PMID- 10929935
OWN - NLM
STAT- MEDLINE
DCOM- 20001222
LR  - 20181113
IS  - 0012-6667 (Print)
IS  - 0012-6667 (Linking)
VI  - 60
IP  - 1
DP  - 2000 Jul
TI  - Dalteparin: an update of its pharmacological properties and clinical efficacy in 
      the prophylaxis and treatment of thromboembolic disease.
PG  - 203-37
AB  - Dalteparin is a low molecular weight heparin (LMWH) with a mean molecular weight 
      of 5000. Compared with unfractionated heparin (UFH), the drug has markedly 
      improved bioavailability and increased plasma elimination half-life, and exerts a 
      greater inhibitory effect on plasma activity of coagulation factor Xa relative to 
      its effects on other coagulation parameters. Dalteparin also has less lipolytic 
      activity than UFH. Dalteparin 2500U once daily subcutaneously is of similar 
      antithrombotic efficacy to UFH 5000IU twice daily, and 2 studies have shown 
      superiority over UFH 2 or 3 times daily of dalteparin 5000U once daily in 
      patients requiring surgical thromboprophylaxis. After total hip arthroplasty, 
      dalteparin was superior to adjusted-dosage warfarin and was of greater 
      thromboprophylactic efficacy when given for 35 than for 7 days. Intravenous or 
      subcutaneous dalteparin is as effective as intravenous UFH when given once or 
      twice daily in the initial management of established deep vein thrombosis (DVT). 
      The drug is also effective in long term home treatment. Dalteparin has been shown 
      to be effective in combination with aspirin in the management of unstable 
      coronary artery disease (CAD), with composite end-point data from 1 study 
      suggesting benefit for up to 3 months. Current data indicate potential of the 
      drug in the management of acute myocardial infarction (MI). Dalteparin is also of 
      similar efficacy to UFH, with a single bolus dose being sufficient in some 
      patients, in the prevention of clotting in haemodialysis and haemofiltration 
      circuits. Pharmacoeconomic data indicate that overall costs relative to UFH from 
      a hospital perspective can be reduced through the use of dalteparin in patients 
      receiving treatment for venous thromboembolism. Dalteparin has also been shown to 
      be cost effective when used for surgical thromboprophylaxis. Overall, rates of 
      haemorrhagic complications in patients receiving dalteparin are low and are 
      similar to those seen with UFH. CONCLUSIONS: Dalteparin is effective and well 
      tolerated when given subcutaneously once daily in the prophylaxis and treatment 
      of thromboembolic disease. The simplicity of the administration regimens used and 
      the lack of necessity for laboratory monitoring facilitate home or outpatient 
      treatment and appear to translate into cost advantages from a hospital 
      perspective over UFH or warfarin. Dalteparin also maintains the patency of 
      haemodialysis and haemofiltration circuits, with beneficial effects on blood 
      lipid profiles and the potential for prophylaxis with a single bolus injection in 
      some patients. Data are also accumulating to show dalteparin to be an effective 
      and easily administered alternative to UFH in patients with CAD.
FAU - Dunn, C J
AU  - Dunn CJ
AD  - Adis International Limited, Auckland, New Zealand. demail@adis.co.nz
FAU - Jarvis, B
AU  - Jarvis B
LA  - eng
PT  - Journal Article
PT  - Review
PL  - New Zealand
TA  - Drugs
JT  - Drugs
JID - 7600076
RN  - S79O08V79F (Dalteparin)
SB  - IM
EIN - Drugs 2000 Oct;60(4):719
MH  - Blood Coagulation/drug effects
MH  - Coronary Disease/complications
MH  - Dalteparin/administration & dosage/*pharmacology/therapeutic use
MH  - Drug Costs
MH  - Drug Interactions
MH  - Economics, Pharmaceutical
MH  - Female
MH  - Humans
MH  - Male
MH  - Postoperative Complications/prevention & control
MH  - Pregnancy
MH  - Pregnancy Complications/prevention & control
MH  - Thromboembolism/*drug therapy/physiopathology/*prevention & control
RF  - 157
EDAT- 2000/08/10 11:00
MHDA- 2001/02/28 10:01
CRDT- 2000/08/10 11:00
PHST- 2000/08/10 11:00 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2000/08/10 11:00 [entrez]
AID - 10.2165/00003495-200060010-00010 [doi]
PST - ppublish
SO  - Drugs. 2000 Jul;60(1):203-37. doi: 10.2165/00003495-200060010-00010.