Heparin interactions. Heparin: Uses, Dosage, Side Effects, and Interactions – A Comprehensive Guide
What are the main uses of heparin. How is heparin dosed. What are the common side effects of heparin. Which drugs interact with heparin. What precautions should be taken when using heparin.
Understanding Heparin: A Powerful Anticoagulant
Heparin is a widely used anticoagulant medication that plays a crucial role in preventing blood clots. This injectable drug is derived from animal tissues, typically porcine (pig) intestines, and has been a mainstay in medical practice for decades. Let’s delve into the key aspects of heparin, including its uses, dosage considerations, potential side effects, and important interactions.
The Primary Uses of Heparin in Medical Practice
Heparin serves several important functions in healthcare settings. Its primary uses include:
- Prevention of deep vein thrombosis (DVT) and pulmonary embolism
- Treatment of existing blood clots
- Anticoagulation during surgical procedures, especially cardiovascular surgeries
- Management of certain types of heart attacks
- Prevention of clotting in dialysis machines and intravenous lines
Why is heparin so effective in preventing blood clots? Heparin works by binding to and enhancing the activity of antithrombin III, a natural anticoagulant protein in the blood. This interaction accelerates the inactivation of several clotting factors, effectively reducing the blood’s ability to form clots.
Heparin Dosage: Tailoring Treatment to Individual Needs
The dosage of heparin can vary significantly depending on the specific medical condition being treated, the patient’s weight, and their individual response to the medication. Heparin is available in different concentrations, typically 1,000 units/mL, 5,000 units/mL, and 10,000 units/mL.
Common Dosing Regimens
- For DVT prophylaxis: 5,000 units subcutaneously every 8-12 hours
- For treatment of acute DVT or pulmonary embolism: Initial bolus of 80 units/kg, followed by continuous infusion
- For anticoagulation during surgery: Dosing varies based on the procedure and patient factors
How is the appropriate heparin dose determined? Healthcare providers often use weight-based nomograms and monitor the patient’s activated partial thromboplastin time (aPTT) to adjust the dose. This personalized approach ensures that the anticoagulant effect is both safe and effective for each individual.
Navigating the Side Effects of Heparin Therapy
While heparin is an essential medication, it can cause various side effects. Being aware of these potential adverse effects is crucial for both patients and healthcare providers.
Common Side Effects
- Bleeding or bruising at the injection site
- Mild pain or irritation at the injection site
- Elevated liver enzymes
- Allergic reactions (rare)
Serious Side Effects
- Heparin-induced thrombocytopenia (HIT) – a potentially life-threatening decrease in platelets
- Major bleeding events
- Osteoporosis with long-term use
What should patients do if they experience side effects from heparin? It’s crucial to report any unusual symptoms to a healthcare provider immediately, especially signs of excessive bleeding or allergic reactions. Regular monitoring of platelet counts and other blood parameters is essential during heparin therapy to detect potential complications early.
Critical Interactions: Heparin and Other Medications
Heparin can interact with numerous medications, potentially altering its effectiveness or increasing the risk of side effects. Understanding these interactions is vital for safe and effective treatment.
Major Drug Interactions
According to the drug interaction checker, heparin has 58 major interactions. Some of the most significant include:
- Warfarin (Coumadin): Can dramatically increase the risk of bleeding
- Apixaban (Eliquis): May enhance the anticoagulant effect
- Clopidogrel (Plavix): Increases the risk of bleeding when used together
- NSAIDs (e.g., ibuprofen, naproxen): Can increase the risk of gastrointestinal bleeding
How can patients minimize the risk of drug interactions with heparin? It’s essential to provide a complete list of all medications, including over-the-counter drugs and supplements, to healthcare providers. They can then assess potential interactions and adjust treatment plans accordingly.
Heparin and Disease Interactions: Important Considerations
Certain medical conditions can affect the safety and efficacy of heparin therapy. The drug interaction checker lists seven disease interactions with heparin:
- Peptic ulcer disease
- Active bleeding
- Hypertension
- Prematurity
- Renal dysfunction
- Thrombocytopenia
- Hyperkalemia
Why are these disease interactions important? They can either increase the risk of bleeding complications or alter the effectiveness of heparin. For example, patients with renal dysfunction may require dose adjustments due to altered drug clearance, while those with active bleeding or peptic ulcer disease may be at higher risk for serious bleeding events.
Special Populations and Heparin Use
Certain groups of patients require special consideration when using heparin:
Pregnancy and Breastfeeding
Heparin is often the anticoagulant of choice during pregnancy as it does not cross the placenta. However, close monitoring is essential. Breastfeeding while on heparin is generally considered safe, as the drug is not significantly excreted in breast milk.
Elderly Patients
Older adults may be more sensitive to the effects of heparin and may require lower doses. They are also at higher risk for bleeding complications, necessitating careful monitoring.
