Heparin - Instructions For Use, Indications, Doses, Analogues

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Heparin

Instructions for use:

1. 1. Release form and composition
2. 2. Indications for use
3. 3. Contraindications
4. 4. Method of application and dosage
5. 5. Side effects
6. 6. Special instructions
7. 7. Drug interactions
8. 8. Analogs
9. 9. Terms and conditions of storage
10. 10. Terms of dispensing from pharmacies

Prices in online pharmacies:

from 66 rubles.

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Heparin is a direct-acting anticoagulant.

Release form and composition

Dosage forms of the drug:

• Solution for intravenous (i / v) and subcutaneous (s / c) administration: light yellow or colorless transparent liquid (bottle (bottle) 1 ml, 5 or 10 pcs. In a blister strip or plastic (pallets) packaging, in a cardboard box 1 or 2 packs; 5 or 10 pieces in a cardboard box without packaging. Ampoule 1 ml with an ampoule knife, 5 or 10 pieces in a blister strip or plastic (pallets) packaging, in a cardboard box 1 or 2 packages; 5 or 10 pieces in a carton pack without packaging Ampoule 2 ml with an ampoule knife, 5 pieces in a blister, in a carton pack 1 or 2. Ampoule 5 ml with an ampoule knife, 5 or 10 pieces in a contour cell or plastic (pallets) packaging, in a pack of cardboard 1 or 2. Ampoule 5 ml with an ampoule knife, 5 or 10 pcs in a pack of cardboard Ampoule 5 ml, 5 or 10 pcs. in a pack of cardboard. Bottle (bottle) 5 ml, 5 or 10 pcs. in a contour acheikova or plastic packaging (pallets), in a cardboard box 1 or 2 packages. Bottle (bottle) 5 ml, 1, 5 or 10 pcs. in a cardboard box. Polymer ampoule 5 ml, 5 pcs. in a cardboard box. Bottle (bottle) 5 ml, 5 pcs. in a polystyrene container);
• Ointment for external use (10 or 25 g in aluminum tubes, in a cardboard box 1 tube);
• Gel for external use (15, 20, 30, 50 or 100 g each in aluminum tubes, 1 tube in a cardboard box).

The active ingredient is sodium heparin:

• 1 ml of solution - 5000 IU;
• 1 g of ointment - 100 IU;
• 1 g of gel - 1000 IU.

Auxiliary components:

• Solution: sodium chloride - 3.4 mg, benzyl alcohol - 9 mg, water for injection up to 1 ml;
• Ointment: benzocaine - 40 mg, benzyl nicotinate - 0.8 mg.

Indications for use

• Therapy and prevention: thrombophlebitis, pulmonary embolism (including in the case of peripheral vein diseases), deep vein thrombosis, coronary artery thrombosis, unstable angina pectoris, acute myocardial infarction, atrial fibrillation (including accompanied by embolism), syndrome disseminated intravascular coagulation (DIC), microcirculation and microthrombus formation disorders, renal vein thrombosis, hemolytic uremic syndrome, bacterial endocarditis, glomerulonephritis, lupus nephritis;
• Prevention: blood clotting during operations in which extracorporeal blood circulation methods are used, mitral heart disease, hemodialysis, peritoneal dialysis, hemosorption, forced diuresis, cytapheresis;
• Flushing of venous catheters;
• Preparation of non-clotting blood samples for laboratory use and blood transfusion.

Contraindications

Contraindications to the use of Heparin in the form of a solution:

• History or current heparin-induced thrombocytopenia, with or without thrombosis;
• Pregnancy and breastfeeding period;
• Bleeding if the potential risk outweighs the intended benefit of the application.

