Heparin Sod 1000u/ml Inj, 10ml

Heparin binds to antithrombin III (ATIII), a plasma protein that inactivates several coagulation factors, especially thrombin (Factor IIa) and Factor Xa. This binding causes a conformational change in ATIII, greatly accelerating its inhibitory action (by 1000-fold or more). By inactivating thrombin, heparin prevents the conversion of fibrinogen to fibrin, and by inactivating Factor Xa, it prevents the formation of thrombin.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor immediately or seek emergency medical attention:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of bleeding, including:
+ Vomiting or coughing up blood
+ Vomit that resembles coffee grounds
+ Blood in the urine
+ Black, red, or tarry stools
+ Bleeding from the gums
+ Abnormal vaginal bleeding
+ Unexplained bruises or bruises that enlarge
+ Uncontrollable bleeding
Neurological symptoms, such as:
+ Weakness on one side of the body
+ Difficulty speaking or thinking
+ Balance problems
+ Drooping on one side of the face
+ Blurred vision
Confusion
Severe headache
Dizziness or fainting
Upset stomach or vomiting
Unusual burning sensations, particularly on the soles of the feet
Swelling, warmth, numbness, color changes, or pain in a leg or arm
Chest pain or pressure
Shortness of breath
Back pain
Groin or pelvic pain or swelling
Changes in skin color at the injection site
Skin breakdown at the site of administration
Fever or chills

Other Possible Side Effects

Like all medications, this drug can cause side effects. However, many people experience no side effects or only mild ones. If you have any side effects that bother you or persist, contact your doctor for advice.

Please note that this list is not exhaustive. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced.
If you are allergic to pork products, as this may be relevant to your treatment.
* Certain health conditions, including:
+ Bleeding problems or a low platelet count.
+ A history of low platelet count caused by heparin or pentosan polysulfate.

This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health problems with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other medications and health conditions.

Remember, do not start, stop, or change the dose of any medication without first consulting your doctor.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

While using this drug, you may experience easier bleeding. To minimize the risk of injury, exercise caution and take preventive measures such as using a soft toothbrush and an electric razor.

Be aware that severe and potentially life-threatening bleeding complications have been associated with this medication. Additionally, this drug can cause a condition known as heparin-induced thrombocytopenia (HIT), which may lead to the formation of blood clots, also referred to as heparin-induced thrombocytopenia and thrombosis (HITTS). Both HIT and HITTS can be fatal or result in other serious complications, and may occur up to several weeks after discontinuing the medication. If you have any concerns or questions, consult your doctor. It is crucial to undergo regular blood tests as directed by your doctor.

This medication may interfere with certain laboratory tests. Therefore, it is vital to notify all your healthcare providers and laboratory personnel that you are taking this drug.

In the event of a fall, injury, or head trauma, contact your doctor immediately, even if you feel fine.

Ensure that you have the correct product, as this medication is available in various containers and strengths. If you are unsure, consult your doctor or pharmacist.

If you have a sulfite allergy, discuss this with your doctor, as some products contain sulfites.

Individuals over 60 years old should use this medication with caution, as they may be more susceptible to side effects.

Some products contain benzyl alcohol, which can cause serious side effects in newborns and infants, particularly when combined with other medications containing benzyl alcohol. Consult your doctor to determine if this product contains benzyl alcohol and to discuss potential risks.

If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor to discuss the potential benefits and risks to you and your baby.

• Other anticoagulants (e.g., warfarin, direct oral anticoagulants)
• Antiplatelet agents (e.g., aspirin, clopidogrel, ticagrelor)
• NSAIDs (e.g., ibuprofen, naproxen)
• Thrombolytic agents (e.g., alteplase, tenecteplase)
• Dextran
• Nitroglycerin (may decrease heparin effect)

• Cephalosporins (some, e.g., cefoperazone, cefotetan, cefazolin - may increase bleeding risk)
• Penicillins (high dose, may inhibit platelet function)
• Probenecid (may increase heparin levels)
• Quinine/Quinidine (may increase bleeding risk)

• Unusual bleeding (e.g., nosebleeds, gum bleeding, bruising, blood in urine/stools)
• Excessive bruising or petechiae
• Headache, dizziness, weakness (signs of internal bleeding)
• Pain, swelling, or discomfort at injection sites
• Signs of allergic reaction (rash, itching, hives, difficulty breathing)
• New or worsening pain/swelling in limbs (may indicate thrombosis despite therapy or HIT with thrombosis)

Heparin does not cross the placenta and is generally considered the anticoagulant of choice for pregnant women when anticoagulation is required. However, close monitoring is essential due to physiological changes in pregnancy that can affect heparin pharmacokinetics and increased risk of bleeding.

Heparin is considered safe during breastfeeding as it is a large molecule and is not excreted into breast milk in clinically significant amounts. It is also not orally absorbed by the infant.

Dosing is weight-based and requires careful titration and monitoring (aPTT or anti-Xa). Neonates and infants may require higher doses per kg due to higher antithrombin levels and faster clearance. Increased risk of bleeding, especially in neonates. Use preservative-free formulations in neonates to avoid benzyl alcohol toxicity.

Increased risk of bleeding due to age-related physiological changes (e.g., decreased renal function, increased capillary fragility, concomitant medications). Lower initial doses or more conservative dosing strategies may be considered. Close monitoring of aPTT/anti-Xa and bleeding signs is crucial.

• Heparin is highly acidic and can bind to basic proteins, leading to unpredictable effects. Dosing should always be based on a weight-based nomogram and adjusted based on aPTT or anti-Xa levels.
• Heparin-induced thrombocytopenia (HIT) is a serious, immune-mediated complication. Monitor platelet counts regularly (every 2-3 days from day 4-14 or until discontinued). If HIT is suspected, discontinue heparin immediately and initiate an alternative anticoagulant.
• Protamine sulfate is the antidote for heparin overdose. 1 mg of protamine neutralizes approximately 100 units of heparin. Administer slowly to avoid hypotension.
• Heparin flush solutions (e.g., 10 units/mL, 100 units/mL) are used to maintain catheter patency and are distinct from therapeutic anticoagulation doses.
• Avoid intramuscular (IM) injections in patients receiving heparin due to risk of hematoma formation.
• Heparin resistance can occur due to antithrombin III deficiency, acute phase reactants, or high levels of Factor VIII. Consider anti-Xa monitoring in these cases.

• Low Molecular Weight Heparins (LMWHs) (e.g., enoxaparin, dalteparin)
• Fondaparinux (synthetic pentasaccharide)
• Direct Thrombin Inhibitors (DTIs) (e.g., argatroban, bivalirudin, dabigatran)
• Direct Factor Xa Inhibitors (e.g., rivaroxaban, apixaban, edoxaban)
• Warfarin (Vitamin K antagonist)

If your symptoms or health problems persist or worsen, it is essential to contact your doctor for further evaluation and guidance. To ensure safe use, never share your medication with others, and do not take medication prescribed to someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Properly dispose of unused or expired medications by checking with your pharmacist for guidance on the best disposal method. Unless instructed to do so, avoid flushing medications down the toilet or pouring them down the drain, as this can harm the environment. Many communities have drug take-back programs; your pharmacist can provide information on these programs. Some medications may come with an additional patient information leaflet; consult your pharmacist if you have questions. If you have any concerns or questions about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek emergency medical attention. Be prepared to provide information on the medication taken, the amount, and the time it was taken to ensure prompt and effective treatment.