When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to dalteparin, heparin, or pork, or if you have a history of bleeding or other problems caused by heparin.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin.
• A nurse or other health provider will give you this medicine.
• You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
• You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas.
• Use a new needle and syringe each time you inject your medicine.
• Missed dose: You must use this medicine on a fixed schedule. Call your doctor or pharmacist if you miss a dose.
• If you store this medicine at home, keep it at room temperature, away from heat and direct light. Use the medicine within 14 days after the bottle is opened.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how dalteparin works. Tell your doctor if you are using any of the following:
  
  • Clopidogrel, prasugrel, ticlopidine
  • Another blood thinner (including warfarin)
  • Medicine that dissolves blood clots (including alteplase, reteplase, streptokinase)
  • NSAID pain or arthritis medicine (including aspirin, celecoxib, diclofenac, ibuprofen, naproxen)

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, bleeding problems, diabetes, high blood pressure, digestion problems, recent surgery, or a history of stroke.
• This medicine may cause nerve damage if you have a medical procedure to your back, including anesthesia or a spinal puncture. This is more likely to happen if you have a history of back or spine injury, surgery, or other problems or if you are taking another blood thinner.
• You might bleed and bruise more easily while you are using this medicine. Brush and floss your teeth gently, do not play rough sports, and be careful with sharp objects.
• This medicine contains benzyl alcohol which may cause serious reactions (such as gasping syndrome) to newborn or premature infants.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Black, tarry stools
• Blood in your urine or stools
• Pain, swelling, or bruising where the shot was given
• Pinpoint red spots on the skin
• Unusual bleeding, bruising, or weakness
• Vomiting of blood or material that looks like coffee grounds

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088