Heparin Sodium
Ampoules
Parentral anticoagulants Composition :
Each ampoule ( 1 ml ) contains :
Heparin sodium 5000 I.U . Properties :
Heparin acts as parental anticoagulant by affecting reactions leading to blood clotting
via inhibiting the conversion of prothrombin to thrombin , fibrinogen to fibrin , also prevents activation of fibrin stabilizing factor .
Indications &usage :
- Prophylaxis and treatment of deep venous thrombosis , mural thrombosis ,
pulmonary embolism , peripheral arterial embolism and atrial fibrillation with
embolization .
-Prophylaxis in general surgery , arterial and heart surgery .
- Unstable angina , myocardial infarction for the prevention of coronary re- occlusion
after thrombolysis
- Extracorporeal circuits in cardiopulmonary bypass and hemodialysis .
- Anticoagulant in blood transfusion , for laboratory purposes . Contra-indications :
Hemophilia , thrombocytopenia and other hemorrhagic disorders .
Severe hypertension .
Hypersensitivity to heparin .
Eye or nervous system surgery .
Spinal or epidural anesthesia with treatment doses of heparin . Side effects :
Hemorrhage with overdose , and hypersensitivity reactions may occur . Drug interactions :
- Anti-platelet drugs ( e.g. acetyl salicylate , ibuprofen , indomethacin ) .
- Digitalis . tetracycline , nicotine , anti-histaminics , may counteract the
anticoagulant effect of heparin .
- Heparin shouldn’t be mixed with doxorubicin or droperidol since a precipitate may
form . Warnings & precautions :
Heparin should not be given intramuscularly .
At least 5 hours after the last I.V dose or 24 hours after the last S.C. dose should
elapse before shifting to oral anticoagulants . Caution should be taken in the following cases :
- Hepatic and renal impairment , hyperkalemia .
- Pregnancy .
- Hypersensitivity to low molecular weight heparin .
- Peptic ulcer .
Administer the heparin as an infusion ( Not a bolus ) whenever possible .
Use the lowest dose necessary at the slowest infusion rate acceptable to obtain the
desired clinical effect .
Closely monitor the patient for adverse events , particularly Hypotension & sings &
symptoms of Hypersensitivity & ensure the resuscitation equipment is available .
Consider pretreatment with corticosteroids ( Cortisone type medicine ) or
Antihistamine ( Drugs that relief the symptoms of allergic reactions ) although it is not known if such pretreatment is effective . Dosage & administration :
Prophylactic dose in general surgery : 5000 U by S.C two hours before surgery then every ( 8 -12 ) hours for 7 days . N.B. The dosage of Heparin sodium should be adjusted according to age and the patient
coagulation results prior to each injection
Therapeutic doses :
Method of administration Frequency Recommended dose Initial dose 5.000 U I.V. injection followed by 10.000- 20.000 U of concentrated solution S.C .
Every 8 hours
or every 12 hours 8.000 – 10.000 U. of concentrated solution.
15.000 -20.000 U of concentrated solution. Initial dose 10.000 U either undiluted or in
50 -100 ml isotonic sodium chloride.
Every 4 -6 hours
5.000 -10.000 U either undiluted or in
50 -100 ml isotonic sodium chloride
Initial dose 5.000 U I.V. injection
Continues 20.000 – 40.000 in 1000 ml
isotonic sodium chloride / day N. B:
- When heparin is added to I.V infusion the container should be inverted at least 6 times
to prevent pooling of heparin .
- Don’t use if solution is discolored or contains a precipitate . Packing :
Box contains 6 or 100 ampoules . Storage :
Store at temperature not exceeding 30OC, away from light.
It should not be stored in a frozen form. | 
