: 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 organisms
Not Available
Not Available
Pharmacogenomic Effects/ADRs
Not Available


Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
(1,2,6,7-3H)Testosterone(1,2,6,7-3H)Testosterone may increase the anticoagulant activities of Dalteparin.
(R)-warfarinThe risk or severity of bleeding can be increased when Dalteparin is combined with (R)-warfarin.
(S)-WarfarinThe risk or severity of bleeding can be increased when Dalteparin is combined with (S)-Warfarin.
1-Testosterone1-Testosterone may increase the anticoagulant activities of Dalteparin.
18-methyl-19-nortestosterone18-methyl-19-nortestosterone may increase the anticoagulant activities of Dalteparin.
3,5-Diiodotyrosine3,5-Diiodotyrosine may increase the anticoagulant activities of Dalteparin.
4-hydroxycoumarinThe risk or severity of bleeding can be increased when Dalteparin is combined with 4-hydroxycoumarin.
4-Hydroxytestosterone4-Hydroxytestosterone may increase the anticoagulant activities of Dalteparin.
5beta-dihydrotestosterone5beta-dihydrotestosterone may increase the anticoagulant activities of Dalteparin.
7,8-Dichloro-1,2,3,4-tetrahydroisoquinolineThe risk or severity of bleeding and hemorrhage can be increased when 7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline is combined with Dalteparin.
Additional Data Available
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  • Evidence Level
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Food Interactions
  • Avoid herbs and supplements with anticoagulant/antiplatelet activity. Examples include ginseng, ginkgo, ginger, and garlic.


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
PubChem Substance
ATC Codes
B01AB04 — Dalteparin
AHFS Codes
  • 20:12.04.16 — Heparins

Clinical Trials

Clinical Trials
0TerminatedTreatmentAntiphospholipid Syndrome in Pregnancy / Pregnancy Loss1
1CompletedTreatmentClear Cell Sarcoma of the Kidney / Renal Cell Carcinoma Recurrent / Stage III Renal Cell Cancer / Stage IV Renal Cell Cancer1
1, 2CompletedPreventionNeoplasms, Lung / Pulmonary Embolism / Venous Thromboembolism1
2CompletedTreatmentBrain and Central Nervous System Tumors1
2CompletedTreatmentEmbolism and Thrombosis1
2CompletedTreatmentMalignant Neoplasm of Pancreas / Thromboembolism1
2CompletedTreatmentOvarian Cancer1
2CompletedTreatmentShock, Septic1
2CompletedTreatmentSickle Cell Disease (SCD) / Vaso-occlusive Crisis1
2CompletedTreatmentVenous Thromboembolism1
2RecruitingTreatmentAmpulla of Vater Cancer / Biliary Cancer (Cholangiocarcinoma, Gall Bladder Cancer) / Cancer-associated Thrombosis / Duodenal Cancer / Esophageal Cancers / Esophagogastric Junction Cancer / Hepatobiliary Cancers / Hepatocellular,Carcinoma / Malignant Gastrointestinal Stromal Tumor / Malignant Neoplasm of Pancreas / Malignant Neoplasm of Stomach1
2RecruitingTreatmentBMI >30 kg/m2 / Malignancies / Venous Thromboembolism1
2RecruitingTreatmentCerebral Venous Thrombosis1
2TerminatedPreventionSpinal Cord Injuries (SCI) / Venous Thromboembolism1
2TerminatedSupportive CareDeep Vein Thrombosis / Malignancies / Pulmonary Embolism / Thrombotic events / Venous Thromboembolism1
2TerminatedTreatmentColorectal Cancers1
2TerminatedTreatmentDeep Vein Thrombosis / Neoplasms1
2TerminatedTreatmentStage I Multiple Myeloma / Stage II Multiple Myeloma / Stage III Multiple Myeloma1
2, 3CompletedPreventionHemodialysis Treatment / Thromboembolism1
2, 3CompletedScreeningImpaired kidney function1
2, 3CompletedTreatmentDiabetic Foot Ulcers (DFU)2
3Active Not RecruitingPreventionStroke1
3Active Not RecruitingTreatmentVenous Thromboembolism1
3CompletedPreventionCritically-ill Patients / Deep Venous Thrombosis1
3CompletedPreventionDeep Venous Thrombosis / Illness, Critical1
3CompletedPreventionNeoplasms, Brain / Venous Thromboembolism1
3CompletedPreventionPostpartum / Venous Thromboembolism1
3CompletedSupportive CareCerebral Vein Thrombosis / Deep Vein Thrombosis / Gonadal Thrombosis / Hepatic Thrombosis / Mesenteric Thrombosis / Metastatic Malignant Neoplasm / Neoplasms, Malignant / Portal Vein Thrombosis / Pulmonary Embolism / Renal Vein Thrombosis / Splenic thrombosis / Venous Thromboembolism1
3CompletedSupportive CareCervical Cancers / Chronic Myeloproliferative Disorders / Leukemias / Malignant Lymphomas / Multiple Myeloma and Plasma Cell Neoplasm / Myelodysplastic Syndromes / Precancerous/Nonmalignant Condition / Unspecified Adult Solid Tumor, Protocol Specific / Veno-Occlusive Disease1
3CompletedTreatmentArterial Thromboembolic Events / Atrial Fibrillation (AF)1
3CompletedTreatmentBreast Cancer / Colorectal Cancers / Lung Cancers / Prostate Cancer / Veno-Occlusive Disease1
3CompletedTreatmentChronic Renal Failure (CRF)1
3CompletedTreatmentComplications, Pregnancy / Hypercoagulability / Pregnancy1
3CompletedTreatmentDeep Vein Thrombosis / Malignancies / Pulmonary Embolism / Venous Thromboembolism1
3CompletedTreatmentNeoplasms / Venous Thromboembolism1
3CompletedTreatmentRecurrent Abortion1
3RecruitingPreventionTraumatic Brain Injury (TBI)1
3TerminatedPreventionPulmonary Embolism / Venous Thromboembolism1
3TerminatedTreatmentMalignant Neoplasm of Pancreas / Thromboembolism1
3TerminatedTreatmentNeoplasms / Venous Thromboembolism1
3Unknown StatusSupportive CareLung Cancers / Thromboembolism1
4CompletedPreventionArthritis of the Hip / Infection / Transfusion Related Complications / Wound Discharge1
4CompletedPreventionDeep Vein Thrombosis / Pulmonary Embolism1
4CompletedPreventionRenal Failure1
4CompletedTreatmentDeep Vein Thrombosis1
4CompletedTreatmentLower Extremity Superficial Thrombophlebitis / Superficial Thrombophlebitis / Upper Extremity Superficial Thrombophlebitis1
4CompletedTreatmentLung Cancers1
4CompletedTreatmentMalignant Neoplasm of Pancreas / Venous Thromboembolism1
4CompletedTreatmentSuperficial Thrombophlebitis1
4RecruitingPreventionCOVID / Deep Vein Thrombosis / Novel Coronavirus Infectious Disease (COVID-19) / Pulmonary Embolism / Thrombotic events1
4RecruitingPreventionDeep Venous Thrombosis / Pulmonary Embolism1
4TerminatedNot AvailablePreeclampsia1
4TerminatedPreventionDalteparin / Deep Vein Thrombosis / Thromboembolism1
4TerminatedPreventionVenous Thromboembolism2
4TerminatedTreatmentMyocardial Infarction / Unstable Angina Pectoris1
Not AvailableActive Not RecruitingPreventionBone Cancer / Femur Fractures / Malignant Lymphomas / Neoplasms, Metastatic / Pathological Fractures / Plasma Cell Myeloma / Sarcoma, Bone / Soft Tissue Sarcoma (STS)1
Not AvailableActive Not RecruitingTreatmentBlood Clots / Deep Vein Thrombosis / Malignancies / Pulmonary Embolism / Venous Thromboembolism1
Not AvailableCompletedNot AvailableAcute Coronary Syndromes (ACS)1
Not AvailableCompletedNot AvailableAcute Deep Vein Thrombosis1
Not AvailableCompletedNot AvailableBMI >30 kg/m21
Not AvailableCompletedNot AvailableThrombosis, Venous1
Not AvailableCompletedNot AvailableUnsuspected Pulmonary Embolism1
Not AvailableCompletedNot AvailableVenous Thromboembolism1
Not AvailableCompletedPreventionThrombophylaxis in Transurethral Surgery1
Not AvailableCompletedPreventionVenous Thromboembolism1
Not AvailableRecruitingTreatmentAcute DVT of Lower Extremity1
Not AvailableRecruitingTreatmentRecurrent Pregnancy Losses / Undifferentiated Connective Tissue Disease1
Not AvailableTerminatedDiagnosticCoagulation, Blood / Compression Devices, Intermittent Pneumatic / Postoperative Complications / Thrombelastography1
Not AvailableTerminatedTreatmentAntiphospholipid Antibody Syndrome / Recurrent Pregnancy Losses1


