Frimley Guidelines

Dalteparin Doses

DVT, PE, AF, Mechanical Heart Valves

Dalteparin doses for the treatment of:

  • DVT and PE
  • AF (Unlicensed indication)
  • Mechanical heart valves (Unlicensed indication)

Please note the doses below are not suitable for pregnant women. Please see trust guideline for dosing in pregnancy.

USE FIXED DOSE SYRINGES and give dalteparin subcutaneously.

Body weight (kg)Dose if CrCl >20ml/minDose if CrCl 10-20ml/min
< 467500 units once daily5000 units once daily
46 – 5610000 units once daily6500* units once daily
57 - 6812500 units once daily8500* units once daily
69 - 8215000 units once daily10000 units once daily
83-9818000 units once daily12500 units once daily
99-11210000 units twice daily15000 units once daily
113-13712500 units twice daily18000 units once daily
138-16515000 units twice daily10000 units twice daily
≥16618000 units twice daily12500 units twice daily

*Graduated syringes 10,000 units in 1ml available for administration

Patients with CrCl <10ml/min, consider unfractionated heparin use AND discuss with haematology

ACS, STEMI when not on fondaparinux

Dalteparin doses for the treatment of:

  • ACS not on fondaparinux
  • STEMI not on fondaparinux (Unlicensed indication)

Note: Fondaparinux is 1st line treatment (See ACS protocol)

Body weight (kg)Dalteparin dose (in units)
Branded dose based on 120 units/kg		Volume from the 10,000 units in 1ml syringe to give
30-374,000 units s/c twice a day0.4 mL
38-455,000 units s/c twice a day0.5 mL
46-546,000 units s/c twice a day0.6 mL
55-627,000 units s/c twice a day0.7 mL
63-708,000 units s/c twice a day0.8 mL
71-799,000 units s/c twice a day0.9 mL
> 8010,000 units s/c twice a day1 mL

Creatinine clearance 10-20ml/minute use 50% of recommended dose

Creatinine clearance <10ml/minute do not use LMWH – use unfractionated heparin infusion

There is no need to routinely monitor anti-Xa assays in patients who weight between 40-180 kg. Contact haematology for advice regarding monitoring.

About

Version:2
Guidelines Lead(s):Dr Clare Rees – Haematology Consultant FPH
Dr Nicola Philpott – Haematology Consultant WPH
Contributors:Harminder Sangha – Anticoagulation Specialist Pharmacist
Ann Parker – Principal pharmacist for Chronic Medicine
Lead Director/ Chief of Service:Dr Gareth Roberts – Chief of Service for Medicine
Version Implementation Date:Feb 2024
Review Date:Feb 2027
Ratified at:VTE dosing tables taken from existing VTE treatment protocols (DVT care pathway v3.3, issued Nov 2023)
Pharmaceutical dosing advice and formulary compliance checked by:Harminder Sangha, 18th March 2021
Keywords:Dalteparin, DVT, PE, AF

This guideline has been registered with the trust. However, clinical guidelines are guidelines only. The interpretation and application of clinical guidelines will remain the responsibility of the individual clinician. If in doubt contact a senior colleague or expert. Caution is advised when using guidelines after the review date. This guideline is for use in Frimley Health Trust hospitals only. Any use outside this location will not be supported by the Trust and will be at the risk of the individual using it.

Version History

VersionDateLead Author(s)StatusComments
1March 2021Dr C Rees, Dr N PhilpottFinal
2Feb 2024Dr C Rees, Dr N PhilpottFinalLink to VTE in Pregnancy corrected. Dosage unchanged.

Related Document

Suspected DVT Care Pathway