Heparin
Generic Name: heparin (injection) (HEP a rin)
Brand Names: Hep-Pak (obsolete), Heparin Lock Flush (obsolete), Hep-Pak CVC (obsolete), Hep-Lock (obsolete), Heparin Sodium ADD-Vantage
Brand Names: Hep-Pak (obsolete), Heparin Lock Flush (obsolete), Hep-Pak CVC (obsolete), Hep-Lock (obsolete), Heparin Sodium ADD-Vantage
What is heparin injection?
Heparin is an anticoagulant (blood thinner) that prevents the formation of blood clots.
Heparin is used to treat and prevent blood clots in the veins, arteries, or lung. Heparin is also used before surgery to reduce the risk of blood clots.
Heparin injection should not be used to flush (clean out) an intravenous (IV) catheter. A separate heparin product is available to use as catheter lock flush.
Important information
Heparin injection should not be used to flush (clean out) an intravenous (IV) catheter. A separate heparin product is available to use as catheter lock flush.
You should not use heparin if you have uncontrolled bleeding or a severe lack of platelets in your blood.
Heparin increases your risk of bleeding, which can be severe or life-threatening. You will need frequent tests to measure your blood-clotting time.
10 Common Symptoms That Should Never Be Ignored
SLIDESHOW
10 Common Symptoms That Should Never Be Ignored
Call your doctor or seek emergency medical attention if you have unusual bleeding or bruising, severe stomach or back pain, unusual tiredness, a nosebleed, blood in your urine or stools, coughing up blood, or any bleeding that will not stop.
Heparin can cause you to have bleeding episodes while you are using it and for several weeks after you stop.
Certain medicines can increase your risk of bleeding while you are using heparin, such as aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) including ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), nabumetone (Relafen), piroxicam (Feldene), and others. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
Before taking this medicine
You should not use this medicine if you are allergic to heparin or pork products, or if you have:
a severe lack of platelets in your blood; or
uncontrolled bleeding.
To make sure heparin is safe for you, tell your doctor if you have ever had:
an infection of the lining of your heart (also called bacterial endocarditis);
uncontrolled high blood pressure;
a bleeding or blood clotting disorder;
a stomach or intestinal disorder;
liver disease;
if you use a blood thinner (warfarin, Coumadin, Jantoven) and you have routine "INR" or prothrombin time tests; or
if you are having a menstrual period.
It is not known whether heparin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
Do not use heparin without telling your doctor if you are breast-feeding a baby.
Women over 60 years of age may be more likely to have bleeding episodes while using heparin.
How should I use heparin injection?
Heparin is injected under the skin or into a vein through an IV. You may be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of needles, IV tubing, and other items used.
Do not use the medicine if it has changed colors or has particles in it. Call your pharmacist for new medicine.
You may be switched from injectable heparin to an oral (taken by mouth) blood thinner. Do not stop using the heparin until your doctor tells you to. You may need to use both the injection and the oral forms of heparin for a short time.
Use a disposable needle and syringe only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.
To be sure heparin is helping your condition, you may need frequent blood tests. The timing of these tests is very important in helping your doctor determine whether it is safe for you to continue using heparin.
Store at room temperature away from moisture and heat.
See also: Dosage Information (in more detail)
What happens if I miss a dose?
Call your doctor for instructions if you miss a dose of heparin.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include easy bruising, nosebleeds, blood in your urine or stools, black or tarry stools, or any bleeding that will not stop.
What should I avoid while using heparin injection?
Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with heparin may cause you to bleed more easily.
Heparin injection side effects
Get emergency medical help if you have signs of an allergic reaction to heparin: nausea, vomiting, sweating, hives, itching, trouble breathing, swelling of your face, lips, tongue, or throat, or feeling like you might pass out.
Heparin may cause you to bleed more easily, which can be severe or life-threatening. You may also have bleeding on the inside of your body. Seek emergency medical attention if you have:
any unusual bleeding or bruising;
severe pain in your stomach, lower back, or groin;
swelling or bruising in your lower stomach or groin area;
nausea, vomiting, loss of appetite;
unusual tiredness;
any bleeding that will not stop; or
other signs of bleeding, such as a nosebleed, blood in your urine or stools, black or tarry stools, or coughing up blood or vomit that looks like coffee grounds.
Heparin can cause you to have bleeding episodes while you are using it and for several weeks after you stop.
Stop using heparin and call your doctor at once if you have:
signs of a blood clot - sudden numbness or weakness, severe headache, slurred speech, problems with speech or vision, chest pain, sudden cough, wheezing, swelling or warmth in one or both legs;
fever, chills, runny nose, or watery eyes;
trouble breathing; or
(in an infant) extreme drowsiness, weakness, or gasping for breath.