Pediatric Patients
Dosing in children, especially premature infants, requires special expertise due to differences in drug metabolism and clearance.
How do healthcare providers manage heparin therapy in these special populations? They typically employ more frequent monitoring, careful dose adjustments, and may consider alternative anticoagulants when appropriate.
Monitoring Heparin Therapy: Ensuring Safety and Efficacy
Regular monitoring is crucial for patients on heparin therapy to maintain the delicate balance between preventing clots and avoiding excessive bleeding.
Key Monitoring Parameters
- Activated Partial Thromboplastin Time (aPTT)
- Platelet count
- Signs of bleeding or thrombosis
- Liver function tests
What is the target aPTT for heparin therapy? The typical target range is 1.5 to 2.5 times the patient’s baseline aPTT, but this can vary depending on the specific protocol used and the indication for anticoagulation.
Frequent monitoring allows healthcare providers to adjust the heparin dose promptly, ensuring that patients remain within the therapeutic range and minimizing the risk of complications.
In conclusion, heparin remains a cornerstone of anticoagulation therapy in modern medicine. Its versatility in treating and preventing blood clots makes it an invaluable tool in various clinical settings. However, the complexity of its interactions and potential side effects necessitates careful management and monitoring. By understanding the nuances of heparin therapy, healthcare providers can optimize its use, maximizing benefits while minimizing risks for their patients.
Heparin Interactions Checker – Drugs.com
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There are 224 drugs known to interact with
heparin, along with
7 disease interactions, and 1 alcohol/food interaction.
Of the total drug interactions,
58 are major, 143 are moderate, and 23 are minor.
Does heparin interact with my other drugs?
Enter other medications to view a detailed report.
- View all 224 medications that may interact with heparin
- View heparin alcohol/food interactions (1)
- View heparin disease interactions (7)
Most frequently checked interactions
View interaction reports for heparin and the medicines listed below.
- Major
- Moderate
- Minor
- Unknown
- Ativan (lorazepam)
- Benadryl (diphenhydramine)
- Cardizem (diltiazem)
- Colace (docusate)
- Combivent (albuterol / ipratropium)
- Coumadin (warfarin)
- Dilaudid (hydromorphone)
- Eliquis (apixaban)
- Lantus (insulin glargine)
- Lasix (furosemide)
- Lipitor (atorvastatin)
- Lopressor (metoprolol)
- Lovenox (enoxaparin)
- MiraLAX (polyethylene glycol 3350)
- Norco (acetaminophen / hydrocodone)
- Normal Saline Flush (sodium chloride)
- Norvasc (amlodipine)
- Paracetamol (acetaminophen)
- Percocet (acetaminophen / oxycodone)
- Phenergan (promethazine)
- Plavix (clopidogrel)
- Protonix (pantoprazole)
- Rocephin (ceftriaxone)
- Synthroid (levothyroxine)
- Tylenol (acetaminophen)
- Vitamin B12 (cyanocobalamin)
- Vitamin C (ascorbic acid)
- Vitamin D3 (cholecalciferol)
- Xanax (alprazolam)
- Zofran (ondansetron)
Heparin alcohol/food interactions
There is 1 alcohol/food interaction with heparin.
Heparin disease interactions
There are 7 disease interactions with heparin which include:
- peptic ulcer disease
- active bleeding
- hypertension
- prematurity
- renal dysfunction
- thrombocytopenia
- hyperkalemia
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- Reviews (2)
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- Side effects
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- Patient tips
- During pregnancy
- Drug class: heparins
- Breastfeeding
- En español
Related treatment guides
- Angina
- Anticoagulation During Pregnancy
- Antiphospholipid Syndrome
- Deep Vein Thrombosis
Drug Interaction Classification
Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
---|---|
Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Unknown | No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medical Disclaimer
Heparin (Porcine) Injection: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing
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This medicine is a colorless, clear, vial
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This medicine is a colorless, clear, vial
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This medicine is a colorless, clear, vial
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This medicine is a colorless, clear, vial
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This medicine is a colorless, clear, vial
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This medicine is a colorless, clear, vial
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This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 10,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: Shape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 20,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 20,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 10,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 20,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 10,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 10,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL (1 mL) injection cartridge
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 10,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 20,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 10,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 10,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 10,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL injection solution
Color: clearShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 10,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 1,000 unit/mL injection solution
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
heparin (porcine) 5,000 unit/mL (1 mL) injection cartridge
Color: colorlessShape: Imprint:
This medicine is a colorless, clear, vial
Heparin sodium drug interactions with other drugs (compatibility) | Vidal.
