Greater Glasgow and Clyde Medicines

LMWH dose adjustments in renal impairment

The GGC guideline on low molecular weight heparin (LMWH) dose adjustments in renal impairment has been updated. For more information, please refer to the guideline available on StaffNet here.

Key messages

  • Creatinine clearance (CrCL) should be used when assessing the need for a dose adjustment in patients with renal impairment. This applies to LMWHs prescribed for prophylaxis or treatment.
  • The use of CrCL is in line with recommendations for dose adjustments from the manufacturers of most commonly used LMWHs across GGC.
  • To calculate CrCL, use the electronic calculator within the GGC Medicines App or on StaffNet here.
  • Patients with CrCL < 15 ml/min who require thromboprophylaxis, should now be prescribed dalteparin 2500 units once a day. If CrCl is > 15ml/min, refer to the guideline here.
  • When prescribing dalteparin for thromboprophylaxis, ensure that the word units is written in full and consider endorsing the Kardex with the following message to avoid misinterpretation and dosing errors: THROMBOPROPHYLAXIS – SEVERE RENAL IMPAIRMENT.
  • Recommendations in the GGC Adult Therapeutics Handbook will be reviewed in due course in order to align its advice with this updated guideline.


Originally published on 28/10/2020 and updated on 24/11/2020. Medicines Update blogs are correct at the time of publication.