Fragmin overdose by hospital?!

[LondonLassInTheCountry]

Hello.

Put here for traffic. Sorry.

Im currently in hospital.

Given a 25,000 injection of fragmin. For my weight i suppose to have only 15.000
No reason to have a bigger dose.
Just normal run of the meal, injection as im laying in a hospital bed

When given it i asked why so big, the nurse said thats what the dr said.... As soon as it was injected i thought it was way to much. Googled it and everywhere it says max dose is 18.000.

Iv spoke to the nurse and shes apparently spoke to the doctor but an hour later and no one has been to see me.

What signs should i look out for? In case of internal bleeding.

This isnt on, is it

I inject this (dalteparin) daily as part of my pregnancy treatment due to clotting issues with previous miscarriages, my preventative dose is 5000iu and this is the same doseage given (well for my weight at least) for a week after c-section when it’s not as easy to be mobile. Hope you’ve got your answers op.

OP I have never administered such a large dose and I really do think you need to urgently demand answers from the staff. Good luck.

sugarnotsweetener - me too, in my last pregnancy. IIRC the dose was 5000 too, so 25000 (if it was really given) does sound large. I had to keep taking it for six weeks after (vaginal) birth because of the heightened risk of PE - I do have two genetic clotting issues as well as previous rmc, but IIWY I might be checking whether I should be carrying it on for a bit longer after birth. Hope all goes well!

OP - hope you're OK.

Hello everyone.

Thank you for everyone's comments

I was given 25,000 but im not sure what i suppose to of been given.
The doctor was called and he come to see me, him himself said that he had never seen such a large dose but he rang another consultant and the pharmacy and they both reassured him i will be ok. They took some extra blood tests to make sure the drug hadnt had an effect of some sort...
Will be interesting tonight when they give me another jab to see what the amount is.
If its 25,000 I'm going to decline it and go with 15,000 only.

Thank you for all replies.
My first language is English, but im on the phone, in a hospital bed and feeling ill, so my language / spelling may not be up to AIBU scratch.

Thanks everyone

From the BNF. It's fine

@toddlerteaplease No, it's not - the BNF makes it clear that the max dose is 18,000 units daily. Thromboprophylaxis in a renal patient is 2500 units a day, not 25,000 units a day.

Toddlerteaplease

I think you need to read that again.

I think perhaps as pp suggested that 2500 units was intended but it has been mid-written. Usually 2500-5000 for prevention of clots if not mobile whilst in hospital. Maximum dose for all patients is 18000 and doses higher than 7500 are treatment doses so only if you have had a clot or whilst awaiting tests to exclude a clot. I think in your situation I would be asking a doctor to explain what your working diagnosis is and whether the treatment plan if for ‘full blood thinning’ treatment. If they cannot explain why then I would not be receiving any injections, 15000 is very high dose if you are only meant to be on prevention dose. Usually there would be a pharmacist available mon-fri and tomorrow I would be asking to speak to them and the error documented and investigated.

This advice is based both on my professional experience and how I would act if I was a patient in this situation.

Toddler, you are wrong, that is how mistakes are made, it says 2500 units, 25,000 is what she was given. OP, I would ask what dose you should be on, why you are on that that particular dose, what they are giving it to you for. I would even question 15,000 units.

I would check with the nurse now what dose is prescribed for you tonight and what the doctor has written in your notes about your dose. If any uncertainty they can bleep the doctor and clarify in time before your dose is due, hopefully the doctor who spoke to you earlier will still be there.

Don't wait until this evening when they come round with your injection, as by then the doctor staffing levels will be lower and there will be a long delay before a doctor can get round (if at all as may be dealing with emergencies only overnight), so you may end up either missing your dose or getting the wrong dose.

I sat and corrected. Though I was presuming the op meant 2500, rather than 25,000

@toddlerteaplease The op gives a good account of the dose being administered via two separate syringes - one containing 15,000 units and one containing 10,000 units. Fragmin is supplied in pre-mixed syringes containing the common doses - 2500 units, 5000 units, 15,000 units etc. Given that there is an available syringe which contains 2500 units, if she were given that dose, it would almost certainly be administered in one injection. Obviously none of us were there watching the nurse administer the medication, but I think she gives a convincing account of having been given 25,000 units of Fragmin.

How are you today op?

Did you get this sorted in the end?

Last night they went to give me the 25,000 again. I declined. Asked again why such a huge dose, nurse said to ask doctor when they come round.

Turns out they thought i may have a blood clot in my head!!!! And was treating me like i had one till i had a Head MRI today
(I havent btw)

So now fragmin has gone down to a basic amount... 2 or 3 thousand i think

Thank you