The solution is prescribed with caution in pathological conditions associated with an increased risk of bleeding:

• Traumatic brain injury, hemorrhagic stroke;
• Malignant neoplasms;
• Cardiovascular system: cerebral aneurysm, acute and subacute infective endocarditis, severe uncontrolled arterial hypertension, aortic dissection;
• Organs of the lymphatic system and hematopoiesis: hemorrhagic diathesis, leukemia, hemophilia, thrombocytopenia;
• Ulcerative colitis, erosive and ulcerative lesions of the gastrointestinal tract (GIT), varicose veins of the esophagus, prolonged use of gastric and small intestinal drains, hemorrhoids;
• Congenital deficiency of antithrombin III synthesis and replacement therapy with antithrombin III drugs (to reduce the risk of bleeding, small doses of the drug should be used).

Other physiological conditions and pathologies in which the Heparin solution should be used with caution: chronic renal failure; severe liver disease with impaired protein-synthetic function; vasculitis; proliferative diabetic retinopathy; recent surgical interventions on the spinal cord or brain, eyes; early postpartum period; recent epidural anesthesia or lumbar puncture; threatening abortion; period of menstruation.

It is recommended to use the solution under close medical supervision when treating children under the age of 3 years and patients over 60 years old, especially women.

Contraindications to the use of ointment and gel:

• Diseases accompanied by impaired blood coagulation, bleeding, cerebral aneurysm, hypothesis of intracranial hemorrhage, hemorrhagic stroke, dissecting aortic aneurysm, malignant arterial hypertension, subacute bacterial endocarditis, antiphospholipid syndrome;
• Erosive and ulcerative lesions of the gastrointestinal tract, malignant neoplasms in the liver, severe lesions of the liver parenchyma, cirrhosis of the liver with varicose veins of the esophagus, shock conditions;
• The recovery period after surgery on the liver and biliary tract, brain, eyes, prostate gland, spinal cord puncture;
• Recent childbirth, menstruation, threatened miscarriage.

Ointment and gel should not be applied for ulcerative necrotic processes, on mucous membranes or open wounds.

Application of an ointment or gel during pregnancy and during breastfeeding (lactation) is possible under close medical supervision, only on strict indications.

The use of all dosage forms of Heparin is contraindicated in patients with hypersensitivity to the components of the drug.

Method of administration and dosage

The solution is administered by intravenous drip or bolus and subcutaneous injection into the abdomen. Do not inject the drug intramuscularly! Dosing is prescribed by the doctor based on clinical indications and taking into account the patient's age. Usually, treatment begins with an intravenous injection of 5000 IU, then switches to subcutaneous injections or intravenous drip.

Maintenance dosage depending on the method of application of the solution:

• Continuous intravenous infusion - 24000-48000 IU per day at a rate of 1000-2000 IU per hour;
• Regular intravenous injections - 5000-10000 IU with an interval of 4-6 hours;
• Subcutaneous injections - 15,000-20,000 IU 2 times or 8,000-10000 IU - 3 times a day.

For infusion administration, the drug is diluted with 0.9% sodium chloride solution. Correction of each subsequent dose is made on the basis of regular studies of activated partial thromboplastin time (APTT) and / or blood clotting time. With the subcutaneous administration of 10,000-15,000 IU per day, regular monitoring of APTT is not necessary.

The period of treatment depends on the route of administration and indications. The drug is used intravenously for 7-10 days, then treatment should be continued with oral anticoagulants. Oral anticoagulants are recommended to be prescribed from the first or from 5 to 7 days of treatment, the withdrawal of the solution is prescribed on the 4-5 day of the combined treatment.

The use of Heparin in special clinical situations is carried out according to a special scheme.

Ointment and gel are used depending on the clinical indications and the patient's age.

Side effects

• On the part of the blood coagulation system: thrombocytopenia in a transient and severe form, in rare cases with a fatal outcome, can cause the development of skin necrosis, arterial thrombosis, gangrene, stroke, myocardial infarction; hemorrhagic complications in the form of bleeding of the gastrointestinal tract or urinary tract, retroperitoneal hemorrhages in the ovaries, adrenal glands with the risk of developing acute adrenal insufficiency;
• From the digestive tract: nausea, vomiting, diarrhea, decreased appetite, increased levels of transaminases in the blood;
• On the part of the musculoskeletal system: in the case of prolonged use - soft tissue calcification, osteoporosis and spontaneous fractures;
• Allergic reactions: urticaria, pruritus, skin flushing, bronchospasm, rhinitis, drug fever, anaphylactoid reactions, anaphylactic shock;
• Local reactions: pain, hematoma, bleeding, hyperemia or ulceration at the injection site;
• Others: inhibition of aldosterone synthesis, transient alopecia.

special instructions

Long-term treatment with large doses is recommended in stationary conditions.

