More from Heparon
Other strengths and forms by Beacon Pharmaceuticals PLC
Indications & Uses
Heparon is indicated for:
Pharmacology
Heparin inhibits reactions that lead to blood clotting and fibrin clot formation, both in the test tube and in the body. It acts at multiple points in the normal clotting process. In small amounts, combined with antithrombin III (heparin cofactor), it can prevent thrombosis by inactivating activated Factor X and blocking the conversion of prothrombin to thrombin. Once a thrombosis has already developed, larger amounts of heparin can halt further clotting by inactivating thrombin and preventing the conversion of fibrinogen to fibrin. Heparin also stops a stable fibrin clot from forming by inhibiting activation of the fibrin stabilising factor.
Bleeding time is usually unaffected by heparin. Clotting time is prolonged by full therapeutic doses, though in most cases low doses do not measurably affect it.
Heparin has no fibrinolytic activity, so it will not dissolve clots that have already formed.
Clinical trials have not shown heparin to be better than anticoagulant free fluids (such as normal saline) at keeping catheters patent.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Give Heparin Sodium Injection by intermittent IV injection, IV infusion, or deep subcutaneous injection. It is not meant for intramuscular (IM) use. Heparin sodium doesn't work when taken by mouth, so it should not be given orally.
Look at parenteral products before giving them, to check for particles and any change in colour. Where possible, use a final filter during administration of all parenteral solutions.
Therapeutic anticoagulant effect with full-dose heparin
the initial dose is 333 units/kg subcutaneously. Use a different site for each injection. After that, give 250 units/kg subcutaneously every 12 hours.
the initial dose is 10,000 units. Then give 5,000 to 10,000 units every 4 to 6 hours.
start with 5,000 units by intravenous injection, then run the infusion continuously at 20,000 to 40,000 units/24 hours. These figures are based on a 150 lb. (68 kg) patient.
Surgery of the heart and blood vessels
For intravascular use via total body perfusion, the initial dose is 150 units/kg or more. Adjust it for longer procedures.
Use in extracorporeal therapy
A concentration of 2 units/mL will be enough to prevent clotting when extracorporeal therapy starts, if the devices are primed with this solution.
NOTE: A proper and effective heparinisation schedule must be started in the patient before the procedure and kept up throughout, to prevent later clotting and blockage of the blood path. Refer to the particular manufacturer's directions for the dialyser or other extracorporeal apparatus. Refer equally to the direction sheets for the therapeutic dosage forms of heparin, and adjust to the patient's condition and response so that anticoagulation is effective, sustained and within clinically safe limits. Intermittent and continuous infusion of 5000, 10000 or 20000 units are both used for this purpose. They are unrelated to the low dose heparin in this preparation, which is meant only for preparing the apparatus for first use.
Maintenance of catheter patency
The infusion rate for the 2 units/mL formulation depends on the patient's age, weight and clinical condition and on the procedure being used. A rate of 3 mL/hour has been found satisfactory.
Periodic platelet counts, hematocrits, and tests for occult blood in stool are recommended throughout the whole course of heparin therapy, whatever the route of administration.
Because the dose of this drug is titrated to response, don't add anything to heparin sodium injection.
Side Effects
Haemorrhage: Haemorrhage is the chief complication that may result from heparin therapy. An overly prolonged clotting time or minor bleeding during therapy can usually be controlled by withdrawing the drug. Gastrointestinal or urinary tract bleeding during anticoagulant therapy may indicate the presence of an underlying occult lesion. Bleeding can occur at any site, but certain specific haemorrhage complications may be difficult to detect. Adrenal haemorrhage, with resultant acute adrenal insufficiency, has occurred during anticoagulant therapy. Such treatment should therefore be discontinued in patients who develop signs and symptoms of acute adrenal haemorrhage and insufficiency. Initiation of corrective therapy should not depend on laboratory confirmation of the diagnosis, since any delay in an acute situation may result in the patient's death. Ovarian (corpus luteum) haemorrhage has developed in a number of women of reproductive age receiving short or long-term anticoagulant therapy. This complication, if unrecognised, may be fatal. Retroperitoneal haemorrhage has also been reported. Local Irritation: Local irritation, erythema, mild pain, haematoma or ulceration may follow deep subcutaneous (intrafat) injection of Multiparin. These complications are much more common after intramuscular use, and such use is not recommended. Hypersensitivity: General hypersensitivity reactions have been reported, with chills, fever and urticaria as the most usual manifestations. Asthma, rhinitis, lacrimation, headache, nausea and vomiting, and anaphylactoid reactions, including shock, occur more rarely. Itching and burning, especially on the plantar surface of the feet, may occur. Thrombocytopenia has been reported in patients receiving heparin, with a reported incidence of 0 to 30%. While often mild and of no obvious clinical significance, such thrombocytopenia can be accompanied by severe thromboembolic complications such as skin necrosis, gangrene of the extremities that may lead to amputation, myocardial infarction, pulmonary embolism, stroke and possible death. Certain episodes of painful, ischaemic and cyanosed limbs have in the past been attributed to allergic vasospastic reactions. Whether these are in fact identical to the thrombocytopenia-associated complications remains to be determined. Miscellaneous: Osteoporosis following long-term administration of high doses of heparin, cutaneous necrosis after systemic administration, suppression of aldosterone synthesis, delayed transient alopecia, priapism, and rebound hyperlipidaemia on discontinuation of Multiparin have also been reported. Significant elevations of aminotransferase (SGOT [S-AST] and SGPT [S-ALTI]) levels have occurred in a high percentage of patients (and healthy subjects) who have received heparin.
