Heparin Sod 5000u/ml Inj, 1ml

Heparin is a heterogeneous group of straight-chain anionic mucopolysaccharides. It exerts its anticoagulant effect by binding to antithrombin III (ATIII), a plasma protein that inactivates thrombin (Factor IIa) and Factor Xa. This binding causes a conformational change in ATIII, greatly accelerating its inhibitory action (by 1000-fold or more) on these coagulation factors. Heparin also inhibits the activation of Factor IX to IXa, and Factor XI to XIa, and Factor XII to XIIa, and the stabilization of fibrin by Factor XIIIa.

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 advice.

Not all possible side effects are listed 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, 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 on this medication, 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.

There is a risk of severe and potentially life-threatening bleeding problems 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, referred to as heparin-induced thrombocytopenia and thrombosis (HITTS). Both HIT and HITTS can be fatal or cause other 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 important to have your blood work checked as directed by your doctor.

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

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 comes in various containers and strengths. If you are unsure, consult your doctor or pharmacist.

If you have a sulfite allergy, inform your doctor, as some products may 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, discuss it with your doctor to determine if the product you are using contains benzyl alcohol.

If you are pregnant, plan to become pregnant, or are 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): 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 decrease heparin's anticoagulant effect (monitor aPTT).

• Cephalosporins (certain types, e.g., cefoperazone, cefotetan): May increase risk of bleeding due to vitamin K antagonism.
• Probenecid: May increase heparin levels.
• Digoxin: May decrease digoxin levels (clinical significance uncertain).

• Unusual bleeding or bruising (e.g., nosebleeds, gum bleeding, blood in urine or stool, excessive bruising)
• Severe headache or vision changes (may indicate intracranial bleed)
• Unusual pain or swelling (e.g., joint pain, abdominal pain)
• Dizziness or weakness (signs of blood loss)
• Cold, pale, or painful limb (may indicate arterial thrombosis, paradoxical effect of HIT)
• Skin lesions at injection sites (may indicate HIT-related skin necrosis)

Heparin does not cross the placenta and is generally considered the anticoagulant of choice for pregnant women requiring anticoagulation. However, it is associated with risks such as maternal bleeding, osteoporosis (with long-term use), and heparin-induced thrombocytopenia (HIT). Close monitoring is essential.

Heparin is considered safe 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. Neonates and infants may require higher doses per kg due to higher antithrombin III levels and faster clearance. Increased risk of bleeding, especially in neonates.

Elderly patients may be more sensitive to the effects of heparin and have an increased risk of bleeding. Lower initial doses or more conservative dosing strategies may be considered. Close monitoring of aPTT/anti-Xa and signs of bleeding is crucial.

• Heparin is highly variable in its anticoagulant response due to binding to plasma proteins and cells; therefore, careful monitoring (aPTT or anti-Xa) is crucial for therapeutic dosing.
• Always confirm the concentration of heparin before administration to avoid dosing errors (e.g., 10 units/mL vs. 10,000 units/mL).
• Heparin-Induced Thrombocytopenia (HIT) is a serious, immune-mediated complication. Monitor platelet counts regularly. If HIT is suspected, discontinue all heparin products immediately and initiate an alternative 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.
• Subcutaneous heparin should be injected into the abdominal fat, at least 2 inches from the navel, using a short needle and not rubbing the site after injection to minimize bruising.

• Low Molecular Weight Heparins (LMWHs) (e.g., enoxaparin, dalteparin): Often preferred for VTE prophylaxis and outpatient treatment due to more predictable pharmacokinetics and less frequent monitoring.
• Fondaparinux: Synthetic pentasaccharide, selective Factor Xa inhibitor, used for VTE prophylaxis and treatment, and in patients with HIT.
• Direct Thrombin Inhibitors (DTIs) (e.g., argatroban, bivalirudin, dabigatran): Used for HIT or as alternatives to heparin.
• Direct Oral Anticoagulants (DOACs) / Novel Oral Anticoagulants (NOACs) (e.g., rivaroxaban, apixaban, edoxaban, dabigatran): Oral alternatives for long-term VTE treatment and stroke prevention in atrial fibrillation.

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 or take someone else's medication. 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; do not flush them down the toilet or pour them down the drain unless instructed to do so by a healthcare professional or pharmacist. If you are unsure about the correct disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Additionally, some medications may come with a separate 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 emergency medical attention. Be prepared to provide information about the medication taken, the amount, and the time of ingestion to ensure timely and effective treatment.