From the Guidelines
Fragmin (dalteparin) at a therapeutic dose of 100 units/kg is typically administered every 12 hours or once daily, with the once-daily regimen being a viable option for therapeutic anticoagulation in patients with venous thromboembolism (VTE) or pulmonary embolism (PE) as seen in the study by 1. The dosing regimen for Fragmin can vary depending on the clinical context and patient-specific factors, such as renal function and risk of bleeding.
- For patients with normal renal function, the once-daily dosing regimen of 100 units/kg may be appropriate, as it provides effective anticoagulation and improves patient adherence compared to twice-daily regimens.
- However, for patients with renal impairment (creatinine clearance <30 mL/min), dose adjustment or monitoring of anti-Xa levels may be necessary to minimize the risk of bleeding, as noted in the study by 1. The pharmacokinetic profile of dalteparin, with its relatively long half-life and sustained anti-Xa activity, allows for 24-hour coverage with a single injection, making once-daily administration a convenient option for patients. When administering dalteparin, subcutaneous injections should be given in the abdominal wall, alternating sides, and avoiding the 2-inch area around the navel, as recommended in the study by 1. It's also important to consider the clinical context and patient-specific factors when selecting a dosing regimen for Fragmin, and to consult the latest clinical guidelines and evidence-based recommendations, such as those provided by 1 and 1.
From the FDA Drug Label
Age Group Starting Dose 8 Years to less than 17 Years 100 units/kg twice daily
The therapeutic Fragmin dosing of 100 units per kg is administered twice daily in patients from 8 years to less than 17 years 2.
From the Research
Therapeutic Fragmin Dosing
- The dosing of Fragmin (dalteparin) can vary depending on the specific condition being treated and the patient's weight.
- According to the study 3, the initial dose of Fragmin for the treatment of deep vein thrombosis is 100 U anti-Xa/kg/12 h, which is administered subcutaneously twice daily.
- This suggests that a dose of 100 units per kg of Fragmin is typically administered twice daily, rather than once daily.
Comparison with Other Studies
- The study 4 used a dose of 200 U/kg of dalteparin daily for the treatment of pulmonary embolism, but this was a different condition and a different dosing regimen than the one specified in the question.
- The studies 5, 6, and 7 did not provide information on the specific dosing of Fragmin, as they focused on other aspects of anticoagulant therapy.
- Therefore, based on the available evidence, it appears that a dose of 100 units per kg of Fragmin is typically administered twice daily, rather than once daily, for the treatment of deep vein thrombosis 3.