Heparin injections are prescribed to the patient medical workers mainly for the purpose of thinning and preventing the formation of blood clots. In addition, Heparin injections are used for a number of diseases. Let us consider in more detail the principle of action of this drug, indications and features of its use.

What is Heparin used for? This drug belongs to pharmacological group direct acting anticoagulants. The presented drug prevents blood clotting and the formation of blood clots by slowing down the processes of fibrin formation and reducing thrombin activity. Heparin is characterized by the presence of the following clinical properties:

Indications for use

Due to its clinical properties and characteristics this drug is quite widespread in modern medicine. Heparin injections are prescribed to the patient for the following diseases:

1. Thrombophlebitis.
2. Acute myocardial infarction.
3. Glomerulonephritis.
4. Deep venous thrombosis.
5. Atrial fibrillation.
6. Disseminated intravascular coagulation syndrome.
7. Bacterial endocarditis.
8. Thrombosis coronary arteries.
9. Lupus nephritis.
10. Thromboembolism of the pulmonary arteries.
11. Unstable angina.
12. Pathological lesions of peripheral veins.
13. Embolization accompanying atrial fibrillation.
14. Arrhythmia.
15. Disorders of blood flow in the kidney area.
16. Disorders of blood microcirculation processes.
17. Bronchial asthma.
18. Rheumatism.
19. Some types of heart defects.
20. Hemolyticouremic syndrome.

Heparin reduces the risk sudden death in patients suffering from myocardial infarction or coronary artery thrombosis.

Heparin injections give a good effect as prophylactic, preventing the development of venous thrombophlebia after surgical interventions.

The drug is used in the case of so-called extracorporeal methods. In addition, this drug is widely used for blood transfusions, its selection for diagnostic studies and also for washing purposes venous catheters, during hemosorption and hemodialysis procedures.

Contraindications

Despite the fairly wide range of uses of the drug, in some cases the use of Heparin injections is highly discouraged and poses a serious danger to the patient’s health. The main contraindications to its use are:

1. Pulmonary infarction.
2. Individual intolerance to certain components of the drug.
3. Bleeding.
4. Thrombocytopenia (reduced blood clotting).
5. Hemorrhagic diathesis.
6. Hemophilia.
7. Increased permeability of blood vessels.
8. Werlhof's disease.
9. Aplastic anemia.
10. Leukemia in acute or chronic form.
11. Venous gangrene.
12. Hypoplastic anemia.
13. Kidney failure.
14. Liver pathologies.
15. Acute cardiac aneurysm.
16. Ulcerative lesions of the stomach and duodenum.
17. Arterial hypertension in severe form.
18. Transferred surgical interventions in the area of ​​the brain, visual apparatus, prostate gland.
19. Hemorrhagic stroke.
20. Recent puncture spinal cord.
21. Polyvalent allergy.
22. Ulcerative colitis.
23. Availability tumor neoplasms oncological nature in the area gastrointestinal tract.
24. Varicose veins of the esophagus.
25. Traumatic brain injury.

This medicine is used with extreme caution during pregnancy and breastfeeding. Usually the drug is prescribed only in exceptional cases, when its benefit to the mother significantly exceeds possible harm for a child.

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Side effects

In some cases, the use of Heparin injections can lead to the development of the following undesirable reactions:

• allergy;
• hives;
• thrombocytopenia;
• rhinitis;
• bronchial spasms;
• bleeding;
• formation of hematomas (especially in the case of intramuscular administration of Heparin);
• osteoporosis;
• nausea;
• bouts of vomiting;
• headaches reminiscent of migraine in nature;
• disruption of digestive processes;
• diarrhea;
• fever;
• necrosis of the skin;
• disruption of calcium distribution processes in the soft tissue area;
• hyperemia.

It is worth noting that in most cases, the development of the above side effects is observed with prolonged and uncontrolled use of Heparin. In order to minimize risks, the therapeutic course must be carried out exclusively as prescribed by a doctor and under his strict supervision.

Types of injections

The instructions for use of Heparin state that the dosage and duration of treatment depend on the disease, its severity and are prescribed individually in each specific case. The drug is administered intravenously, subcutaneously or intramuscularly. Most quick effect observed when intramuscular injections(in approximately 30 minutes). In the case of subcutaneous administration, the effect occurs after 1 hour.

