FRAGMIN Please bring this booklet the day of your surgery. QHC#72
Fragmin (dalteparin sodium injection); an anticoagulant (blood thinner) is used to help prevent blood clots after surgery. While on Fragmin, you should avoid taking Aspirin, Ibuprofen, Motrin, Advil, vitamin E, any herbal remedies (i.e. garlic, ginger, gingko, ginseng and Lakota products) and any other blood thinner medication without first consulting your doctor. Do not drink alcohol while taking blood thinners. Inform all healthcare professionals (doctors, dentists) that you come in contact with that you are taking Fragmin. Carry a card in your purse or wallet that says you are taking a blood thinner. Carry the card only while you take the medicine. Fragmin should be injected at the same time each day. It is important that you take your medication exactly as directed. Do not change your dosing schedule without talking to your health care provider. If you miss a dose, take your usual dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Call your doctor to let him know. 1
To store this medicine Keep out of reach of children Store at room temperature Store away from heat and direct light Do not refrigerate Do not keep outdated medicine. Be sure that any discarded medicine is out of reach of children Before you leave the hospital, your nurse will have given you and/or a family member instruction on how to give the injections. Fragmin comes in a prefilled safety syringe. Before you administer Fragmin, look at the solution closely. It should be clear and free of floating material. Do not use the solution if it is discolored, if it contains particles, or if the container leaks. Use a new solution, but show the damaged one to your doctor and/or pharmacist. 2
Before starting the injection, you will need to wash your hands thoroughly. Open the syringe package and remove the syringe, holding it by the open sides. Be careful not to press the plunger, as this could cause some of the premeasured dose to accidentally spill. Sit in a comfortable position. Choose a place on your abdomen (avoid the area around the umbilicus). Remember to use a different site each day. You must give your shot in the fatty tissue under your skin. Pinch a fold of skin together with the thumb and fingers of one hand. 3
Clean the site well with an alcohol swab or cotton ball soaked in alcohol. Remove the cap from the Fragmin syringe. Pull the cap straight off to keep the needle from bending. Hold the syringe in one hand, like a pencil or a dart. With your other hand, insert the needle into the fold of skin at a 90 degree angle. Slowly depress the plunger until the syringe is completely empty. 4
With your finger still on the plunger, remove the needle at the same angle that it was inserted, releasing the fold of skin as you do. Remove your finger from the plunger and the safety guard will automatically slide over the needle. With an alcohol swab, apply pressure for 2 minutes to the site. Do not rub the site. Immediately dispose of the syringe in a puncture resistant container, such as a metal coffee tin or a sharp s container, which can be purchased at your pharmacy. Store the container in a safe place away from children and pets. Do not throw your used syringe and needle into a household wastebasket or trash can. Your pharmacist will give you instructions on disposing of the needles. 5
Since Fragmin is injected into the skin, the injection site may be sore or red. You may even get a bruise ranging from the site of a pinprick to the size of a quarter. If you find a lump at the injection site, don t worry. It is just fluid and will be absorbed into your body. Remember to choose a different site each day for your injections. Although side effects from Fragmin are not common, they can occur. If you experience any of the following symptoms, call your doctor or come to the nearest Emergency Department: Bleeding gums Nose bleeds Blood in your urine or stool Black, tarry stools Vomiting or coughing up blood Increased bruising Pain, swelling, redness or warmth in your legs Shortness of breath Chest pain or rapid heart beat Feeling faint or weak 6
Developed By: Surgical Services, 2005 Approved By: Department of Orthopaedics, Quinte Healthcare Revised: July, 2008 7