heparin

Generic Name: heparin (flush) (HEP a rin)
Brand Name: Heparin Lock Flush, Monoject Prefill Advanced, PosiFlush

What is heparin flush?

Heparin is an anticoagulant (blood thinner) that prevents the formation of blood clots.

Heparin flush is used to flush (clean out) an intravenous (IV) catheter, which helps prevent blockage in the tube after you have received an IV infusion.

Heparin flush should not be used to treat or prevent blood clots in the body. A separate heparin product is available to use for this purpose.

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

What is the most important information I should know about heparin flush?

Heparin flush should not be used to treat or prevent blood clots in the body. A separate heparin product is available to use for this purpose.

You should not use this medication if you are allergic to heparin flush, or if you have uncontrolled bleeding or a severe lack of platelets in your blood.

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

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

Heparin flush can cause bleeding. 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 flush, 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 flush.

What should I discuss with my healthcare provider before taking heparin flush?

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 flush, tell your doctor if you have any of these other conditions:

  • any type of allergy;

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

  • uncontrolled high blood pressure;

  • recent history of heart attack, stroke, cancer, or surgery;

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

  • a stomach or intestinal disorder;

  • congestive heart failure;

  • kidney disease;

  • liver disease; or

  • if you are having a menstrual period.

FDA pregnancy category C. It is not known whether heparin flush will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Do not use this medication 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 flush.

Do not use heparin flush in a newborn baby (less than 1 month old). Do not use this medication in any child without your doctor's advice.

How should I use heparin flush?

Heparin flush is injected directly into the catheter lock of your IV line. You may be shown how to use heparin flush at home.

Do not self-inject heparin flush if you do not fully understand how to give the medication and properly dispose of used needles, IV tubing, and other items used to inject the medicine. Follow your doctor's instructions.

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

Store 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.

What should I avoid while taking heparin flush?

Certain medicines can increase your risk of bleeding while you are using heparin flush, 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 flush side effects

Heparin flush can cause bleeding. 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.

Get emergency medical help if you have any of these signs of an allergic reaction: nausea, vomiting, sweating, hives, itching, trouble breathing, swelling of your face, lips, tongue, or throat, or feeling like you might pass out..

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

  • feeling like you might pass out;

  • 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;

  • skin changes in your arms, legs, hands, or feet; or

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

Less serious side effects are more likely, and you may have none at all.

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 for Patency Maintenance of Indwelling Intravenous Devices:

Heparin flush, 10 or 100 units/mL, is injected as a single dose into an intravenous injection device using a volume of solution equivalent to that of the indwelling venipuncture device.

When using daily flushes of heparin to maintain patency of single and double lumen central catheters, 10 units/mL is commonly used for younger infants (less than 10 kg) while 100 units/mL is used for older infants, children, and adults.

A single dose should be injected following venipuncture when the indwelling device is not to be used immediately. After each use of the indwelling venipuncture device for injection or infusion of medication, or withdrawal of blood samples, another dose should be injected to restore the effectiveness of the heparin lock. The amount of heparin solution is sufficient to prevent clotting within the lumen of indwelling venipuncture devices (usually not holding more than 0.2 to 0.3 mL) for up to twenty-four hours.

When the indwelling device is used to administer a drug which is incompatible with heparin, the entire heparin lock set should be flushed with 0.9% Sodium Chloride Injection, USP before and after the medication is administered. Following the second flush, another dose of heparin solution should be injected to restore the effectiveness of the heparin lock. When the indwelling device is used for repeated withdrawal of blood samples for laboratory analyses and the presence of heparin or saline is likely to interfere with or alter results of the desired blood tests, the in situ heparin flush solution should be cleared from the device by aspirating and discarding 1 mL before the desired blood sample is drawn.

Usual Pediatric Dose for Patency Maintenance of Indwelling Intravenous Devices:

Arterial lines: Heparinize with a usual final concentration of 1 unit/mL; range: 0.5 to 2 units/mL; in order to avoid large total doses and systemic effects, use 0.5 unit/mL in low birth weight/premature newborns and in other patients receiving multiple lines containing heparin.

Peripheral arterial catheters in situ: Neonates and Children: Continuous IV infusion of heparin at a final concentration of 5 units/mL at 1 mL/hour.

Umbilical artery catheter (UAC) prophylaxis: Neonates: Low-dose heparin continuous IV infusion via the UAC with a heparin concentration of 0.25 to 1 unit/mL.

Prophylaxis for cardiac catheterization via an artery: Neonates and Children: IV: Bolus: 100 to 150 units/kg; for prolonged procedures, further doses may be required.

What other drugs will affect heparin flush?

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

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

  • cold or allergy medication that contains an antihistamine;

  • digoxin (digitalis, Lanoxin, Lanoxicaps);

  • dipyridamole (Persantine);

  • hydroxychloroquine (Plaquenil, Quineprox);

  • 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); 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 flush. 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 flush.
  • 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 by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. 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. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.02. Revision Date: 2013-12-03, 2:15:50 PM.

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