As a preventative measure, in most cases the patient is prescribed subcutaneous injections of Heparin in the abdomen, at time intervals of 8 to 12 hours. The dosage and frequency of Heparin injections in the stomach, used to combat certain diseases, are prescribed by the attending physician, taking into account factors such as the patient’s age, his diagnosis, general state health, the presence of concomitant ailments.

It is strictly contraindicated to give injections in the same place, as well as to take any medications without permission, since Heparin actively reacts with wide range drugs.

In the case of a long therapeutic course, it is necessary to monitor the clinical picture of the blood by conducting regular blood tests.

Heparin injections are a very effective drug that helps prevent and accelerate the treatment of a number of diseases.

However, this drug, if taken uncontrolled, can provoke the development of numerous side effects and life-threatening bleeding. Therefore, therapy should be carried out under the strict supervision of the attending physician.

Heparin injections are designed to prevent the formation blood clots in the circulatory system. The drug belongs to the group of anticoagulants, the action of which is aimed at reducing blood viscosity. Heparin injections reduce the risk of acute myocardial infarction and blood clots in the coronary arteries. What is the mechanism of action of the drug, and what are the indications for its use?

Characteristics of the drug

Heparin is medicinal product, which impedes the formation of the high molecular weight protein fibrin in order to prevent the formation of blood clots in the coronary arteries. In addition, the action of the medication is aimed at stopping the growth of already formed fibrin clots and reducing the activity of blood clotting factors.

The drug for injection is available in bottles with a dosage of 5 ml

Introduction medicine in small quantities can slightly increase the properties of blood aimed at dissolving formed blood clots, and in large doses heparin causes a slowdown in the dissolution of blood clots.

To reduce the risk of coronary disease heart and restore the normal balance of the liquid part and blood cells, doctors prescribe Heparin injections. The treatment regimen and dose of the administered drug are selected individually, since the drug can accumulate over inner surface blood vessels, which leads to an increase in the negative charge of blood cells. Due to this, surface adhesion decreases and platelet gluing process is inhibited.

Pharmacological properties

Most patients have a question: why is it necessary to prescribe Heparin injections? The drug is used in the form of a solution for injection, as this promotes rapid penetration active substance into the bloodstream and instantly slows down the clotting process biological fluid.

The drug causes a moderate vasodilator effect

The drug exhibits the following effects in the body:

• increases renal blood supply;
• increases the tone of cerebral vessels;
• slows down enzymatic activity of the brain;
• reduces the rate of excess aldosterone synthesis in the adrenal glands;
• promotes the activation of parathyroid hormone;
• controls the level of adrenaline in the blood.

IN complex therapy in patients diagnosed coronary insufficiency administration of the solution helps prevent the development of the following pathologies:

• acute thrombosis of coronary vessels;
• reducing the number of relapses of myocardial infarction;
• reduction in the number of deaths after surgery coronary disease hearts.

A low dosage of the drug is used to prevent the formation of blood clots inside blood vessels and in patients after surgery. Large doses of the drug are intended for the treatment of pulmonary arterial thromboembolism or venous blockage.

Indications for use

Patients with impaired blood clotting function are recommended to undergo a course of Heparin injections. The drug has a broad pharmacological effect, so in medicine it is used not only as an anticoagulant.

To prevent blood clotting, the drug is used during the hemodialysis procedure.

Administration of the solution is indicated in the presence of the following conditions:

• progressive form of angina;
• IHD in the acute phase;
• prevention and treatment of thrombosis of various origins;
• after operations related to pathology of the heart and blood vessels;
• pathology of the valve apparatus;
• inflammation of the heart valves;
• blockage of the renal vein by a thrombus;
• inflammatory kidney diseases;
• bronchial asthma;
• systemic inflammatory conditions;
• cleaning of venous catheters.

Good results are obtained by using a solution with for preventive purposes, in case of clot formation in the lumen of peripheral arteries and after surgery in the heart area.

Duration of pharmacological effect

If the solution is administered by intradermal injection into the abdominal area, the patient should know that they must be done frequently, since the pharmacological effect occurs quickly and its duration is short-lived. When the drug is administered intravenously, an almost instantaneous inhibition of blood clotting is observed, while its effect lasts up to 5 hours.

To prevent the formation of fibrin clots, the duration of action of the drug increases slightly

After an injection into the muscle therapeutic effect occurs after 30 minutes and lasts for 6 hours. The effect of intradermal administration occurs within 40 minutes and lasts up to 8 hours.

