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BLOOD AND BLOOD FORMING ORGANS › ANTITHROMBOTIC AGENTS › ANTITHROMBOTIC AGENTS › Heparin group
heparin
B01AB01
Forms & Strengths
- Injection: 1,000 units/mL
- Injection: 5,000 units/mL
- Injection: 10,000 units/mL
- Injection: 20,000 units/mL
- Lock Flush: 10 units/mL
- Lock Flush: 100 units/mL
Adult Dosing
- DVT/PE treatment: Initial 80 units/kg IV bolus, then 18 units/kg/hr continuous infusion
- Prophylaxis of thromboembolism: 5,000 units SC every 8 to 12 hours
- ACS/STEMI: Initial 60 units/kg IV bolus (max 4,000 units), then 12 units/kg/hr infusion (max 1,000 units/hr)
- Cardiopulmonary bypass: Initial 300 units/kg IV, adjusted per coagulation clotting time
Pediatric Dosing
- Treatment of thrombosis: Initial 75-81 units/kg IV bolus, then 20-28 units/kg/hr continuous infusion adjusted to target aPTT
- Prophylaxis: Safety and efficacy not well established in neonates/pediatrics for off-label indications
Indications
- Prophylaxis and treatment of venous thrombosis and pulmonary embolism
- Prevention of postoperative thromboembolism
- Treatment of acute and chronic consumption coagulopathies (DIC)
- Prevention of clotting in arterial and cardiac surgery
- Maintenance of patency of IV catheters
Mechanism of Action
- Potentiates the activity of antithrombin III, rapidly inactivating thrombin and activated factor X (Factor Xa)
- Prevents the conversion of fibrinogen to fibrin and inhibits subsequent thrombus formation
Contraindications
- Active uncontrollable bleeding
- History of heparin-induced thrombocytopenia (HIT) or heparin-induced thrombocytopenia and thrombosis (HITT)
- Severe thrombocytopenia
- Hypersensitivity to heparin or pork products
Adverse Reactions
- Hemorrhage and bleeding complications
- Heparin-induced thrombocytopenia (HIT) with or without thrombotic complications
- Osteoporosis with long-term use
- Elevated transaminases (AST/ALT)
- Injection site hematoma, irritation, or hypersensitivity reactions
- Alopecia (reversible)
Drug Interactions
- Anticoagulants and antiplatelet agents (e.g., warfarin, aspirin, NSAIDs, P2Y12 inhibitors) increase bleeding risk
- Thrombolytic agents significantly increase major hemorrhage risk
- Nicotine, antihistamines, digoxin, and tetracyclines may partially counteract the anticoagulant action of heparin
- ACE inhibitors and ARBs may increase the risk of hyperkalemia
Curated Content: Needs Vetting Before Put to Clinical Use