title: The safety of dosing dalteparin based on actual body weight for the treatment of acute venous thromboembolism in obese patients.
abstract: Data evaluating the safety of using weight-based low-molecular-weight heparin in the treatment of obese patients with acute venous thromboembolism are limited. The product monograph of dalteparin suggests the maximum dose should be limited to 18,000 U subcutaneously once daily. There are no specific data regarding the risk of recurrence or bleeding in patients given dalteparin in a weight-based dose of 200 IU kg(-1). We report a retrospective chart review of 193 obese patients who weighed more than 90 kg and who received dalteparin at or near to 200 IU kg(-1) actual body weight for 5-7 days for acute venous thromboembolism with 90 day follow-up information. Of the patients, 77% had idiopathic venous thromboembolism, 16% had an underlying malignancy, and 7% had a transient risk factor. Warfarin was initiated within 2 days with a target International Normalized Ratio range of 2.0-3.0. All patients were followed for 12 weeks post diagnosis. Only two patients had a major hemorrhage, 4 and 8 weeks from diagnosis. This study supports the safety of dosing dalteparin based on actual body weight in obese patients.
authors.affiliation: London Health Sciences Center, London, Ontario, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Al-Yaseen
authors.forename: P S
authors.initials: PS
authors.lastname: Wells
authors.forename: J
authors.initials: J
authors.lastname: Anderson
authors.forename: J
authors.initials: J
authors.lastname: Martin
authors.forename: M J
authors.initials: MJ
authors.lastname: Kovacs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage*; D001835:Body Weight; D017985:Dalteparin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013923:Thromboembolism / Q000188:drug therapy*; D013997:Time Factors; D020246:Venous Thrombosis / Q000188:drug therapy*; D014859:Warfarin / Q000494:pharmacology
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D017985:Dalteparin