The use of the solution should take place taking into account the indicators of blood coagulation, in case of a sharp decrease in the number of platelets, the use of the drug should be immediately discontinued.

In the case of prescribing the drug in high doses or in the absence of a response to Heparin, it is necessary to control the level of antithrombin III.

It is not recommended to administer other drugs intramuscularly while using the drug solution.

In patients with arterial hypertension, treatment should be accompanied by regular monitoring of blood pressure.

The drug should be used with caution in patients with radiation therapy, dental procedures, active tuberculosis, in the presence of an intrauterine contraceptive.

When treating women over 60 years of age, the use of sodium heparin can increase bleeding, so this category of patients should reduce the dose of the solution.

Adequate dosing, regular monitoring of blood clotting, and careful assessment of contraindications reduce the risk of bleeding.

Drug interactions

Heparin solution is compatible only with 0.9% sodium chloride solution.

Sodium heparin enhances the effect of drugs containing benzodiazepine derivatives, phenytoin, propranolol, quinidine.

The activity of the drug is reduced by tricyclic antidepressants, protamine sulfates, polypeptides.

The anticoagulant effect of the drug is enhanced by the simultaneous use of thrombolytic agents (alteplase, urokinase, streptokinase), antiplatelet agents (acetylsalicylic acid, dipyridamole, clopidogrel, ticlopidine, prasugrel), indirect anticoagulants (warfarin, non-inflammatory drugs), NSAIDs, NSAIDs.

The risk of bleeding increases the simultaneous use of Heparin with dextran, glucocorticosteroids, cytostatics, hydroxychloroquine, cefamandole, valproic and ethacrynic acid, propylthiouracil.

The anticoagulant effect of the drug reduces the simultaneous intake of corticotropin, ascorbic acid, nitroglycerin, ergot alkaloids, quinine, nicotine, tetracycline, cardiac glycosides, antihistamines or thyroxine.

The drug can reduce the effect of glucocorticosteroids, adrenocorticotropic hormone, insulin.

Analogs

Analogs of Heparin are: Heparin-Sodium Brown, Heparin-Ferein, Heparin-Richter, Heparin J, Heparin-Akrihin 1000, Heparin-Sandoz, Lioton 1000, Lavenum, Trombless.

Terms and conditions of storage

Keep out of the reach of children, dry, protected from light at a temperature: solution and gel - no higher than 25 ° C; ointment - up to 20 ° C.

Shelf life: solution, ointment - 3 years; gel - 2 years.

Terms of dispensing from pharmacies

The solution is available with a prescription, and the gel and ointment are available without a prescription.

Heparin: prices in online pharmacies

Drug name Price Pharmacy

Heparin ointment for external use tube 25 g RUB 66 Buy

Heparin gel 1000 IU / g gel for external use 30 g 1 pc. 227 r Buy

Heparin 1000 1 thousand IU / g gel for external use 30 g 1 pc. 230 RUB Buy

Heparin 1000 for outdoor use approx. 1000 IU / g 30g 254 r Buy

Heparin gel 1000 IU / g gel for external use 50 g 1 pc. 265 RUB Buy

Heparin gel 1000 IU / g gel for external use 100 g 1 pc. 765 RUB Buy

Heparin 5000 IU / ml solution for intravenous and subcutaneous administration 5 ml 5 pcs. RUB 1577 Buy

Heparin 5000 IU / ml injection 5 ml 5 pcs. 1694 RUB Buy

Sodium heparin 5000 IU / ml solution for intravenous and subcutaneous administration 5 ml 5 pcs. 1863 RUB Buy

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Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!