Cautions & Contraindications
Warnings & Precautions
General. White Clot Syndrome: Patients on heparin have been reported to develop new thrombus formation together with thrombocytopenia caused by irreversible aggregation of platelets induced by heparin, the so-called "white clot syndrome". This process may lead to severe thromboembolic complications such as skin necrosis, gangrene of the extremities that may lead to amputation, myocardial infarction, pulmonary embolism, stroke and possible death. Heparin administration should therefore be promptly discontinued if a patient develops new thrombosis in association with thrombocytopenia. Spinal/Epidural Haematomas: When neuraxial anaesthesia (epidural/spinal anaesthesia) or spinal puncture is employed, patients who are anticoagulated or scheduled to be anticoagulated with unfractionated heparin or low molecular weight heparins/heparinoids for prevention of thromboembolic complications are at risk of developing an epidural or spinal haematoma, which can result in long-term or permanent paralysis. The risk of these events is increased by the use of indwelling epidural catheters for administration of analgesia or by the concomitant use of drugs affecting haemostasis, such as non-steroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors or other anticoagulants. The risk also appears to be increased by traumatic or repeated epidural or spinal puncture. Patients should be frequently monitored for signs and symptoms of neurological impairment. If neurological compromise is noted, urgent treatment is necessary. The physician should weigh the potential benefit against the risk before neuraxial intervention in patients who are anticoagulated or are to be anticoagulated for thromboprophylaxis. Multiparin Resistance Haemorrhage: Haemorrhage can occur at virtually any site in patients receiving heparin. An unexplained fall in haematocrit, a fall in blood pressure, or any other unexplained symptom should lead to serious consideration of a haemorrhagic event. Multiparin should be used with extreme caution in disease states in which there is an increased danger of haemorrhage. Some of the conditions in which an increased danger of haemorrhage exists are: Cardiovascular: subacute bacterial endocarditis and severe hypertension. Surgical: during and immediately following (a) spinal tap or spinal anaesthesia or (b) major surgery, especially involving the brain, spinal cord or eye. Haematologic: conditions associated with increased bleeding tendencies, such as haemophilia, thrombocytopenia, and some vascular purpuras. Gastrointestinal: ulcerative lesions and continuous tube drainage of the stomach or small intestine. Other: menstruation and liver disease with impaired haemostasis. Coagulation Testing: When Multiparin is administered in therapeutic amounts, its dosage should be regulated by frequent blood coagulation tests. If the coagulation test is unduly prolonged or if haemorrhage occurs, Multiparin should be discontinued promptly. Thrombocytopenia: Thrombocytopenia has been reported in patients receiving heparin, with a reported incidence of 0 to 30%. Mild thrombocytopenia (count greater than 100,000/mm3) may remain stable or reverse even if heparin is continued. However, thrombocytopenia of any degree should be monitored closely. If the count falls below 100,000/mm3 or if recurrent thrombosis develops, the heparin product should be discontinued. If continued heparin therapy is essential, administration of heparin from a different organ source can be reinstituted with caution. Solutions containing sodium ions should be used with great care in patients with congestive heart failure, severe renal insufficiency, and in clinical states in which oedema with sodium retention exists. The intravenous administration of solutions can cause fluid and/or solute overloading, resulting in dilution of serum electrolyte concentrations, overhydration, congested states or pulmonary oedema. The risk of dilutional states is inversely proportional to the electrolyte concentrations and volume of the infusion. The risk of solute overload causing congested states with peripheral and pulmonary oedema is directly proportional to the electrolyte concentrations and volume of the infusion. Excessive administration of potassium-free solutions may result in significant hypokalaemia. In patients with diminished renal function, administration may result in sodium retention. Multiparin-induced Thrombocytopenia (HIT) and Multiparin-induced Thromocytopenia and Thrombosis (HITT): Multiparin-induced Thrombocytopenia (HIT) is a serious antibody-mediated reaction resulting from irreversible aggregation of platelets. HIT may progress to the development of venous and arterial thromboses, a condition referred to as Multiparin-induced Thrombocytopenia and Thrombosis (HITT). Thrombotic events may also be the initial presentation of HITT. These serious thromboembolic events include deep vein thrombosis, pulmonary embolism, cerebral vein thrombosis, limb ischaemia, stroke, myocardial infarction, mesenteric thrombosis, renal arterial thrombosis, skin necrosis, gangrene of the extremities that may lead to amputation, and possibly death. Thrombocytopenia of any degree should be monitored closely. If the platelet count falls below 100,000/mm3 or if recurrent thrombosis develops, the heparin product should be promptly discontinued and an alternative anticoagulant considered if the patient requires continued anticoagulation. Delayed Onset of HIT and HITT: Multiparin-induced Thrombocytopenia and Thrombosis can occur up to several weeks after the discontinuation of heparin therapy. Patients presenting with thrombocytopenia or thrombosis after discontinuation of heparin should be evaluated for HIT and HITT. Laboratory Tests: Periodic platelet counts, haematocrits, and tests for occult blood in stool are recommended during the entire course of heparin therapy, regardless of the route of administration (see Dosage and Administration). Carcinogenesis, Mutagenesis, Impairment of Fertility: No long-term studies in animals have been performed to evaluate the carcinogenic potential of heparin. Likewise, no reproduction studies in animals have been performed concerning mutagenesis or impairment of fertility.
