Doses of dalteparin sodium are given in WHO international units (IU) of anti-Factor Xa activity.
Regimens:
(1) start 10-14 hours before surgery (typically the night before a morning surgery)
(2) start >= 2 hours before surgery
(3) start after surgery
Usually dosage adjustment and coagulation monitoring are not required if the regimens are followed.
Regimen starting 10-14 hours before surgery:
(1) 5,000 IU anti-Xa activity is administered subcutaneously 10-14 hours before the start of surgery.
(2) Following the joint replacement, 5,000 IU anti-Xa activity is administered subcutaneously 4-8 hours after hemostasis has been achieved..
(3) 5,000 IU anti-Xa activity is administered subcutaneously the next day (postoperative day 1) at a time at least 6 hours after the first postoperative dose.
(4) 5,000 IU anti-Xa activity is administered subcutaneously once a day for the next 4 to 9 days (postoperative days 5 to 10) at the same time as that given on postoperative day 1.
(5) Dosing may continue on postoperative days 11 to 14 if clinically indicated.
Regimen starting >=2 hours before surgery:
(1) 2,500 IU anti-Xa activity is administered subcutaneously >= 2 hours before the start of surgery.
(2) Following the joint replacement, 2,500 IU anti-Xa activity is administered subcutaneously 4-8 hours after hemostasis has been achieved..
(3) 5,000 IU anti-Xa activity is administered subcutaneously the next day (postoperative day 1) at a time at least 6 hours after the first postoperative dose.
(4) 5,000 IU anti-Xa activity is administered subcutaneously once a day for the next 4 to 9 days (postoperative days 5 to 10) at the same time as that given on postoperative day 1.
(5) Dosing may continue on postoperative days 11 to 14 if clinically indicated.
Regimen starting after surgery:
(1) Following the joint replacement, 2,500 IU anti-Xa activity is administered subcutaneously 4-8 hours after hemostasis has been achieved..
(2) 5,000 IU anti-Xa activity is administered subcutaneously the next day (postoperative day 1) at a time at least 6 hours after the first postoperative dose.
(3) 5,000 IU anti-Xa activity is administered subcutaneously once a day for the next 4 to 9 days (postoperative days 5 to 10) at the same time as that given on postoperative day 1.
(4) Dosing may continue on postoperative days 11 to 14 if clinically indicated.
