Dalteparin

• If you are known to be allergic to Dalteparin or any other medicines, please tell your doctor.

• If you are pregnant or breastfeeding, it is advised to consult a doctor before using Dalteparin.

• Dalteparin should be given to children only if prescribed by a doctor.

• Do not use multiple-dose formulations of Dalteparin in neonates and infants as they contain benzyl alcohol that may harm a newborn.

• Dalteparin should be used with caution in the elderly above 65 years of age as they may be at high risk of bleeding. 

• If you have diabetes, high blood pressure, congestive heart failure,  blood cell disorder (low platelets or low red blood cells), bleeding in the stomach or intestines, had a stroke, kidney, liver or bleeding problems, stomach ulcer, inform your doctor before taking Dalteparin.

• Do not stop taking Dalteparin of your own. Stopping a sudden intake of Dalteparin may worsen your condition and increase your risk of cardiovascular death, heart attack and stroke. Hence, you should consult a doctor before stopping the dose of Dalteparin.

• You should inform the doctor that you are taking Dalteparin before any surgery is scheduled. 

• Dalteparin can cause a serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anaesthesia (epidural).

• Avoid consumption of alcohol while taking Dalteparin as it may increase the risk of stomach bleeding.

• Extra care must be taken while brushing your teeth or shaving to prevent bleeding.

Drug-Drug Interactions: Dalteparin may have interaction with other blood thinners (abciximab, apixaban, enoxaparin, warfarin, clopidogrel, prasugrel, rivaroxaban, dabigatran, anisindione), pain killers (ibuprofen, naproxen, diclofenac, bromfenac, celecoxib), and antihypertensive (lisinopril, losartan, aliskiren, spironolactone, eplerenone).

Drug-Food Interactions: Dalteparin may interact with cranberry juice, grapefruit juice, noni juice, pomegranate juice, and green tea. Also, Dalteparin may interact with St. John’s wort (herbal medicine for depression), garlic, ginkgo biloba, ginseng, echinacea, goldenseal and coenzyme Q10. Also, avoid alcohol intake as it may increase the risk of bleeding.

Drug-Disease Interactions: If you have haemophilia (blood doesn't clot normally), diabetes, high blood pressure, congestive heart failure,  blood cell disorder (low platelets or low red blood cells), bleeding in the stomach or intestines, had a stroke, kidney, liver or bleeding problems, stomach ulcer, inform your doctor before taking Dalteparin.

• Do not make any changes in your diet without first talking to your doctor.
• Avoid vitamin K-rich foods such as coriander, cabbage, spinach, broccoli, collard greens, kale (leaf cabbage), black liquorice, turnip greens, avocados, and Brussels sprouts as they may decrease the effectiveness of Dalteparin.
• Avoid cranberry juice, grapefruit juice, noni juice, pomegranate juice and green tea as they may interact with Dalteparin and lead to unwanted side effects.
• Do the regular exercise as it helps to dissolve blood clots, especially in obese people.
• Avoid the consumption of alcohol as it may increase the risk of bleeding.
• Take the medication as directed by the doctor and at regular intervals. Do not use other over-the-counter medications, herbal or vitamin supplements without informing your pharmacist or doctor when you take Dalteparin.
• Keep your cholesterol and triglyceride levels under control.
• Eat at regular intervals and maintain a healthy diet that includes fresh fruits and vegetables.
• Limit alcohol intake since it raises blood pressure and increases the risk of heart disease.
• Keep a check on your weight and exercise regularly to keep your heart healthy.
• Your doctor also guides you on how to notice and manage the early symptoms of detecting heart diseases. 

You should have a regular platelet count, factor V assay, fibrinogen level test, prothrombin time test (PT or PT-INR), and the INR, or international normalized ratio, to analyze your blood clotting time.