|  | | Interactions: |  | Acenocoumarol 
Adverse Effect: Increased risk of bleeding and hematoma when neuraxial anesthesia is employed     Clinical Management: Acenocoumarol should be discontinued prior to the initiation of therapy with Dalteparin . If this is not possible, patients receiving Dalteparin and Acenocoumarol concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy.Celecoxib 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Dipyridamole 
Adverse Effect: Increased risk of bleeding and hematoma when neuraxial anesthesia is employed     Clinical Management: Drugs which affect hemostasis should be discontinued prior to the initiation of therapy with Dalteparin or heparinoid. If this is not possible, patients receiving Dalteparin or heparinoid and Dipyridamole concurrently should be monitored closely for bleeding, which may be serious.Flurbiprofen 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Ibuprofen 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Indomethacin 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Ketoprofen 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Ketorolac 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Mefenamic Acid 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Meloxicam 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Nabumetone 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Naproxen 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Nimesulide 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Oxyphenbutazone 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Paracetamol 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Phenacetin 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Phenindione 
Adverse Effect: Increased risk of bleeding and hematoma when neuraxial anesthesia is employed     Clinical Management: Phenindione should be discontinued prior to the initiation of therapy with Dalteparin . If this is not possible, patients receiving Dalteparin and an Phenindione concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy.Phenylbutazone 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Piroxicam 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Tenoxicam 
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed     Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.Tissue type plasminogen activator (t p a) 
Adverse Effect: Increased risk of bleeding   Clinical Management: If coadministration of low molecular weight heparins like Dalteparin is required close clinical and lab monitoring is required and the drug should be administered with caution.Warfarin 
Adverse Effect: Increased risk of bleeding and hematoma when neuraxial anesthesia is employed     Clinical Management: Warfarin should be discontinued prior to the initiation of therapy with Dalteparin . If this is not possible, patients receiving Dalteparin and Warfarin concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. | 
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