Indications |
Subcutaneous Venous thromboembolism Adult: 15,000 u injected every 12 hr. Child: 250 u/kg every 12 hr. Subcutaneous Prophylaxis of postoperative venous thromboembolism Adult: 5000 u given 2 hr before surgery then every 8-12 hr for 7 days or until the patient is ambulant, may increase to 10,000 u every 12 hr during the 3rd trimester of pregnancy. Subcutaneous Prophylaxis of mural thrombosis Adult: 12,500 u every 12 hr for at least 10 days. Intravenous Unstable angina Adult: 5000 u (10,000 u in severe pulmonary embolism) IV loading dose followed by 1000-2000 u/hr continuous infusion. Alternatively, intermittent inj of 5000-10,000 u every 4-6 hr. Child: Administer a lower loading dose. Maintenance: 15-25 u/kg/hr continuous infusion. Intravenous Venous thromboembolism Adult: 5000 u (10,000 u in severe pulmonary embolism) IV loading dose followed by 1000-2000 u/hr continuous infusion. Alternatively, intermittent inj of 5000-10,000 u every 4-6 hr. Child: Administer a lower loading dose. Maintenance: 15-25 u/kg/hr continuous infusion. Intravenous Peripheral arterial embolism Adult: 5000 u (10,000 u in severe pulmonary embolism) IV loading dose followed by 1000-2000 u/hr continuous infusion. Alternatively, intermittent inj of 5000-10,000 u every 4-6 hr. Child: Administer a lower loading dose. Maintenance: 15-25 u/kg/hr continuous infusion. Intravenous Prophylaxis of re-occlusion of the coronary arteries following thrombolytic therapy in myocardial infarction Adult: 5000 u IV followed by 1000 u/hr IV with alteplase. Incompatibility: Heparin calcium or sodium is reported to be incompatible with alteplase, reteplase, amikacin sulfate, amiodarone hydrochloride, ampicillin sodium, aprotinin, benzylpenicillin potassium or sodium, cefalotin sodium, ciprofloxacin lactate, cytarabine, dacarbazine, daunorubicin hydrochloride, diazepam, dobutamine hydrochloride, doxorubicin hydrochloride, droperidol, erythromycin lactobionate, gentamicin sulfate, haloperidol lactate, hyaluronidase, hydrocortisone sodium succinate, kanamycin sulfate, meticillin sodium, netilmicin sulfate, some opioid analgesics, oxytetracycline hydrochloride, some phenothiazines, polymyxin B sulfate, streptomycin sulfate, tetracycline hydrochloride, tobramycin sulfate, vancomycin hydrochloride and vinblastine sulfate. Heparin sodium has also been reported to be incompatible with cisatracurium besilate, labetalol hydrochloride, levofloxacin, nicardipine hydrochloride and vinorelbine tartrate. |
Contraindications |
Patients predisposed to active bleeding including thrombocytopenia, peptic ulcer disease, cerebrovascular disorders, haemorrhagic blood disorders, bacterial endocarditis, severe hypertension, oesophageal varices. Recent surgery at sites where haemorrhage would be an especial risk. Severe renal and hepatic impairment. Cerebral or subarachnoid haemorrhage, abdominal or thoracic bleeding into closed space, severe traumatic bleed, hepatic, renal, splenic or arterial injury, severe haemostatic defect, arterial thrombosis with heparin-associated thrombocytopenia. IM admin. |
Warnings / Precautions |
Monitor platelet counts. Discontinue treatment if thrombocytopenia occurs. Hypersensitivity, elderly, pregnancy. |
Adverse Reactions |
Slight fever, headache, chills, nausea, vomiting, constipation, epistaxis, bruising, slight haematuria, skin necrosis (SC inj), osteoporosis, alopecia. Hypersensitivity reactions include urticaria, conjunctivitis, rhinitis, asthma, angioedema and anaphylactic shock. Priapism. Potentially Fatal: Heparin-induced thrombocytopenia with or without thrombosis; bleeding. |
Overdose Reactions |
Slight haemorrhage can be treated by withdrawing heparin. Severe bleeding may be treated with IV protamine sulfate. |
Drug Interactions |
Inhibited by zinc. Antiplatelet drugs e.g. aspirin and dipyridamole may precipitate bleeding. Potentially Fatal: NSAIDs may increase risk of haemorrhage. Effect increased by dextrans, high doses of penicillin and cephalosporins, phenylbutazone, asparaginase. streptokinase and some contrast media. See Below for More heparin Drug Interactions |
Mechanism of Actions |
Heparin increases the inhibitory action of antithrombin III (AT III) on clotting factors XIIa, XIa, IXa, Xa and thrombin. This inhibits the conversion of prothrombin to thrombin and fibrinogen to fibrin. It also inhibits platelet function. It may reduce the activity of ATIII at very high doses. Absorption: Absorbed from systemic circulation (IV, SC). Distribution: Reticuloendothelial system. Protein-binding: Extensive. Excretion: Via urine (as metabolites, or up to 50% as unchanged after admin of large doses); 1-6 hr (elimination half-life), prolonged in renal impairment, decreased in pulmonary embolism, increased or decreased in hepatic impairment. |
Storage Conditions |
Intravenous: Store at 15-30°C. Subcutaneous: Store at 15-30°C. |
ATC Classification |
C05BA03 - heparin ; Belongs to the class of heparins or heparinoids used topically in antivaricose therapy. S01XA14 - heparin ; Belongs to the class of other ophthalmologicals. B01AB01 - heparin ; Belongs to the class of heparin group. Used in the treatment of thrombosis. |
Storage |
Intravenous: Store at 15-30°C. Subcutaneous: Store at 15-30°C. |
Available As |
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Heparin
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Heparin Containing Brands
Heparin is used in following diseases
Drug - Drug Interactions of Heparin
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