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Heparin - Benefits, dosage and side effects

 Heparin is a drug to treat and prevent blood clots that are at risk of causing blockage of blood vessels and endangering the patient. This drug is available in the form of injections, gels, and ointments whose use must be according to a doctor's prescription.

Heparin - Benefits, dosage and side effects

Heparin is an anticoagulant drug, also known as a blood thinner. This drug works by inhibiting the activity of several proteins that play a role in the blood clotting process.

Heparin can prevent blood clots and stop the blood clotting process that has occurred. However, this drug cannot eliminate or shrink blood clots that have formed.

Heparin trademarks: Clotastop, Heparinol, Heparin Sodium, Hepagusan, Hico, Inviclot, Oparin, Thrombogel, Thrombophob, Thromboflash, Thromecon

What is Heparin

Prescription drug class

Category Anticoagulants

Benefits Prevent and treat blood clots

Used by Adults, children, and the elderly

Heparin for pregnant and lactating women Category C: Animal studies have shown adverse effects on the fetus, but there are no controlled studies in pregnant women.

Drugs should only be used if the expected benefit outweighs the risk to the fetus.

Heparin is not absorbed into breast milk. However, breastfeeding mothers are advised to still consult a doctor before using this drug

Injectable, gel, and ointment forms

Precautions Before Using Heparin

Heparin should not be used carelessly. There are several things that must be considered before using this drug, including:

  1. Do not use heparin if you are allergic to this drug. Tell your doctor about any allergies you have.
  2. Tell your doctor if you have ever had uncontrolled bleeding or have a blood clotting disorder caused by certain conditions, such as thrombocytopenia or hemophilia.
  3. Tell your doctor if you have or are currently suffering from heart disease, such as endocarditis, heart failure, or a heart attack. Also let them know if you have hypertension and are on a low-salt diet.
  4. Tell your doctor if you have or have had liver disease, gastrointestinal bleeding, kidney disease, gastric ulcer, duodenal ulcer, cancer, hyperkalemia, diabetes mellitus, or metabolic acidosis.
  5. Tell your doctor if you are having a menstrual period, have a fever, or have an infection.
  6. Do not consume alcoholic beverages during treatment with heparin because it can increase the risk of bleeding in the stomach.
  7. Consult a doctor about the use of heparin in the elderly (over 60 years), especially women.
  8. Tell your doctor if you are pregnant, breastfeeding, or planning a pregnancy.
  9. Tell your doctor if you have recently had surgery, especially on areas of the brain, spine, or eyes, before taking heparin. Also let them know if you have recently had a certain medical procedure, such as a lumbar puncture or spinal anesthetic procedure.
  10. Tell your doctor that you are taking heparin if you are planning to have surgery or certain medical procedures during treatment.
  11. Do not smoke while on treatment with heparin, because smoking can decrease the effectiveness of heparin in the body.
  12. Tell your doctor if you are taking any other medications, including supplements and herbal products, to anticipate drug interactions.
  13. Do not use heparin gel or ointment on open wounds or mucous membranes, such as the eyes or the inside of the nose and mouth.
  14. See your doctor immediately if you have an allergic reaction to the drug, a more serious side effect, or an overdose after using heparin.
  15. Dosage and Instructions for Use of Heparin

The following is the division of heparin doses based on the form of the drug and the purpose of treatment:

1. Injectable heparin

Vein injections (intravenous/IV)

Objective: Post-cardiac arrest treatment with thrombolytic drugs

Adults: 60 units/kg body weight, with a maximum dose of 4,000 units. Then, followed by an infusion of 12 units/kgBW per hour. The maximum dose is 1000 units per hour, with a duration of treatment of 48 hours

Goal: Treatment of embolism, unstable angina, and deep vein thrombosis (DVT)

Adult: Initial dose 75–80 units/kg or 5,000 units (10,000 units in severe pulmonary embolism). Continued dose by infusion of 18 units/kgBW or 1,000–2,000 units per hour. Alternate dose 5,000–10,000 units every 4–6 hours.

Children: The initial dose is 50 units/kg. Follow-up dose by infusion of 15–25 units/kg per hour.

Injections under the skin (subcutaneous / SC)

Goal: Prevention of postoperative blood clots and embolism

Adult: 5,000 units given 2 hours before surgery, then every 8–12 hours for 7 days or until patient is immobile.

Goal: Treatment of embolism in veins

Adults: 15,000–20,000 units every 12 hours or 8,000–10,000 U every 8 hours.

Children: 250 units/kg, 2 times a day.

For elderly patients, the dose of injectable heparin may be reduced from the usual dose, because the possibility of side effects is greater.

2. Heparin gel or ointment

Goal: prevent and treat thrombophlebitis

Apply heparin gel or ointment to the affected skin surface 2-3 times a day.

How to Use Heparin Correctly

Injectable heparin should only be given by a doctor or medical personnel under the supervision of a doctor. Heparin injections can be given through a vein (intravenous/IV) or under the skin (SC/subcutaneous).

If you are prescribed heparin in the form of a gel or ointment, follow your doctor's advice and read the instructions for use on the package before using it. Do not increase or decrease the dose without consulting your doctor first.

Apply a thin layer on the area of ​​​​the skin that has blood clots or bruises. Use heparin gel or ointment at the same time every day for maximum effect.

If you forget to use heparin gel or ointment, it is recommended to use it immediately if the break with the next schedule of use is not too close. If it is close, ignore it and do not double the dose.

During treatment with heparin, doctors will advise patients to have regular blood tests, to monitor blood thinning effects and side effects that may occur.

Store heparin at room temperature. Do not store it in a humid place or in direct sunlight. Keep this medicine out of reach of children.

Heparin Interactions with Other Drugs

The following are interactions that can occur when heparin is used with certain medications:

  • Increased risk of bleeding if used with warfarin, antiplatelets, salicylic acid, NSAIDs, dextran, or fibrinolytic drugs, such as alteplase

  • Decreased effectiveness of heparin when used with nitroglycerin

  • Increased risk of developing hyperkalemia when used with ACE inhibitors or angiotensin II receptor blockers (ARBs)

Side Effects and Dangers of Heparin

Side effects that may arise after using heparin are:

  • Pain, redness, or irritation at the injection site

  • Hair loss

  • Easy bruising

  • Bleeding from gums or wounds stops longer

Check with your doctor if these side effects do not subside or get worse. See your doctor immediately if you experience serious side effects, such as:

  • Severe swelling at the injection site

  • Frequent nosebleeds

  • Menstruation that is prolonged or heavier than usual

  • Dark urine

  • Black stool

  • Vomit is black like coffee grounds

  • Annoying headaches or dizziness

  • Symptoms of infection, characterized by fever, chills, runny nose, or watery eyes

  • Bone pain

Go to the ER immediately if you have an allergic drug reaction or a more serious side effect, such as:

  • Coughing up blood

  • Shortness of breath, dizziness, restlessness, and sweating

  • Dark or bluish skin color on the hands or feet

  • Chest pain or arrhythmia

  • Confusion

  • Numbness or weakness on one side of the body

  • Difficult to speak

  • Visual disturbances, especially those that occur suddenly

  • Severe pain in the abdomen, lower back, or groin

  • Dizzy until you feel like passing out

See more about:

  • Deep Vein Thrombosis

  • Protein C Deficiency

  • Thrombophlebitis

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