Heparin Sod 1000u/ml Inj, 2ml

Heparin binds to antithrombin (AT), a plasma protein that inactivates thrombin (Factor IIa) and Factor Xa. This binding causes a conformational change in AT, accelerating its inhibitory action by approximately 1000-fold. The heparin-AT complex then inactivates thrombin and Factor Xa, preventing the conversion of fibrinogen to fibrin and the activation of platelets, thereby inhibiting clot formation.

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 or seek immediate 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
+ Changes in balance
+ Drooping on one side of the face
+ Blurred vision
Feeling confused
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 do not experience any side effects or only have mild ones. If you have any side effects that bother you or persist, contact your doctor for guidance.

Please note that this list is not exhaustive, and you may experience other side effects not mentioned here. 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, any of its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
If you are allergic to pork products, discuss this with your doctor.
* Certain health conditions, including:
+ Bleeding problems
+ 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 disclose all your medications (prescription, over-the-counter, natural products, and vitamins) and health issues to your doctor and pharmacist. They will help determine if it is safe to take this medication in conjunction with your other treatments and health conditions. Never start, stop, or adjust the dosage 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, so it's crucial to be cautious and avoid injuries. To minimize the risk of bleeding, use a soft toothbrush and an electric razor for shaving.

This medication can cause severe and potentially life-threatening bleeding problems. Additionally, it may lead to a condition known as heparin-induced thrombocytopenia (HIT), which can cause 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 they may occur up to several weeks after stopping the medication. If you have any questions or concerns, discuss them with your doctor. It is also vital to undergo blood tests as directed by your doctor and to consult with your doctor about any concerns.

This drug may interfere with certain laboratory tests, so it's essential to inform all your healthcare providers and laboratory personnel that you are taking this medication.

If you fall, injure yourself, or hit your head, 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 have any doubts, consult your doctor or pharmacist.

If you are allergic to sulfites, inform 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. If you are concerned about this, consult your doctor to determine if the product contains benzyl alcohol.

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, dabigatran, rivaroxaban, apixaban, edoxaban, LMWHs): Increased risk of bleeding.
• Antiplatelet agents (e.g., aspirin, clopidogrel, prasugrel, ticagrelor, NSAIDs): Increased risk of bleeding.
• Thrombolytic agents (e.g., alteplase, reteplase, tenecteplase): Increased risk of bleeding.

• Nitroglycerin (IV): May cause a decrease in heparin's anticoagulant effect (monitor aPTT closely).
• Cephalosporins (certain, e.g., cefoperazone, cefotetan): May increase bleeding risk due to hypoprothrombinemia.
• Herbal supplements (e.g., ginkgo biloba, garlic, ginger, dong quai, feverfew): May increase bleeding risk.

• Unusual bleeding or bruising (e.g., nosebleeds, gum bleeding, blood in urine or stools, excessive bruising)
• Severe headache or changes in vision (may indicate intracranial bleeding)
• Unusual pain or swelling (e.g., joint pain, abdominal pain)
• Dizziness or weakness (signs of blood loss)
• Rash or skin lesions (may indicate HIT or other hypersensitivity reactions)

Heparin is generally considered the anticoagulant of choice during pregnancy because it does not cross the placenta and therefore does not cause fetal anticoagulation or teratogenicity. However, it carries risks for the mother, including bleeding and heparin-induced osteoporosis.

Heparin is considered safe for use during breastfeeding. 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 of aPTT or anti-Xa levels due to variability in response and higher clearance rates in younger children compared to adults. Neonates and infants may require higher doses per kg. Increased risk of bleeding, especially in neonates.

Increased risk of bleeding due to age-related physiological changes (e.g., decreased renal function, increased capillary fragility, concomitant medications). Lower starting doses or more conservative dosing strategies may be appropriate. Close monitoring for bleeding is essential.

• Heparin has a highly variable dose-response relationship due to its binding to various plasma proteins and cells. Therefore, individualized dosing and close monitoring (aPTT or anti-Xa) are crucial.
• Heparin-induced thrombocytopenia (HIT) is a serious, immune-mediated complication that can lead to paradoxical thrombosis. Monitor platelet counts regularly (every 2-3 days from day 4 to 14 or until discontinued). If HIT is suspected, discontinue heparin immediately and initiate a non-heparin anticoagulant.
• Protamine sulfate is the antidote for heparin overdose. The dose is calculated based on the amount of heparin given and the time elapsed.
• Heparin is the preferred anticoagulant for patients with severe renal impairment or those on dialysis, as it is primarily metabolized and does not accumulate significantly in renal failure (unlike LMWHs or DOACs).
• Subcutaneous heparin for prophylaxis should not be rubbed after injection, as this can increase bruising and alter absorption.

• Low Molecular Weight Heparins (LMWHs) (e.g., enoxaparin, dalteparin): For VTE prophylaxis and treatment, and certain ACS indications. Offer more predictable pharmacokinetics and do not require routine monitoring.
• Fondaparinux: Synthetic pentasaccharide, selective Factor Xa inhibitor. Used for VTE prophylaxis and treatment.
• Direct Oral Anticoagulants (DOACs) (e.g., dabigatran, rivaroxaban, apixaban, edoxaban): Used for VTE treatment and prevention in non-valvular AF. Not typically used in acute, critical care settings where rapid onset/offset is needed.
• Warfarin: Oral vitamin K antagonist, used for long-term anticoagulation.
• Direct Thrombin Inhibitors (e.g., argatroban, bivalirudin, dabigatran): Used in specific situations, such as HIT (argatroban, bivalirudin) or non-valvular AF (dabigatran).

If your symptoms or health problems persist or worsen, it is essential to contact your doctor promptly. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless instructed otherwise, do not flush medications down the toilet or pour them down the drain. If you are unsure about the proper disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional patient information leaflet, which your pharmacist can provide. If you have any questions or concerns 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 medical attention. Be prepared to provide information about the medication taken, the amount, and the time it occurred.