heparin Intravenous, Subcutaneous

HEP-a-rin SOE-dee-um

Available Dosage Forms:

• Injectable


• Solution

Therapeutic Class: Anticoagulant

Pharmacologic Class: Heparin

Uses For heparin

Heparin injection is an anticoagulant. It is used to decrease the clotting ability of the blood and help prevent harmful clots from forming in blood vessels. heparin is sometimes called a blood thinner, although it does not actually thin the blood. Heparin will not dissolve blood clots that have already formed, but it may prevent the clots from becoming larger and causing more serious problems.

Heparin is used to prevent or treat certain blood vessel, heart, and lung conditions. Heparin is also used to prevent blood clotting during open-heart surgery, bypass surgery, kidney dialysis, and blood transfusions. It is used in low doses to prevent the formation of blood clots in certain patients, especially those who must have certain types of surgery or who must remain in bed for a long time. Heparin may also be used to diagnose and treat a serious blood condition called disseminated intravascular coagulation.

heparin is available only with your doctor's prescription.

Before Using heparin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For heparin, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to heparin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of heparin injection in children. However, because heparin contains benzyl alcohol, use in newborn babies is not recommended.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of heparin injection in the elderly. However, elderly patients are more likely to develop bleeding problems, which may require an adjustment in the dose for patients receiving heparin injection.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving heparin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using heparin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Abciximab


• Alprostadil


• Alteplase, Recombinant


• Anistreplase


• Antithrombin, Recombinant


• Argatroban


• Aspirin


• Bivalirudin


• Bromfenac


• Cefamandole


• Cefoperazone


• Celecoxib


• Chamomile


• Citalopram


• Clopidogrel


• Dabigatran Etexilate


• Dalteparin


• Danaparoid


• Desvenlafaxine


• Dextran


• Diclofenac


• Diflunisal


• Dipyridamole


• Drotrecogin Alfa


• Enoxaparin


• Eptifibatide


• Escitalopram


• Etodolac


• Fluoxetine


• Flurbiprofen


• Fluvoxamine


• Garlic


• Ginkgo


• Ibuprofen


• Ibuprofen Lysine


• Indomethacin


• Ketoprofen


• Ketorolac


• Magnesium Salicylate


• Mefenamic Acid


• Meloxicam


• Milnacipran


• Moxalactam


• Nabumetone


• Naproxen


• Nepafenac


• Nitroglycerin


• Oxaprozin


• Papaya


• Paroxetine


• Piroxicam


• Reteplase, Recombinant


• Rivaroxaban


• Salsalate


• Sertraline


• St John's Wort


• Streptokinase


• Sulindac


• Tan-Shen


• Tenecteplase


• Ticlopidine


• Tirofiban


• Tolmetin


• Urokinase


• Venlafaxine

Using heparin with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Avocado


• Chondroitin


• Coenzyme Q10


• Curcumin


• Dong Quai


• Ginger


• Green Tea


• Palifermin


• Vitamin A


• Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of heparin. Make sure you tell your doctor if you have any other medical problems, especially:

• Bacterial endocarditis (heart infection) or


• Bleeding problems (eg, hemophilia) or


• Hypertension (high blood pressure), severe or


• Liver disease or


• Major surgery (eg, eye, brain, or spine) or


• Menstrual bleeding (periods), heavy or unusual or


• Spinal anesthesia (numbing medicine placed in the back) or


• Stomach or intestinal ulcer—Use with caution. The risk of bleeding may be increased.

• Bleeding, active or


• Thrombocytopenia (low platelets in the blood) caused by heparin, history of or


• Thrombocytopenia (low platelets in the blood), severe—Should not be used in patients with these conditions.

Proper Use of heparin

A nurse or other trained health professional will give you heparin in a hospital. heparin is given through a needle placed in one of your veins or as a shot under your skin.

If you are using heparin at home, your doctor will explain how heparin is to be given. Your doctor will prescribe your exact dose and tell you how often it should be given.

Use heparin exactly as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

You will be shown the body areas where the shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas. This will help prevent skin problems from the shots.

It is recommended that you carry an identification card stating that you are using heparin. If you have any questions about what kind of identification to carry, check with your doctor.

Missed Dose

If you miss a dose of heparin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.

Precautions While Using heparin

It is very important that your doctor check you at regular visits after you leave the hospital for any problems or unwanted effects that may be caused by heparin. If you are using the medicine at home, blood tests will be needed to check for unwanted effects. Be sure to keep all appointments.

Do not take aspirin, ibuprofen, or other anti-inflammatory medicines (eg, NSAIDs) while you are using heparin. Many nonprescription (over-the-counter [OTC]) medicines and some prescription medicines contain these ingredients. Check the labels of all medicines you take. There are many other medicines that may change the way heparin works or increase the chance of bleeding if they are used together with heparin. It is best to check with your doctor before taking any other medicine while you are using heparin.

You may bleed and bruise more easily while you are using heparin. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Tell your doctor about any falls, blows to the body or head, or other injuries, since serious bleeding may occur inside the body with heparin. Be careful when using sharp objects, including razors and fingernail clippers. Avoid picking your nose. If you need to blow your nose, blow it gently. Check with your doctor right away if you notice any unusual bleeding or bruising; black, tarry stools; blood in the urine or stools; or pinpoint red spots on your skin.

Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.

heparin may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash; itching; swelling of the face, tongue, and throat; trouble breathing; or chest pain after you receive heparin.

heparin may cause new blood clots to form in some people while they are receiving the medicine or after it is stopped. Stop using heparin and check with your doctor right away if you have pain in the chest, groin, or legs, especially the calves; difficulty with breathing; a sudden, severe headache; slurred speech; a sudden, unexplained shortness of breath; a sudden loss of coordination; or vision changes while using heparin.

Make sure any doctor or dentist who treats you knows that you are using heparin. You may need to stop using heparin several days before having surgery or medical tests.

heparin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Less common

• Abdominal or stomach pain or swelling


• back pain or backaches


• bleeding from the gums when brushing teeth


• blood in the urine


• constipation


• coughing up blood


• dizziness


• headaches, severe or continuing


• heavy bleeding or oozing from cuts or wounds


• joint pain, stiffness, or swelling


• menstrual bleeding, unexpected or unusually heavy


• unexplained bruising or purplish areas on the skin


• unexplained nosebleeds


• vomiting of blood or material that looks like coffee grounds

Rare

• Blood under the skin (blood blister) at the place of injection


• chest pain


• chills or fever


• fast or irregular breathing


• irritation, pain, redness, or ulcers at the place of injection


• itching and burning feeling, especially on the bottom of the feet


• nausea or vomiting


• numbness or tingling in the hands or feet


• pain, coldness, or blue color of the skin on the arms or legs


• peeling of the skin


• puffiness or swelling of the eyelids or around the eyes


• shortness of breath


• skin color change, especially near the place of injection or in the fingers, toes, arms, or legs


• skin rash, hives, or itching


• tearing of the eyes


• tightness in the chest


• trouble with breathing


• wheezing

After you stop using heparin, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

• Black, tarry stools


• bleeding gums


• blood in the urine or stools


• pain in the chest, groin, or legs, especially calves of legs


• pinpoint red spots on the skin


• severe headaches of sudden onset


• sudden loss of coordination


• sudden shortness of breath for no apparent reason


• sudden slurred speech


• sudden vision changes


• unusual bleeding or bruising

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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