Drug interactions
Dalteparin + Protamine
Severity: Moderate
Dalteparin and Protamine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Protamine is the antidote for heparins and binds dalteparin, partially neutralizing its anticoagulant effect. This is a deliberate reversal strategy rather than additive anticoagulation, and neutralization of anti-Xa activity is only partial.
What this interaction means in plain words
Dalteparin and Protamine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Protamine, a cationic protein, binds the anionic heparin molecules, though it neutralizes the anti-Xa activity of LMWH only incompletely.
What to do
Use protamine only for dalteparin overdose or life-threatening bleeding, dosed according to the amount and timing of the last dalteparin dose, and monitor for hypersensitivity and hypotension.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Dalteparin
- Dalteparin + Defibrotide Contraindicated
- Dalteparin + Ketorolac Contraindicated
- Dalteparin + Mifepristone Contraindicated
- Abciximab + Dalteparin Major
- Acalabrutinib + Dalteparin Major
- Aceclofenac + Dalteparin Major
Frequently asked questions
Can I take Dalteparin with Protamine?
MediHelp rates the interaction as moderate. Dalteparin and Protamine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Protamine is the antidote for heparins and binds dalteparin, partially neutralizing its anticoagulant effect. This is a deliberate reversal strategy rather than additive anticoagulation, and neutralization of anti-Xa activity is only partial.
How serious is the interaction between Dalteparin and Protamine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use protamine only for dalteparin overdose or life-threatening bleeding, dosed according to the amount and timing of the last dalteparin dose, and monitor for hypersensitivity and hypotension.
What other medicines interact with Dalteparin?
MediHelp also lists interactions of Dalteparin with, for example, Defibrotide, Ketorolac, Mifepristone. The full list is on the Dalteparin page.
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