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💊 Composition of the drug Heparin ✅ Use of the drug Heparin Save Search for analogues Interaction Description of the active ingredients of the preparation Heparin The scientific information provided is general and cannot be used to make decisions. Update date: 2019.12.04 Marketing authorization holder: SYNTHESIS JSC ATX code: B01AB01 (Heparin) Active substance: Rec. INN WHO registered Dosage form
Release form, packaging and composition |
D59.3 | Hemolytic uremic syndrome |
D65 | Disseminated intravascular coagulation [defibrination syndrome] |
I20.0 | Unstable angina |
I21 | Acute myocardial infarction |
I26 | Pulmonary embolism |
I33.9 | Acute endocarditis, unspecified |
I34. 0 | Mitral (valvular) insufficiency |
I48 | Atrial fibrillation and flutter |
I74 | Arterial embolism and thrombosis |
I80 | Phlebitis and thrombophlebitis |
I82 | Embolism and thrombosis of other veins |
N00 | Acute nephritic syndrome (acute glomerulonephritis) |
N03 | Chronic nephritic syndrome |
N08.5 | Glomerular lesions in systemic connective tissue diseases |
Z51.4 | Preparatory procedures for subsequent treatment or examination, not elsewhere classified |
Dosing regimen
The method of administration and dosing regimen of a particular drug depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. Compliance of the dosage form of a particular drug with indications for use and dosing regimen should be strictly observed.
Individual, depending on the dosage form used, indications, clinical situation and age of the patient.
Side effects
On the part of the blood coagulation system: possible bleeding of the gastrointestinal tract and urinary tract, bleeding at the injection site, in areas subjected to pressure, from surgical wounds, as well as hemorrhages in other organs, hematuria, thrombocytopenia.
From the digestive system: nausea, loss of appetite, vomiting, diarrhea, increased activity of liver transaminases.
Allergic reactions: flushing of the skin, drug fever, urticaria, rhinitis, pruritus and sensation of heat in the soles, bronchospasm, collapse, anaphylactic shock.
On the part of the blood coagulation system: thrombocytopenia (may be severe up to death) with subsequent development of skin necrosis, arterial thrombosis, accompanied by the development of gangrene, myocardial infarction, stroke.
From the musculoskeletal system: with prolonged use – osteoporosis, spontaneous fractures, soft tissue calcification.
Local reactions: irritation, pain, hyperemia, hematoma and ulceration at the injection site.
Other: transient alopecia, hypoaldosteronism.
Contraindications for use
Bleeding, diseases accompanied by impaired blood coagulation, suspected intracranial hemorrhage, cerebral aneurysm, hemorrhagic stroke, dissecting aortic aneurysm, antiphospholipid syndrome, malignant arterial hypertension, subacute bacterial endocarditis, erosive ulcerative lesions of the gastrointestinal tract , severe lesions of the liver parenchyma, cirrhosis of the liver with varicose veins of the esophagus, malignant neoplasms in the liver, shock conditions, recent surgical interventions on the eyes, brain, prostate, liver and biliary tract, condition after spinal cord puncture, menstruation, threatened miscarriage, childbirth (including recent), hypersensitivity to heparin.
Use during pregnancy and lactation
Use during pregnancy is possible only under strict indications, under close medical supervision.
Contraindication: threatened miscarriage, childbirth (including recent).
Can be used during breastfeeding if indicated.
Use for violations of liver function
Contraindications: severe lesions of the liver parenchyma, cirrhosis of the liver with varicose veins of the esophagus, malignant neoplasms in the liver.
Use for impaired renal function
Used when indicated in patients with severe kidney disease.
Use in children
May be used in children if indicated.
Use in elderly patients
Use with caution in elderly patients (over 60 years, especially in women).
Special instructions
Use with caution in patients suffering from polyvalent allergies (including bronchial asthma), arterial hypertension, dental procedures, diabetes mellitus, endocarditis, pericarditis, in the presence of an intrauterine contraceptive, with active tuberculosis, radiation therapy, liver failure, chronic renal failure, in elderly patients (over 60 years, especially women).
IM administration of heparin is not recommended due to the possibility of developing a hematoma, as well as IM administration of other drugs during treatment with heparin.
Use with caution externally for bleeding and conditions of increased bleeding, thrombocytopenia.
During treatment with heparin, monitoring of blood coagulation parameters is necessary.
Only normal saline is used to dilute heparin.
With the development of severe thrombocytopenia (a decrease in the number of platelets by 2 times from the original number or below 100,000 / µl), heparin should be urgently discontinued.
The risk of bleeding can be minimized with careful evaluation of contraindications, regular laboratory monitoring of blood clotting, and adequate dosing.
Drug interactions
The anticoagulant effect of heparin is enhanced by the simultaneous use of anticoagulants, antiplatelet agents and NSAIDs.
Ergot alkaloids, thyroxine, tetracycline, antihistamines, and nicotine reduce the effect of heparin.