Anticoagulant response after dalteparin overdose

Inadvertent Overdose of Low-Molecular- Weight Heparin in an Elderly Patient with Deep Vein Thrombosis and Acute Kidney Injury

“…Furthermore, most case reports of LMWH overdose have involved patients who were relatively young. [1][2][3][5][6][7] To the authors' knowledge, the current article is the first report of LMWH overdose in a patient over 80 years of age.…”

“…1,3,13 However, there have also been reports of supportive management of LMWH overdose without administration of protamine sulphate. 5,6 Definitive evidence-based guidelines on dosing of protamine sulphate and frequency of monitoring are lacking. In its guidelines, the American College of Chest Physicians suggests using 1 mg of protamine sulphate per 100 anti-Xa units of LMWH in the first 8 h and another 0.5 mg per 100 anti-Xa units if the bleeding continues.…”

“…It is not possible to draw definitive conclusions about the effectiveness of this therapeutic approach on the basis of a single case report, and the outcome of the case might have been equally satisfactory with observation and supportive care alone, as noted in some previous reports. 5,6 …”

Erratum to: Pharmacology of anticoagulants used in the treatment of venous thromboembolism

“…Enoxaparin administration may prolong the aPTT by up to 20 s whereas there is a more pronounced effect following dalteparin administration [ 28 , 31 ]. There are limited reports suggesting that at higher doses, the aPTT correlates with dalteparin anti-Factor-Xa activity [ 32 , 33 ].…”