What is heparin, and how does it work (mechanism of action)?
Heparin is a widely used
injectable anticoagulant (stops the formation of blood clots). The blood
coagulation system is composed of various steps and heparin acts at multiple
sites in this process. Heparin prevents blood clots by blocking the action of
two of the 12 clot-promoting proteins in blood (factors X and II) whose action
is necessary for blood to clot. The FDA approved heparin in 1939.
What brand names are available for heparin?
Hemochron, Hep-Lock, Hep-Lock U/P, Heparin in 5%
Dextrose, Heparin Lock Flush, HepFlush-10
Is heparin available as a generic drug?
Yes
Do I need a prescription for heparin?
Yes
What are the side effects of heparin?
The most common side effects are hemorrhage
(bleeding), thrombocytopenia (decrease platelet count), heparin induced
thrombocytopenia (HIT), heparin induced thrombocytopenia and thrombosis (HITT),
injection site discomfort/irritation, allergy or hypersensitivity type
reactions, and increase in liver enzymes.
What is the dosage for heparin?
Doses vary considerably based on use and desired
level of anticoagulation. Consult published guidelines for various uses
(myocardial infarction, DVT, pulmonary embolism, for example) and the
manufacturer’s recommendations as dosage varies; some patients may require
dosage adjustments if they have certain conditions (for example, renal or liver
problems).
Which drugs or supplements interact with heparin?
Medications that increase the risk of
bleeding will add to the effects of heparin and further increase the risk of
bleeding that is associated with heparin. Such medications include aspirin,
clopidogrel (Plavix), warfarin (Coumadin), other anticoagulants, and
nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin; Advil), naproxen
(Naprosyn), diclofenac (Voltaren), and others.
Is heparin safe to take if I’m pregnant or breastfeeding?
Heparin has not been adequately evaluated in
pregnant women. Heparin should only be used during pregnancy if the potential
benefit justifies the potential risk to the fetus. Preservative-free heparin is
recommended when heparin is needed during pregnancy.
It is not known whether heparin is excreted
into breast milk. However, due to its large molecular weight, it is thought that
heparin is not likely to be excreted into breast milk. Preservative-free heparin
is recommended when heparin is needed during breastfeeding.
What else should I know about heparin?
What preparations of heparin are available?
Injectable Solution: 1000, 2500, 5000, 10000,
20000 units/ml.
Heparin Lock Flush: 10, 100 units/ml.
Premixed Solution: 20000 units/500 ml, 25000 units/250 ml, 25000 units/500
ml.
How should I keep heparin stored?
Heparin sodium injections should be stored at 20 C
to 25 C (68 F to 77 F).