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Overview: Fragmin is a blood thinner that you inject under your skin to treat or prevent blood clots or prevent problems after heart problems, such as a heart attack or severe chest pain. The most common side effects with Fragmin are pain or blood clots at the injection site or bleeding or bruising more easily. Call your healthcare provider right away if you have severe bleeding or bleeding that is difficult to stop.

Uses

What is Fragmin used for?

Fragmin (dalteparin) is commonly used for the following conditions.

Fragmin may also be used for other conditions as determined by your healthcare provider.

How does Fragmin work (mechanism of action)?

Fragmin is a blood thinner, or anticoagulant. It works by blocking certain substances in the blood that form clots. 

How is Fragmin supplied (dosage forms)?

Brands and other names

  • Fragmin

Dosage forms and strengths

  • 2500 IU/0.2 mL, 5000 IU/0.2 mL, 7500 IU/0.3 mL, 12,500 IU/0.5 mL, 15,000 IU/0.6 mL, 18,000 IU/0.72 mL single-dose prefilled syringe
  • 10,000 IU/mL single-dose graduated syringe
  • 10,000 IU/4 mL single-dose vial
  • 95,000 IU/3.8 mL multiple-dose vial

How should I store Fragmin?

Fragmin should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of Fragmin?

The most common side effects of Fragmin are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Bleeding (see below)
  • Low platelet levels (see below)
  • Pain or blood clot at the injection site
  • Temporary increase in liver enzymes

There may be other side effects of Fragmin that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Fragmin?

While less common, the most serious side effects of Fragmin are described below, along with what to do if they happen.

Spinal Blood Clots. Blood clots can form around the spinal cord if you are using Fragmin and have a spinal tap or receive an epidural. These blood clots can cause long-term or permanent paralysis (unable to move). Your risk is higher if a thin tube (catheter) is placed in your spine, you are taking other medicines that may cause bleeding, including other blood thinners, you have a history of difficult or repeated spinal punctures, you have a history of problems with your spine, or had a recent surgery on your spine. Your healthcare provider will monitor you closely during the procedure. Tell your healthcare provider right away if you have back pain, tingling, numbness, muscle weakness (especially in your legs and feet), or loss of control of the bowels or bladder. 

Bleeding. Fragmin can increase your risk of severe bleeding that can lead to death. Some patients with serious bleeding may need a blood transfusion or surgery. Some medicines and other problems may increase your risk for severe bleeding. Call your healthcare provider right away if you have any of the following signs of severe bleeding while using Fragmin.

  • Pink, red, or brown urine (pee)
  • Vomit with blood that looks like coffee grounds
  • Red or black stools (looks like tar)
  • Coughing up blood or blood clots

Low Platelet Levels. Fragmin can cause you to have a severely low number of platelets in your blood, also called thrombocytopenia. Platelets help to form blood clots. Having a low level of platelets may increase your risk of bleeding. Tell your healthcare provider if you have any of the following symptoms of low platelet levels.

  • Easy bruising or bleeding
  • Bleeding that does not stop
  • Nosebleeds

Severe Allergic Reactions. Fragmin may cause allergic reactions, which can be serious. Stop using Fragmin and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use Fragmin?

Allergies to Ingredients. People who are allergic to any of the following should not use Fragmin.

  • Dalteparin
  • Fragmin
  • Heparin
  • Pork products
  • Benzyl alcohol
  • Latex (applies to Fragmin prefilled syringes)
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Fragmin.

Bleeding problems. Do not use Fragmin if you have uncontrolled bleeding. 

Heparin-Induced Thrombocytopenia (HIT). Do not use Fragmin if you have had HIT or HIT with blood clots, also called HIT with thrombosis. 

What should I know about Fragmin before using it?

Do not use Fragmin unless it has been prescribed to you by a healthcare provider. Use it as prescribed.

Do not share Fragmin with other people, even if they have the same condition as you. It may harm them.

Keep Fragmin out of the reach of children.

This medicine is injected under the skin. Make sure that you or a caregiver understands how to properly prepare and use Fragmin. Avoid using the same injection site each time you use Fragmin by rotating where you inject it. If you have any questions, talk to your pharmacist or other healthcare provider.

Fragmin is a blood thinner. It may take longer than usual to stop bleeding if you get injured. You also may notice that you bruise or bleed more easily while using Fragmin. See the Side Effects section for more details.

Some forms of Fragmin may have a preservative in it, called benzyl alcohol. Benzyl alcohol should not be used in babies or pregnant women because it may cause problems in the baby. If you have any concerns about this, talk with your pharmacist or healthcare provider. 

Fragmin should be clear and seem colorless. Look at the Fragmin liquid before you inject it. If it has any particles floating in it, is not clear, or the color has changed, do not inject it. Throw it away and use a new injection.

What should I tell my healthcare provider before using Fragmin?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Fragmin is right for you.

In particular, make sure that you discuss any of the following.

  • Upcoming surgery or procedures at the dentist
  • High blood pressure that is not well controlled
  • An infection in your heart (endocarditis)
  • Bleeding problems, including ulcers in your stomach, intestines or esophagus
  • Stroke 
  • Recent brain, spine, or eye surgery 
  • Kidney or liver problems
  • Problems with your platelets or low platelet levels (thrombocytopenia)
  • Eye problem, such as diabetic retinopathy

Pregnancy. It is not known if or how Fragmin could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should use Fragmin while you are pregnant or trying to get pregnant. 

Breastfeeding. Small amounts of Fragmin pass into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use Fragmin while breastfeeding.

How can I get more information about Fragmin?

For more information about Fragmin, you can visit the manufacturer’s website at www.pfizermedicalinformation.com/patient/fragmin or call them at 800-438-1985.

Interactions

Does Fragmin interact with foods or drinks?

There are no known interactions between Fragmin and foods or drinks.

It is unknown if drinking alcohol will affect Fragmin, but both Fragmin and alcohol can increase your risk of bleeding. It is best to limit the amount of alcohol you drink.

Does Fragmin interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over the counter (OTC) medicines, vitamins/minerals, herbal products, or other supplements you are taking. 

In particular, make sure that you discuss if you are using any of the following before using Fragmin:

  • A blood thinner, which is a medicine used to treat or prevent blood clots
  • An antiplatelet medicine, such as clopidogrel (Plavix), ticagrelor (Brilinta), aspirin/dipyridamole, or cilostazol, which is a medicine used to prevent blood clots
  • A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which is in many prescription and OTC products for pain, swelling, and fever
  • A salicylate, such as diflunisal or salsalate, which is a medicine used for osteoarthritis or rheumatoid arthritis
  • Aspirin, which is in many prescription and OTC products, including those for pain, swelling, and fever

This may not be a complete list of medicines that can interact with Fragmin. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Fragmin?

If you or someone else has used too much Fragmin, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Fragmin?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.