Contraindications
Heparin sodium should not be used in the following patients: those with severe thrombocytopenia; those in whom suitable blood coagulation tests, such as the whole-blood clotting time and partial thromboplastin time, cannot be performed at appropriate intervals (this contraindication applies to full-dose heparin; there is usually no need to monitor coagulation parameters in patients receiving low-dose heparin); and those with an uncontrollable active bleeding state, except when this is due to disseminated intravascular coagulation.
Pregnancy & Breastfeeding
Heparin sodium is Pregnancy Category C. It does not cross the placental barrier. No animal reproduction studies have been done with it, so it isn't known whether heparin sodium can harm the foetus when given to a pregnant woman, or whether it can affect reproductive capacity. For this reason, give it to pregnant women only if it is clearly needed.
Heparin sodium is not excreted in human milk.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Paediatric use: the safety and effectiveness of Heparin Sodium in children have not been established.
Overdose
Symptoms: Bleeding is the main sign of a Heparin Sodium overdose. The first signs may be nosebleeds, blood in the urine or tarry stools. Easy bruising or petechiae (tiny red or purple spots on the skin) can appear before the bleeding becomes obvious.
Treatment: Neutralising the effect of heparin. When bleeding means the heparin has to be reversed, protamine sulphate (1% solution) given by slow infusion will neutralise Heparin Sodium. Give no more than 50 mg, and give it very slowly, in any 10-minute period. Each mg of protamine sulphate neutralises approximately 100 BP heparin units. As the body metabolises heparin, the amount of protamine needed falls over time. Heparin metabolism is complex, but when choosing a protamine dose it can be assumed that heparin has a half-life of about ½ hour after intravenous injection.
Protamine sulphate can cause severe hypotensive and anaphylactoid reactions. Fatal reactions that often resemble anaphylaxis have been reported, so the drug should only be given where resuscitation techniques and treatment of anaphylactoid shock are readily available. For more information, check the labelling of Protamine Sulphate Injection, USP products.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Store Heparin Sodium at a temperature no higher than 30°C. Protect it from light, and keep it out of the reach of children.
Drug Interactions
Common questions about Heparon 25000 iu
What is Heparon 25000 iu Injection?
Heparon 25000 iu Injection is a medicine that contains Heparin Sodium. It is made by Beacon Pharmaceuticals PLC. It belongs to the Parenteral anti-coagulants group of medicines.
What is Heparon used for?
Heparon is used for: Cardiac Arrhythmia, Deep Vein Thrombosis.
What are the side effects of Heparon?
Haemorrhage: Haemorrhage is the chief complication that may result from heparin therapy. An overly prolonged clotting time or minor bleeding during therapy can usually be controlled by withdrawing the drug.
Can I take Heparon during pregnancy or while breastfeeding?
Heparin sodium is Pregnancy Category C. It does not cross the placental barrier. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Heparon?
Symptoms: Bleeding is the main sign of a Heparin Sodium overdose. The first signs may be nosebleeds, blood in the urine or tarry stools. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Heparon?
Store Heparin Sodium at a temperature no higher than 30°C. Protect it from light, and keep it out of the reach of children.
Can I take other medicines with Heparon?
Some medicines can interact with Heparin Sodium, for example: Rivaroxaban, Irbesartan, Panax ginseng + Ginkgo biloba, Curcuma Longa [Turmeric Extract], Meloxicam, Streptokinase. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Heparon?
Heparon is a prescription (Rx) medicine. Take it as your doctor advises.