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Specific Fragmin Warnings and Precautions

Some warnings and precautions to be aware of prior to using Fragmin include the following:
  • As with all "blood thinners," one of the most serious side effects of Fragmin is internal bleeding, which can be fatal. Let your healthcare provider know if you develop any signs of bleeding, such as:
    • Easy bruising
    • Cuts or scrapes that are slow to stop bleeding
    • Black, tarry stools; bright-red blood in the stool; or vomiting of blood (signs of gastrointestinal bleeding)
    • Signs of bleeding in the brain, such as vision or speech changes, weakness or numbness in an arm or leg, or a severe headache.
  • There have been reports of spinal or epidural hematoma in people who had spinal, epidural, or caudal anesthesia (or spinal punctures) while on Fragmin. This is a serious problem that can sometimes cause long-term or permanent paralysis. Each case must be evaluated on an individual basis, but you may not be a candidate for these types of anesthesia or procedures if you are using Fragmin.
  • Make sure your healthcare provider knows if you have kidney disease, diabetic retinopathy, uncontrolled high blood pressure, recent ulcers of the digestive tract, or any obvious bleeding. Extra care must be taken in such situations.
  • Fragmin should be used with extreme caution in people with bacterial endocarditis, bleeding disorders (that increase the risk of bleeding), active stomach or intestinal ulcers, bleeding in the brain, or who have recently had brain, spinal, or eye surgery.
  • Fragmin may interact with a number of other medications (see Fragmin Drug Interactions for more information).
  • As with other heparin-like drugs, Fragmin can cause low blood platelets (thrombocytopenia). In many cases, this is mild and causes no other problems. Rarely, though, a severe reaction known as heparin-induced thrombocytopenia (HIT) may occur. This dangerous problem can cause excessive clotting, loss of limbs, and even death.
  • Fragmin multi-dose vials contain benzyl alcohol, a preservative that can be dangerous to premature newborns. Because benzyl alcohol may cross the placenta, pregnant women should generally avoid using Fragmin multi-dose vials. This is not a problem with the single-dose syringes.
  • Fragmin passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Fragmin and Breastfeeding).
  • Fragmin is considered a pregnancy Category B medication. This means that it is probably safe for use during pregnancy, although the full risks are currently unknown (see Fragmin and Pregnancy).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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