Common heparin side effects may include:
mild pain, redness, warmth, or skin changes where the medicine was injected;
mild itching of your feet; or
bluish-colored skin.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Heparin dosing information
Usual Adult Dose of Heparin for Deep Vein Thrombosis:
The manufacturer provides the following dosing guidelines based on clinical experience:
Continuous IV infusion:
-Initial dose: 5000 units by IV injection
-Maintenance dose: 20,000 to 40,000 units per 24 hours by continuous IV infusion
Intermittent IV injection:
-Initial dose: 10,000 units IV
-Maintenance dose: 5000 to 10,000 units IV every 4 to 6 hours
Deep subcutaneous (intrafat) injection:
333 units/kg subcutaneously followed by 250 units/kg subcutaneously every 12 hours; the following dosage regimen has also been recommended: 5000 units by IV injection followed by 10,000 to 20,000 units subcutaneously, and then 8000 to 10,000 units subcutaneously every 8 hours or 15,000 to 20,000 units subcutaneously every 12 hours.
Comments:
-Recommended doses are based on a 68 kg patient.
-Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions.
-Dosage and administration must be individualized according to the results of suitable laboratory tests.
Uses:
-Prophylaxis and treatment of venous thrombosis and pulmonary embolism.
-Prophylaxis and treatment of thromboembolic complications associated with atrial fibrillation.
-Treatment of acute and chronic consumption coagulopathies (disseminated intravascular coagulation).
-Prophylaxis and treatment of peripheral arterial embolism.
5000 units subcutaneously 2 hours before surgery and 5000 units subcutaneously every 8 to 12 hours thereafter for 7 days or until the patient is ambulatory, whichever is longer.
Comments:
-Administer by deep subcutaneous (intrafat, e.g., above the iliac crest or abdominal fat layer, arm, or thigh) injection with a fine (25 to 26 gauge) needle to minimize tissue trauma.
-Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions.
-Dosage and administration must be individualized according to the results of suitable laboratory tests.
Use: Low-dose regimen for prevention of postoperative deep venous thrombosis and pulmonary embolism in patients greater than 40 years old undergoing major abdominothoracic surgery or who, for other reasons, are at risk of developing thromboembolic disease.
Usual Adult Dose of Heparin for Deep Vein Thrombosis -- Prophylaxis:
The manufacturer provides the following dosing guidelines based on clinical experience:
Continuous IV infusion:
-Initial dose: 5000 units by IV injection
-Maintenance dose: 20,000 to 40,000 units per 24 hours by continuous IV infusion
Intermittent IV injection:
-Initial dose: 10,000 units IV
-Maintenance dose: 5000 to 10,000 units IV every 4 to 6 hours
Deep subcutaneous (intrafat) injection:
333 units/kg subcutaneously followed by 250 units/kg subcutaneously every 12 hours; the following dosage regimen has also been recommended: 5000 units by IV injection followed by 10,000 to 20,000 units subcutaneously, and then 8000 to 10,000 units subcutaneously every 8 hours or 15,000 to 20,000 units subcutaneously every 12 hours.
Comments:
-Recommended doses are based on a 68 kg patient.
-Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions.
-Dosage and administration must be individualized according to the results of suitable laboratory tests.
Uses:
-Prophylaxis and treatment of venous thrombosis and pulmonary embolism.
-Prophylaxis and treatment of thromboembolic complications associated with atrial fibrillation.
-Treatment of acute and chronic consumption coagulopathies (disseminated intravascular coagulation).
-Prophylaxis and treatment of peripheral arterial embolism.
5000 units subcutaneously 2 hours before surgery and 5000 units subcutaneously every 8 to 12 hours thereafter for 7 days or until the patient is ambulatory, whichever is longer.
Comments:
-Administer by deep subcutaneous (intrafat, e.g., above the iliac crest or abdominal fat layer, arm, or thigh) injection with a fine (25 to 26 gauge) needle to minimize tissue trauma.
-Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions.
-Dosage and administration must be individualized according to the results of suitable laboratory tests.
Use: Low-dose regimen for prevention of postoperative deep venous thrombosis and pulmonary embolism in patients greater than 40 years old undergoing major abdominothoracic surgery or who, for other reasons, are at risk of developing thromboembolic disease.
Usual Adult Dose of Heparin for Prevention of Thromboembolism in Atrial Fibrillation:
The manufacturer provides the following dosing guidelines based on clinical experience:
Continuous IV infusion:
-Initial dose: 5000 units by IV injection
-Maintenance dose: 20,000 to 40,000 units per 24 hours by continuous IV infusion
Intermittent IV injection:
-Initial dose: 10,000 units IV
-Maintenance dose: 5000 to 10,000 units IV every 4 to 6 hours
Deep subcutaneous (intrafat) injection:
333 units/kg subcutaneously followed by 250 units/kg subcutaneously every 12 hours; the following dosage regimen has also been recommended: 5000 units by IV injection followed by 10,000 to 20,000 units subcutaneously, and then 8000 to 10,000 units subcutaneously every 8 hours or 15,000 to 20,000 units subcutaneously every 12 hours.
Comments:
-Recommended doses are based on a 68 kg patient.
-Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions.
-Dosage and administration must be individualized according to the results of suitable laboratory tests.
Uses:
-Prophylaxis and treatment of venous thrombosis and pulmonary embolism.
-Prophylaxis and treatment of thromboembolic complications associated with atrial fibrillation.
-Treatment of acute and chronic consumption coagulopathies (disseminated intravascular coagulation).
-Prophylaxis and treatment of peripheral arterial embolism.
