Peri and Post -Operative: Dosing

Dosing

Surgical thromboprophylaxis

Use Fragmin® for peri- and post- operative surgical thromboprophylaxis

Surgery carries with it various risks, one of which is venous thromboembolism (VTE). VTE during the hospital stay affects approximately 60% of patients undergoing hip replacement surgery1

Indication:

Thromboprophylaxis in moderate and high risk surgical patients and prolonged thromboprophylaxis in hip replacement surgery2

Dosage:

Use Fragmin® single dose syringes: 2,500 IU/5,000 IU dalteparin sodium2

Moderate risk of thrombosis:

2,500 IU s.c. 1–2 hours before surgery

Continue 2,500 IU s.c. each morning, until the patient is mobilised, in general for 5–7 days or longer

High risk of thrombosis:

2,500 IU s.c. 1–2 hours before surgery, then 2,500 IU s.c. 8–12 hours later. Continue 5,000 IU s.c. each morning, until the patient is mobilised, in general for 5–7 days or longer

Alternatively: 5,000 IU s.c. the evening before surgery. Continue 5,000 IU s.c. the following evenings until the patient is mobilised, in general for 5–7 days or longer

Prolonged thromboprophylaxis in hip replacement surgery:

5,000 IU s.c. the evening before surgery. Continue 5,000 IU s.c. each evening for 5 post-operative weeks

If pre-operative administration of Fragmin® is not considered appropriate because the patient is at high risk of haemorrhage during the procedure, post-operative Fragmin® may be administered

References

1. Dahl OE et al. Throm Haemost 1977:77(1):26–31.
2. Fragmin SmPC [Surgical Thromboprophylaxis (2,500 IU and 5,000 IU syringes)]. Available at: https://www.medicines.org.uk/emc/product/4246 and https://www.medicines.org.uk/emc/product/4247

*Including, but not limited to: congestive cardiac failure (NYHA class III or IV), acute respiratory failure or acute infection, who also have a predisposing risk factor for VTE such as age over 75 years, obesity, cancer or previous history of VTE.~
†In patients with chronic renal insufficiency or acute renal failure.

PP-FRA-GBR-0150.  June 2019