Heparin (Intravenous Route, Subcutaneous Route)

It is used to decrease the clotting ability of the blood and help prevent harmful clots from forming in the blood vessels . This medicine is sometimes called a blood thinner, although it does not actually thin the blood . Heparin will not dissolve blood clots that have already formed, but it may prevent the clots from becoming larger and causing more serious problems .

Heparin is used to prevent or treat certain blood vessel, heart, and lung conditions. Heparin is also used to prevent blood clotting during open-heart surgery, bypass surgery, kidney dialysis, and blood transfusions. It is used in low doses to prevent the formation of blood clots in certain patients, especially those who must have certain types of surgery or 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 available only with your doctor`s prescription.

This product is available in the following dosage forms:

• Injectable


• Solution

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of heparin in children. However, because heparin contains benzyl alcohol, use in newborn babies is not recommended .

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of heparin in the elderly. However, elderly patients are more likely to develop bleeding problems, which may require an adjustment of dosage in patients receiving heparin.

Pregnancy

Breastfeeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Drug Interactions

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Abciximab


• Acenocoumarol


• Alprostadil


• Alteplase, Recombinant


• Anisindione


• Anistreplase


• Antithrombin, Recombinant


• Ardeparin


• Argatroban


• Aspirin


• Bivalirudin


• Cefamandole


• Cefoperazone


• Certoparin


• Chamomile


• Cilostazol


• Citalopram


• Clopidogrel


• Dalteparin


• Danaparoid


• Defibrotide


• Dermatan Sulfate


• Desirudin


• Desvenlafaxine


• Dextran


• Dicumarol


• Duloxetine


• Enoxaparin


• Eptifibatide


• Escitalopram


• Fluoxetine


• Fluvoxamine


• Fondaparinux


• Garlic


• Ginkgo


• Heparin


• Lamifiban


• Milnacipran


• Moxalactam


• Nadroparin


• Nitroglycerin


• Papaya


• Parnaparin


• Paroxetine


• Phenindione


• Phenprocoumon


• Reteplase, Recombinant


• Reviparin


• Sertraline


• Sibrafiban


• St John`s Wort


• Streptokinase


• Tan-Shen


• Tenecteplase


• Tinzaparin


• Tirofiban


• Urokinase


• Venlafaxine


• Warfarin


• Xemilofiban

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Avocado


• Chondroitin


• Coenzyme Q10


• Curcumin


• Dong Quai


• Ginger


• Green Tea


• Vitamin A

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Allergies or asthma (history of)a€”The risk of an allergic reaction to heparin may be increased .

• Bacterial endocarditis (heart infection) or


• Blood disease or bleeding problems or


• Heavy or unusual menstrual bleeding (periods) or


• High blood pressure (hypertension), severe or


• Liver disease or


• Major surgery (e.g., eye, brain, or spine surgery) or


• Spinal anesthesia (numbing medicine placed in the back) or


• Stomach or intestinal ulcera€”Use with caution. The risk of bleeding may be increased .

• Bleeding, active or


• Thrombocytopenia (low platelet in the blood), severea€”Should not be used in patients with these conditions.

Proper Use

Heparin is usually given in a hospital setting by a nurse or other trained health professional . This medicine is given through a needle placed into one of your veins or as a shot under your skin .

If you are using heparin at home, make sure your doctor has explained exactly how this medicine is to be given. Your doctor will prescribe your exact dose and tell you how often it should be given.

To obtain the best results without causing serious bleeding, use this medicine exactly as directed by your doctor . Be certain that you are using the right amount of heparin, and that you follow a schedule. Be especially careful that you do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

Your doctor should check your progress at regular visits. A blood test must be taken on a regular basis to see how fast your blood is clotting. This helps your doctor decide on the proper amount of heparin you should be receiving each day.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Doubling the dose may cause excessive bleeding. Instead, go back to your regular dosing schedule. It is best to keep a record of each dose as you use it to avoid mistakes. Be sure to give your doctor a record of any doses you miss. If you have any questions about this, check with your doctor .

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions

It is very important that your doctor check you at regular visits after you leave the hospital for any problems or unwanted effects that may be caused by this medicine. Be sure to keep all appointments.

Do not take aspirin while using this medicine. Many nonprescription (over-the-counter [OTC]) medicines and some prescription medicines contain aspirin . Check the labels of all medicines you take. Also, do not take ibuprofen unless it has been ordered by your doctor . There are many other medicines that may change the way heparin works or increase the chance of bleeding if they are used together with heparin. It is best to check with your doctor before taking any other medicine while you are using heparin.

You may bleed and bruise more easily while you are using this medicine. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Tell your doctor about any falls, blows to the body or head, or other injuries, since serious bleeding may occur inside the body with this medicine. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers. Avoid nose picking and forceful nose blowing.

Since many things can affect the way your body reacts to this medicine, you should always watch for signs of unusual bleeding. Unusual bleeding may mean that your body is getting more heparin than it needs. Serious side effects can occur, even up to several weeks after you have stopped using this medicine. Check with your doctor right away if you have any unusual side effects while you are using heparin and after you stop using it.

Tell all medical doctors and dentists that you are using this medicine.

It is recommended that you carry an identification card stating that you are using heparin. If you have any questions about what kind of identification to carry, check with your doctor .

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention .

Check with your doctor or nurse immediately if any of the following side effects occur:

Less common

• Abdominal or stomach pain or swelling


• Back pain or backaches


• Bleeding from the gums when brushing teeth


• Blood in the urine


• Constipation


• Coughing up blood


• Dizziness


• Headaches (severe or continuing)


• Heavy bleeding or oozing from cuts or wounds


• Joint pain, stiffness, or swelling


• Unexplained bruising or purplish areas on the skin


• Unexplained nosebleeds


• Unusually heavy or unexpected menstrual bleeding


• Vomiting of blood or material that looks like coffee grounds

Rare

• Back or rib pain (with long-term use only)


• Change in skin color, especially near the place of injection or in the fingers, toes, arms, or legs


• Chest pain


• Chills


• Collection of blood under the skin (blood blister) at the place of injection


• Decrease in height (with long-term use only)


• Fast or irregular breathing


• Fever


• Frequent or persistent erection


• Irritation, pain, redness, or ulcers at the place of injection


• Itching and burning feeling, especially on the bottom of the feet


• Nausea and/or vomiting


• Numbness or tingling in the hands or feet


• Pain, coldness, or blue color of the skin on the arms or legs


• Peeling of the skin


• Puffiness or swelling of the eyelids or around the eyes


• Runny nose


• Shortness of breath


• Skin rash, hives, and/or itching


• Tearing of the eyes


• Tightness in the chest


• Trouble with breathing


• Unusual hair loss (with long-term use only)


• Wheezing

After you stop using this medicine, it may still produce some side effects that need attention . During this period of time, check with your doctor immediately if you notice the following side effects:

• Black, tarry stools


• Bleeding gums


• Blood in the urine or stools


• Pain in the chest, groin, or legs, especially calves of legs


• Pinpoint red spots on the skin


• Severe headaches of sudden onset


• Sudden loss of coordination


• Sudden shortness of breath for no apparent reason


• Sudden slurred speech


• Sudden vision changes


• Unusual bleeding or bruising

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional .

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