Donanemab-Azbt and Dalteparin Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Dalteparin Injection
Donanemab-Azbt
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased risk of amyloid related imaging abnormalities (ARIA), or intracerebral hemorrhage
Interaction Deep Dive
Exert caution when donanemab-azbt is coadministered with anticoagulants as it may increase risk for intracerebral hemorrhage and in particular for patients who need to be on anticoagulant therapy or patients with findings on MRI that are suggestive of cerebral amyloid angiopathy. In a drug interaction study, baseline use of antithrombotic medication (anticoagulants) was allowed. The incidence of ARIA with hemosiderin deposition (ARIA-H) was 30% (106/349) in patients taking donanemab-azbt with a concomitant antithrombotic medication within 30 days compared to 29% (148/504) who did not receive an antithrombotic within 30 days of an ARIA-H event. The incidence of intracerebral hemorrhage greater than 1 cm in diameter was 0.6% (2/349 patients) in patients taking donanemab-azbt with a concomitant antithrombotic medication compared to 0.4% (2/504) in those who did not receive an antithrombotic. The number of events and the limited exposure to non-aspirin antithrombotic medications limit definitive conclusions about the risk of ARIA or intracerebral hemorrhage in patients taking antithrombotic medications1. The Alzheimer's Disease and Related Disorders Therapeutic Workgroup recommends against the use of donanemab in patients on anticoagulant therapy, including warfarin, vitamin K antagonists, direct oral anticoagulants such as dabigatran, rivaroxaban, edoxaban, apixaban, or betrixaban, or heparin 2.
Why it happens (mechanism)
Additive effects on bleeding
Literature reports
2 reports — tap to read
a) The Alzheimer's Disease and Related Disorders Therapeutic Workgroup recommends against the use of donanemab in patients on anticoagulant therapy, including warfarin, vitamin K antagonists, direct oral anticoagulants such as dabigatran, rivaroxaban, edoxaban, apixaban, or betrixaban, or heparin. Concomitant use may increase the risk of macrohemorrhage associated with amyloid-related imaging abnormalities (ARIA). An increased risk of macrohemorrhages was observed with anticoagulant use and lecanemab, a similar medication 2.
b) In a study, safety was assessed in patients who received donanemab-azbt dosing regimen 1 (n=853) compared to those who received placebo (n=874), baseline use of antithrombotic medication (anticoagulants) was allowed. The incidence of ARIA with hemosiderin deposition (ARIA-H) was 30% (106/349) in patients taking donanemab-azbt with a concomitant antithrombotic medication within 30 days compared to 29% (148/504) who did not receive an antithrombotic within 30 days of an ARIA-H event. The incidence of intracerebral hemorrhage greater than 1 cm in diameter was 0.6% (2/349 patients) in patients taking donanemab-azbt with a concomitant antithrombotic medication compared to 0.4% (2/504) in those who did not receive an antithrombotic. The number of events and the limited exposure to non-aspirin antithrombotic medications limit definitive conclusions about the risk of ARIA or intracerebral hemorrhage in patients taking antithrombotic medications 1.
Common questions
Can I take Donanemab-Azbt and Dalteparin Injection together?
An increased risk of amyloid related imaging abnormalities (ARIA), or intracerebral hemorrhage Always confirm with your pharmacist or prescriber before making any change.
How serious is the Donanemab-Azbt and Dalteparin Injection interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Donanemab-Azbt or Dalteparin Injection need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (2)
Keep reading about Dalteparin Injection
Keep reading about Donanemab-Azbt
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