Not Available
Not Available
Dosage forms
InjectionSubcutaneous10000 [iU]/1mL
InjectionSubcutaneous10000 [iU]/0.4mL
InjectionSubcutaneous12500 [iU]/0.5mL
InjectionSubcutaneous15000 [iU]/0.6mL
InjectionSubcutaneous18000 [iU]/0.72mL
InjectionSubcutaneous2500 [iU]/0.2mL
InjectionSubcutaneous25000 [iU]/1mL
InjectionSubcutaneous5000 [iU]/0.2mL
InjectionSubcutaneous7500 [iU]/0.3mL
SolutionIntravenous; Subcutaneous10000 unit
SolutionIntravenous; Subcutaneous12500 unit
SolutionIntravenous; Subcutaneous15000 unit
SolutionIntravenous; Subcutaneous16500 unit
SolutionIntravenous; Subcutaneous18000 unit
SolutionIntravenous; Subcutaneous2500 unit
SolutionIntravenous; Subcutaneous25000 unit
SolutionIntravenous; Subcutaneous3500 unit
SolutionIntravenous; Subcutaneous5000 unit
SolutionIntravenous; Subcutaneous7500 unit
LiquidIntravenous; Subcutaneous
Not Available
Not Available


Experimental Properties
Not Available
Predicted Properties
Not Available
Predicted ADMET features
Not Available


Mass Spec (NIST)
Not Available
Not Available


Not classified


Pharmacological action
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 a...
Gene Name
Uniprot ID
Uniprot Name
Molecular Weight
52601.935 Da
  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]
Pharmacological action
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...
Gene Name
Uniprot ID
Uniprot Name
Vascular endothelial growth factor A
Molecular Weight
27042.205 Da
  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]
Pharmacological action
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...
Gene Name
Uniprot ID
Uniprot Name
Tissue factor pathway inhibitor
Molecular Weight
35014.835 Da
  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]
Pharmacological action
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 ligan...
Gene Name
Uniprot ID
Uniprot Name
Molecular Weight
90833.105 Da
  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]


Pharmacological action
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. Se...
Gene Name
Uniprot ID
Uniprot Name
Molecular Weight
61148.17 Da
  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]

Drug created on September 14, 2010 10:21 / Updated on May 24, 2020 19:39

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