HEPARIN Injection
Heparin Sodium
5000 IU/ml
Paines & Byrne Limited
| Pack size | 5ml Vial |
|---|---|
| Dispensing mode | POM |
| Source | UK |
| Agent | NEW MEDICAL CENTRE |
| Retail Price | 8.00 AED |
Indications
HEPARIN Injection is used for:
Atrial fibrillation, Acute coronary syndrome, Unstable angina, Pulmonary embolism, Thromboembolism, Deep-vein thrombosis, Cardiopulmonary bypass, Hemofiltration, Peripheral arterial embolism
Adult Dose
DVT & Pulmonary Embolism
Prophylaxis
5000 units Subcutaneous(SC) q8-12hr, OR
7500 units SC q12hr
Treatment
80 units/kg IV bolus, THEN continuous infusion of 18 units/kg/hr, OR
5000 units IV bolus, THEN continuous infusion of 1300 units/hr, OR
250 units/kg (alternatively, 17,500 units) SC, THEN 250 units/kg q12hr
Acute Coronary Syndromes
PCI
Without GPIIb/IIIa inhibitor: Initial IV bolus of 70-100 units/kg (target ACT 250-300 sec)
With GPIIb/IIIa inhibitor: Initial IV bolus of 50-70 units/kg (target ACT >200 sec)
STEMI
Patient on fibrinolytics: IV bolus of 60 units/kg (max: 4000 units), THEN 12 units/kg/hr (max 1000 units/hr) as continuous IV infusion
Dose should be adjusted to maintain aPTT of 50-70 sec
Unstable Angina/NSTEMI
Initial IV bolus of 60-70 units/kg (max: 5000 units), THEN initial IV infusion of 12-15 units/kg/hr (max: 1000 units/hr)
Dose should be adjusted to maintain aPTT of 50-70 sec
Anticoagulation
Intermittent IV injection
8000-10,000 units IV initially, THEN 50-70 units/kg (5000-10,000 units) q4-6hr
Continuous IV infusion
5000 units IV injection, followed by continuous IV infusion of 20,000-40,000 units/24 hr
Catheter Patency
Prevention of clot formation within venous and arterial catheters
Use 100 units/mL; instill enough volume to fill lumen of catheter
Child Dose
Venous Thromboembolic Prophylaxis
100-150 units/kg IV once
Venous Thromboembolic Treatment
<1 year
Loading dose of 75 units/kg IV, THEN 28 units/kg/hr IV as initial maintenance dose
>1 year
Loading dose of 75 units/kg IV, THEN 20 units/kg/hr IV as initial maintenance dose
I
ntermittent IV injection
Initially give 50-100 units/kg IV infusion, THEN 100 units/kg IV infusion q4hr as a maintenance dose
Renal Dose
Administration
IV Preparation
Recommended infusion concentration for most patients is 25,000 units in 500 mL D5W (50 units/mL premixed infusion solution)
IV Administration
IV injection may be given undiluted or diluted in 50-100 mL NS or D5W
Infusion: Dilute in NS, D5W, or other compatible fluid
Continuous IV therapy is preferred because intermittent IV therapy produces a higher incidence of bleeding abnormalities
Contra Indications
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.
Precautions
Monitor platelet counts. Discontinue treatment if thrombocytopenia occurs. Hypersensitivity, elderly, pregnancy.
Lactation: Not excreted in breast milk; compatible
Pregnancy-Lactation
Pregnancy
There are no available data on heparin sodium injection use in pregnant women to inform a drug- associated risk of major birth defects and miscarriage; in published reports, heparin exposure during pregnancy did not show evidence of increased risk of adverse maternal or fetal outcomes in humans; no teratogenicity, but early embryo-fetal death reported in animal reproduction studies with administration of heparin sodium to pregnant rats and rabbits during organogenesis at doses approximately 10 times maximum recommended human dose (MRHD) of 45,000 units/ day; consider benefits and risks of heparin sodium Injection for mother and possible risks to fetus when prescribing heparin sodium injection to pregnant woman
If available, preservative-free injection recommended when heparin therapy needed during pregnancy
Lactation
There is no information regarding presence of heparin sodium injection in human milk, effects on breastfed infant, or on milk production; developmental and health benefits of breastfeeding should be considered along with mother's clinical need for heparin sodium injection and potential adverse effects on breastfed infant from therapy or from the underlying maternal condition
Interactions
Enhanced anticoagulant effect w/ other drugs affecting platelet function or the coagulation system (e.g. platelet aggregation inhibitors, thrombolytic agents, salicylates, NSAIDs, vit K antagonists, dextrans, activated protein C). Decreased anticoagulant effect w/ gyceryl trinitrate infusion. Increased risk of hyperkalaemia w/ ACE inhibitors or angiotensin II antagonists.
Adverse Effects
Side effects of Heparin Sodium :
>10%
Heparin-induced thrombocytopenia, possibly delayed (10-30% )
Frequency Not Defined
Mild pain, Hematoma, Hemorrhage, Local irritation, Erythema, Injection site ulcer (after deep SC injection), Increased liver aminotransferase, Anaphylaxis, Immune hypersensitivity reaction, Osteoporosis (long-term, high-dose use)
Potentially Fatal: Heparin-induced thrombocytopenia with or without thrombosis; bleeding.
Mechanism of Action
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.
Note
HEPARIN 5000 IU/ml Injection manufactured by Paines & Byrne Limited. Its generic name is Heparin Sodium. HEPARIN is availble in United Arab Emirates.
Farmaco UAE drug index information on HEPARIN Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.