Generic Name: heparin (injection) (HEP a rin)
Brand Names: Heparin Sodium ADD-Vantage

What is heparin?

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 product is available to use as catheter lock flush.

Heparin may also be used for purposes not listed in this medication guide.

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 this medication if you are allergic to heparin, or if you have uncontrolled bleeding or a severe lack of platelets in your blood.

Before using heparin, tell your doctor if you have high blood pressure, an infection involving your heart, hemophilia or other bleeding disorder, a stomach or intestinal disorder, liver disease, or if you are on your period.

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Heparin can cause you to have bleeding episodes while you are using it and for several weeks after you stop. Call your doctor at once if you have easy bruising or unusual bleeding, such as a nosebleed, black or bloody tarry stools, or any bleeding that will not 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.

Women over 60 years of age may be more likely to have bleeding episodes while using heparin.

Before using heparin

You should not use this medication if you are allergic to heparin, or if you have:

  • a severe lack of platelets in your blood; or

  • uncontrolled bleeding.

To make sure you can safely use heparin, tell your doctor if you have any of these other conditions:

  • an infection of the lining of your heart (also called bacterial endocarditis);

  • uncontrolled high blood pressure;

  • a bleeding or blood clotting disorder, such as hemophilia;

  • a stomach or intestinal disorder;

  • liver disease; or

  • if you are having a menstrual period.

FDA pregnancy category C. It is not known whether heparin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Do not use heparin without telling your doctor if you are breast-feeding a baby.

See also: Pregnancy and breastfeeding warnings (in more detail)

Women over 60 years of age may be more likely to have bleeding episodes while using heparin.

How should I use heparin?

Heparin is injected under the skin or into a vein through an IV. You may be shown how to use an IV at home.

Do not self-inject heparin if you do not fully understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

Do not use the heparin injection if it has changed colors or has particles in it. Call your doctor for a new prescription.

You may be switched from injectable heparin to an oral (taken by mouth) blood thinner. Do not stop using this medicine until your doctor tells you to. You may need to use both the injection and the oral forms of heparin for a short time.

Store heparin at room temperature away from moisture and heat.

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?

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.

Heparin side effects

Heparin can cause you to have bleeding episodes while you are using it and for several weeks after you stop. Call your doctor at once if you have easy bruising or unusual bleeding, such as a nosebleed, blood in your urine or stools, black or tarry stools, or any bleeding that will not stop. Get emergency medical help if you have any of these 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.

Some people receiving a heparin injection have had a reaction to the infusion (when the medicine is injected into the vein). Tell your caregiver right away if you feel nauseated, light-headed, sweaty, or short of breath during or after a heparin injection.

Stop using heparin and call your doctor at once if you have any of these serious side effects:

  • sudden numbness or weakness, especially on one side of the body;

  • sudden severe headache, confusion, problems with vision, speech, or balance;

  • chest pain, sudden cough, wheezing, rapid breathing, fast heart rate;

  • pain, swelling, warmth, or redness in one or both legs;

  • trouble breathing;

  • (in an infant) extreme drowsiness, weakness, or gasping for breath; or

  • fever, chills, runny nose, or watery eyes.

Less serious heparin side effects may include:

  • mild pain, redness, warmth, or skin changes where the heparin 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 Heparin Dose for Deep Vein Thrombosis:

Continuous IV Infusion: 5000 units IV one time as a bolus dose followed by 1300 units/hour by continuous IV infusion. Alternatively, a bolus dose of 80 units/kg IV one time followed by 18 units/kg/hour by continuous IV infusion may be used.
Intermittent subcutaneous injection: 17,500 units subcutaneously every 12 hours.
The dosage should be adjusted to maintain the aPTT at 1.5 to 2.5 times control.

Usual Adult Dose for Deep Vein Thrombosis -- Prophylaxis:

5000 units subcutaneously every 8 to 12 hours. This dosage may be adjusted to maintain the aPTT at the upper end of the normal range.

Usual Adult Heparin Dose for Pulmonary Embolism:

Continuous IV Infusion: 5000 units IV one time as a bolus dose followed by 1300 units/hour by continuous IV infusion. Alternatively, a bolus dose of 80 units/kg IV one time followed by 18 units/kg/hour by continuous IV infusion may be used.
If it is suspected that the patient has experienced a massive pulmonary embolism, a more appropriate initial dosage may be an IV bolus of 10,000 units followed by 1500 units/hour.
Intermittent subcutaneous injection: 17,500 units subcutaneously every 12 hours.
The dosage should be adjusted to maintain the aPTT at 1.5 to 2.5 times control.

Usual Adult Dose for Myocardial Infarction:

5000 units IV one time as a bolus dose followed by 1000 units/hour by continuous IV infusion.

Usual Adult Heparin Dose for Angina Pectoris:

5000 units IV one time as a bolus dose followed by 1000 units/hour by continuous IV infusion.

Usual Adult Dose for Anticoagulation During Pregnancy:

5000 units subcutaneously every 12 hours. This dosage may be adjusted to maintain the 6-hour aPTT at 1.5 times control or greater.

Usual Adult Heparin Dose for Thrombotic/Thromboembolic Disorder:

100 units/mL every 6 to 8 hours for PVC catheters and peripheral heparin locks. Additional flushes should be given when stagnant blood is observed in catheter, after catheter is used for drug or blood administration, and after blood withdrawal from catheter.

Addition of 0.5 to 1 unit/mL to peripheral and central TPN has been shown to increase duration of line patency. Arterial lines are heparinized with a final concentration of 1 unit/mL.

Usual Pediatric Dose for Thrombotic/Thromboembolic Disorder:

IV line flush:
Infant Dose: 10 units/mL every 6 to 8 hours.

Child Dose: 100 units/mL every 6 to 8 hours for PVC catheters and peripheral heparin locks. Additional flushes should be given when stagnant blood is observed in catheter, after catheter is used for drug or blood administration, and after blood withdrawal from catheter.

Addition of 0.5 to 1 unit/mL to peripheral and central TPN has been shown to increase duration of line patency. Arterial lines are heparinized with a final concentration of 1 unit/mL.

What other drugs will affect heparin?

Tell your doctor about all other medicines you use, especially:

  • another blood thinner, such as warfarin (Coumadin, Jantoven);

  • digoxin (digitalis, Lanoxin, Lanoxicaps);

  • dipyridamole (Persantine);

  • hydroxychloroquine (Plaquenil, Quineprox);

  • ibuprofen (Advil, Motrin);

  • indomethacin (Indocin);

  • nicotine cigarettes, gum, lozenges, or skin patches;

  • nitroglycerin (Nitro Dur, Nitrolingual, Nitrostat, Transderm Nitro, and others);

  • an antibiotic such as demeclocycline (Declomycin), doxycycline (Adoxa, Alodox, Avidoxy, Oraxyl, Doryx, Oracea, Vibramycin), minocycline (Dynacin, Minocin, Solodyn), or tetracycline (Ala-Tet, Brodspec, Panmycin, Sumycin, Tetracap);

  • cold, allergy, or sleep medications (Allerest, Benadryl, Chlor-Trimeton, Dimetapp, Sominex, Tylenol PM, and others); or

  • salicylates such as aspirin, Nuprin Backache Caplet, Kaopectate, KneeRelief, Pamprin Cramp Formula, Pepto-Bismol, Tricosal, Trilisate, and others.

This list is not complete and other drugs may interact with heparin. 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.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about heparin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.

Copyright 1996-2014 Cerner Multum, Inc. Version: 9.02. Revision Date: 2013-10-14, 11:04:03 AM.

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