Heparin

Heparin is a prescription medication used to prevent blood clots from forming in people who have certain medical conditions, such as blood vessel, heart, and lung conditions, or who are undergoing certain medical procedures that increase the chance that clots will form, such as open-heart surgery, bypass surgery, kidney dialysis, and blood transfusions. It is also used in low doses to prevent the formation of blood clots in certain patients, especially those 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 also used in small amounts to prevent blood clots from forming in catheters (small plastic tubes through which medication can be administered or blood drawn) that are left in veins over a period of time.

Heparin can stop the growth of clots that have already formed in the blood vessels, but it cannot be used to decrease the size of clots that have already formed.

Heparin belongs to a class of medications called anticoagulants. These works by decreasing the clotting ability of the blood.

This medication is available in injectable form to be given directly into a vein (IV) or administered under the skin (subcutaneously) by a healthcare professional.

Common side effects of heparin include bleeding and injection site reactions.

Heparin is a prescription medication used to prevent blood clots from forming in people who have certain medical conditions, such as blood vessel, heart, and lung conditions, or who are undergoing certain medical procedures that increase the chance that clots will form, such as open-heart surgery, bypass surgery, kidney dialysis, and blood transfusions. It is also used in low doses to prevent the formation of blood clots in certain patients, especially those 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 also used in small amounts to prevent blood clots from forming in catheters (small plastic tubes through which medication can be administered or blood drawn) that are left in veins over a period of time.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with heparin. See the “Heparin Precautions” section.

Common side effects of heparin include the following:

• bleeding
• decreased platelets
• injection site irritation
• allergic reactions
• hair loss

This is not a complete list of heparin side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

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

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• non-steroidal anti-inflammatory drugs (NSAIDs) including aspirin, celecoxib (Celebrex), indomethacin (Indocin), naproxen (Aleve, Naprosyn), and ibuprofen (Aleve, Motrin)
• glycoprotein IIb/IIIa antagonists such as abciximab (ReoPro), eptifibatide (Integrilin), tirofiban (Aggrastat)
• anti-platelet agents such as prasugrel (Effient), ticlopidine (Ticlid), and clopidogrel (Plavix)
• dipyridamole (Persantine, in Aggrenox)
• hydroxychloroquine (Plaquenil)
• dextran
• antithrombin III (Thrombate III)
• digoxin (Digitek, Lanoxin)
• nicotine
• nitrates such as nitroglycerin (Nitrostat, Nitromist, Nitrolingual Pumpsprapy, Nitro-Bid, Nitro-Dur, Transderm-Nitro, Nitro-Time), isosorbide mononitrate, and isosorbide dinitrate (Isordil, Isordil Titradose, Dilatrate-SR)
• quinine
• tetracycline antibiotics such as demeclocycline (Declomycin), doxycycline (Monodox, Vibramycin), minocycline (Dynacin, Minocin)

This is not a complete list of heparin drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with heparin including the following:

• Bleeding. Tell your healthcare provider right away if you have some or all of the following symptoms of serious or unusual bleeding.
  • unusual bruising or bleeding
  • vomit that is bloody or looks like coffee grounds
  • stool that contains bright red blood or is black and tarry
  • blood in urine

Tell your healthcare provider right away if you experience any of the following symptoms, which may indicate a serious reaction to heparin:

• excessive tiredness
• nausea
• vomiting
• chest pain, pressure, or squeezing discomfort
• discomfort in the arms, shoulder, jaw, neck, or back
• coughing up blood
• excessive sweating
• sudden severe headache
• lightheadedness or fainting
• sudden loss of balance or coordination
• sudden trouble walking
• sudden numbness or weakness of the face, arm or leg, especially on one side of the body
• sudden confusion, or difficulty speaking or understanding speech
• difficulty seeing in one or both eyes
• purple or black skin discoloration
• pain and blue or dark discoloration in the arms or legs
• itching and burning, especially on the bottoms of the feet
• chills
• fever
• hives
• rash
• wheezing
• shortness of breath
• difficulty breathing or swallowing
• hoarseness
• painful erection that lasts for hours

Do not take heparin if you:

• are allergic to heparin or to any of its ingredients
• have thrombocytopenia (decreased platelets in your blood)
• are uncontrollably bleeding
• cannot undergo laboratory tests to assess blood clotting ability

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of heparin, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking heparin, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to heparin or to any of its ingredients
• have a low level of platelets (type of blood cells needed for normal clotting) in your blood
• have heavy bleeding that cannot be stopped anywhere in your body
• are currently experiencing your menstrual period
• have a fever or an infection
• have recently had a spinal tap (removal of a small amount of the fluid that bathes the spinal cord to test for infection or other problems), spinal anesthesia (administration of pain medication in the area around the spine), surgery, especially involving the brain, spinal cord, or eye
• have had a heart attack
• have or have ever had a bleeding disorder such as hemophilia (condition in which the blood does not clot normally), antithrombin III deficiency (condition that causes blood clots to form), blood clots in the legs, lungs, or anywhere in the body, unusual bruising or purple spots under the skin, cancer, or ulcers in the stomach or intestine
• have high blood pressure
• have liver disease
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X - are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Heparin falls into category C. There are no well-controlled studies that have been done in pregnant women. Heparin should be used during pregnancy only if the possible benefit outweighs the possible risk to the unborn baby.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Due to its large size, heparin is not likely to be excreted in human milk, and any heparin in milk would not be orally absorbed by a nursing infant. Benzyl alcohol (a preservative) present in maternal serum is likely to cross into human milk and may be orally absorbed by a nursing infant. Exercise caution when administering heparin to a nursing mother. If available, preservative-free heparin injection is recommended when heparin therapy is needed during lactation.

Take heparin exactly as prescribed.

This medication is available in injectable form to be given directly into a vein (IV) or administered under the skin (subcutaneously) by a healthcare professional. Heparin should not be administered into a muscle. If you must use heparin at home, your doctor will explain how this medicine is to be given. Your doctor will prescribe your exact dose and tell you how often it should be given.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of heparin at the same time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• the method of administration
• other medical conditions you have
• how you respond to this medication
• your weight

Doses of heparin must be individualized for each patient according to the condition being treated, the route and frequency of administration, and the clinical response.

If you take too much heparin, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If heparin is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store heparin at room temperature.
• Keep this and all medicines out of the reach of children.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.