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This medication carries important safety information that users must be aware of to prevent serious health risks. Please review the following points carefully and discuss any questions or concerns with your healthcare provider.

• Risk of Bleeding Near the Spinal Cord: Using this medication, particularly during spinal procedures like a spinal tap or epidural, can increase the risk of bleeding around the spinal cord. This can result in long-term or permanent paralysis. It is crucial to consult with your doctor about the risks and benefits before undergoing any spinal procedure. Your doctor may advise you to stop taking this medication for a certain period before and after the procedure. Follow your doctor's instructions closely.

• Increased Bleeding Risk Factors: The likelihood of bleeding complications may rise if you have a history of spinal deformities, previous spinal surgery, or are concurrently using medications that affect bleeding. These include antiplatelet drugs (e.g., clopidogrel), blood thinners (e.g., warfarin, rivaroxaban), and NSAIDs (e.g., ibuprofen). Monitor for symptoms such as back pain, numbness or tingling in the legs, weakness, or loss of bladder/bowel control, and report these to your doctor immediately.

• Low Platelet Counts and Clotting Issues: This medication may reduce platelet counts, which can lead to a rare but serious condition known as heparin-induced thrombocytopenia (HIT). HIT occurs when the immune system creates antibodies that interfere with platelet function, leading to blood clots. If platelet levels drop significantly, your healthcare provider will likely discontinue this medication and consider alternative treatments. This risk is higher if you have a history of HIT.

• Emergency Actions: If you experience any severe symptoms or suspect an overdose, seek medical attention right away.

By understanding these risks and taking the recommended precautions, you can use this medication more safely. Always communicate openly with your healthcare team regarding any pre-existing conditions or other medications you are taking.

When using this medication, some common side effects include irritation, bruising, and pain at the injection site. These effects are typically mild but should be reported to your healthcare provider if they persist or worsen. Additionally, there is a risk of bleeding, with 14% of users experiencing some bleeding and 6% experiencing major bleeding.

It is crucial to be aware of serious side effects, which include unusual or prolonged bleeding, dark urine, black stools, severe headache, confusion, vision changes, dizziness, fainting, seizures, weakness, or numbness. These symptoms may indicate excessive effects on blood clotting proteins and require immediate medical attention.

Rarely, users may experience serious bleeding around the spinal cord following an epidural or spinal tap, which can lead to paralysis. If you notice symptoms of a serious allergic reaction, such as rash, itching, swelling, severe dizziness, or difficulty breathing, seek medical help promptly. While these severe reactions are uncommon, they are significant and should not be ignored. If you experience any other side effects not mentioned, reach out to your healthcare provider for guidance.

Dalteparin, marketed as Fragmin, may interact with several medications and supplements. It is important to inform your doctor and pharmacist about all the medications and supplements you are currently using, including prescriptions, over-the-counter drugs, vitamins, and herbal products. Not all possible interactions are listed here.

One interaction to be cautious of involves the medication defibrotide, with which dalteparin should generally not be used. Your doctor may choose an alternative treatment strategy if you are taking defibrotide.

There are also other medications that are usually not recommended to be used with dalteparin unless absolutely necessary. If your doctor prescribes them together, dose adjustments or monitoring might be required. These medications include a wide range of blood thinners, anti-platelet drugs, and non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, clopidogrel, warfarin, ibuprofen, naproxen, and many others listed above. These combinations can increase your risk of bleeding, so close monitoring is essential.

If your healthcare provider has advised you to take low-dose aspirin for heart attack or stroke prevention, continue taking it unless instructed otherwise. Always check with your doctor or pharmacist for detailed guidance and keep all medical and lab appointments to ensure safe and effective use of your medications.