See Renal Dosing Protocol and Automatic Dose Rounding Protocol
Medications Approved for Automatic Therapeutic Interchange Dosage Conversion Guidelines (Note: “Therapeutic Interchange” should be placed in the order comments)
Low Molecular Weight Heparins
Medication Ordered
Brand Name
Available Dosages
Indication
Frequency
Formulary Medication
Equivalent Dose
Frequency
Dalteparin
Fragmin
2500 units
Prophylaxis
Daily
Enoxaparin
40 mg
Daily
Dalteparin
Fragmin
5000 units
Prophylaxis
Daily
Enoxaparin
40 mg
Daily
Dalteparin
Fragmin
**
**
**
Enoxaparin
30 mg
Q12 Hours
Dalteparin
Fragmin
120 units/kg
Unstable angina or non-Q-wave myocardial infarction
Q12 Hours
Enoxaparin
1 mg/kg+
Q12 Hours
Dalteparin
Fragmin
200 units/kg
VTE*
Daily
Enoxapain
1 mg/kg
Q12 Hours
Note: If the dosing falls outside of the above dosing, contact the MD to clarify conversion.
+Dosage adjustment necessary in patients with CrCl less than 30 ml/min **Fragmin Does not have an indication for Knee Replacement *Indication for VTE in Cancer Only for Fragmin
See Renal Dosing Protocol and Automatic Dose Rounding Protocol
Medications Approved for Automatic Therapeutic Interchange Dosage Conversion Guidelines
(Note: “Therapeutic Interchange” should be placed in the order comments)
Low Molecular Weight Heparins
Medication
Ordered
Brand Name
Available Dosages
Indication
Frequency
Formulary Medication
Equivalent Dose
Frequency
Dalteparin
Fragmin
2500 units
Prophylaxis
Daily
Enoxaparin
40 mg
Daily
Dalteparin
Fragmin
5000 units
Prophylaxis
Daily
Enoxaparin
40 mg
Daily
Dalteparin
Fragmin
**
**
**
Enoxaparin
30 mg
Q12 Hours
Dalteparin
Fragmin
120 units/kg
Unstable angina or non-Q-wave myocardial infarction
Q12 Hours
Enoxaparin
1 mg/kg+
Q12 Hours
Dalteparin
Fragmin
200 units/kg
VTE*
Daily
Enoxapain
1 mg/kg
Q12 Hours
Note: If the dosing falls outside of the above dosing, contact the MD to clarify conversion.
+Dosage adjustment necessary in patients with CrCl less than 30 ml/min
**Fragmin Does not have an indication for Knee Replacement
*Indication for VTE in Cancer Only for Fragmin
enoxaparin