Treat and prevent blood clots in blood vessels, arteries or lungs; used before surgery to reduce risk of blood clotting; hematological examination in the laboratory; to stop dangerous blood clots that may form in the hemodialysis machines.
Express dose in units only; dose must be individually titrated to desired effect (usually 1.5 - 2 .5 times control clotting test used).
1. Treatment of venous thrombosis or pulmonary embolus. Duration of therapy is 7 -10 days, then followed by oral anticoagulation.
i) Continuous IV solution: 50-100 units/kg initially: then 10-15 units/kg/hr (venous thrombosis) or 20 units/kg/hr (pulmonary embolus).
ii) Intermittent IV: 75-125 units/kg q 4 hr.
iii) Subcutaneous: 10,000-20,000 units initially (proceeded by a 5000 units IV loading dose), then 8000-10,000 units q 8 hr or 15,000-20,000 units q 12 hr.
2. SC for prophylaxis of deep vein thrombosis (low- dose) 5000 units 2 hr before surgery, repeated q 8-12 hr until patient is ambulatory.
3. IV for heparin lock flush inject sufficient solution (of 10-100 units/ml) into injection hub to fill the entire after each heparin lock use.
4 . Haemodialysis: 7500-12,500 IU (without preservative) is normally required per dialysis.
5 . Myocardial infarction: 5 ,000 IU s.c. every 12 hours beginning during the 12 hours following the first sign of myocardial infarction.
6. Intravenous administration: 5000-10,000 IU every 4 hours either by bolus injection or continuous infusion in Sodium Chloride injection or dextrose injection. However, the dose should be monitored with coagulation tests performed just before each administration and varies according to individual response. The clotting time should be 2-3 times the control value.
7. Subcutaneous administration (therapeutic dose): Subcutaneous administration of 10,000 IU may be given every 8 hours after the initial intravenous bolus injection of 5000 IU.
8. Low dosage heparin regimen: The usual recommended dose is 5000 IU by subcutaneous injection every 8 or 12 hours without laboratory control. This regimen administration to: all Hemostatically competent patients over the age 40 subjected to major elective abdominal or thoracic surgical procedure.
The first injection of this regimen (5000 IU) is started two hours before surgery and the treatment is continued for 7 days.
Heparin therapy is contraindicated in patients known to have hypersensitivity reaction, any uncontrolled active bleeding stage, thrombocytopenia and jaundice. It should not be used in the presence of actual or potential haemorrhagic stages, e.g. haemophilia, ascorbic acid deficiency or increased capillary fragility, threatened abortion, immediate postpartum period, subacute bacterial endocarditis, severe hypertension, suspected intracranial haemorrhage, gastric or duodenal ulcers, advanced renal or hepatic disease and after eye, brain or spinal cord surgery.
Heparinol contains benzyl alcohol, its use should be avoided in children below 2 years old and should not be used in neonates.
Heparin therapy should be monitored carefully to reduce the risk of overdosage, haemorrhage and serious adverse reactions such as delayed onset thrombocytopenia.
Risk factors for haemorrhage may include IM injections, trauma, recent surgery, women over 60 years, malignancy, peptic ulcer disease, potential bleeding sites and acquired or congenital homeostatic defects.
As heparin is derived from animal tissue (bovine mucous), it should be used with caution in patients with a history of allergy. Before a therapeutic dose is given to such a patient, a trial dose of 1000 units may be advisable.
Bleeding; blood clots occurs; Heparin Induced Thrombocytophenia; allergic reaction.
Co-administration with dicumarol or warfarin sodium; Risk of bleeding with salicylic acid; dextran, phenylbutazone; indomethacin; dipyridamole; hydroxychloroquine; and other drugs those related to platelet aggregation reaction; digitalis; tetracycline; nicotine or antihistamine.
B01AB01 - heparin ; Belongs to the class of heparin group. Used in the treatment of thrombosis.
Heparinol inj 5,000 IU/mL