Methods of administration

Complex therapy of acute venous and arterial thrombosis involves continuous intravenous drip administration of Heparin solution for several days. At possible contraindications For intravenous infusion, the drug must be administered subcutaneously or intramuscularly.

The optimal route for administering Heparin is considered to be the abdominal wall.

After surgery or directly during the operation, the solution is injected into the artery or intravenously. Then, during the first days after surgery, the administration of Heparin is continued intravenously.

In ophthalmology, a drug for acute blockage of retinal vessels or dystrophic changes inside its shell it is administered intravenously, and then intramuscular injections are used.

Features of dosage selection

The dose of the administered solution depends on the degree of thrombosis, the severity of symptoms and the individual sensitivity of the patient to the drug. In patients, it is necessary to constantly monitor coagulogram parameters, since if the dose is incorrectly selected, the blood clotting period can significantly exceed the norm, which can lead to bleeding.

Before discontinuing the drug, the daily dosage must be reduced so that there is no increase in the intervals between injections

According to the instructions for use, the dosage of the drug is prescribed depending on the route of administration:

• Intravenous drip infusions. Daily dosage selected at a rate of 400 U/kg.
• Intramuscular and subcutaneous injections. The dose of the solution should not exceed 600 units/kg per day.
• Intravenous administration. Single dose – 100 units/kg.

After completing the course of Heparin therapy, anticoagulant treatment with drugs is prescribed indirect action, the administration of which begins one day before the first reduction in the dose of the active substance.

Use of the product during pregnancy

During pregnancy, women's blood viscosity may change. An increase in the number of platelets leads to increased coagulability of biological fluid. According to statistics, 10% of pregnant women are susceptible to homeostatic disorders. Therefore, some doctors prescribe Heparin during pregnancy, when therapeutic effect from the drug is higher than the possible side effects.

Long-term use of heparin may increase a pregnant mother's risk of bleeding

According to clinical studies, the drug does not penetrate the transplacental barrier, which means it does not pose a threat to the fetus. The treatment regimen for a pregnant woman is somewhat different, for example, the calculation of the dose of the injected solution depends on the woman’s weight category, and the frequency of injections is limited to two.

The use of Heparin should be carried out under the strict supervision of specialists, since it may develop spontaneous labor. In case of long-term treatment, it is recommended to take a blood test for coagulation once every two days, and with heparin therapy for more than 7 days, the test is taken once every 3 days.

The use of the medication may interfere with the distribution of calcium in the body. Thus, a pregnant woman may experience acute calcium deficiency, so along with the use of Heparin, supplements containing all the necessary microelements should be taken.

Heparin therapy is carried out under strict control of hemocoagulation parameters. A coagulogram is carried out in the first week of treatment with the drug and immediately after surgery, optimal quantity research is 1 time every 2-3 days. With fractional administration of the solution, a blood test is done immediately before the injection.

It is not recommended to abruptly interrupt the course of treatment with Heparin, as this may lead to the initiation of thrombus formation. Therefore, it is necessary to gradually reduce the dosage of the drug with the parallel use of indirect anticoagulants. The only exceptions are cases of individual intolerance to some components of the solution.

Despite the possibility of intramuscular injection of the solution, experts do not recommend it due to the fact that bruises form at the injection site.

Algorithm for the correct administration of Heparin

Injections of the drug are carried out strictly as prescribed by a specialist. Injections of the drug are made at a strictly defined time of day, so patients often practice self-injections of the solution into the abdominal area. This route of administration is considered the most convenient at home.

Insulin syringes are used for injections, since a thin needle causes minimal pain.

Algorithm for how to give injections in the abdominal area:

1. Perform hand hygiene using soap and antiseptic.
2. Before manipulation, prepare a bottle of solution, a syringe, sterile cotton wool, and alcohol.
3. Using a special nail file, open the bottle and collect the required amount of solution.
4. Disinfect the injection site. Use your thumb and forefinger to form a fold of skin on your abdomen.
5. Insert a needle into the fold formed, press the plunger and slowly inject the medicine.
6. Remove the needle and apply cotton wool to the injection site.

Contraindications for treatment with the drug

Heparin has a wide pharmacological spectrum of action, but its use is contraindicated in the following cases:

• intolerance to the components of the drug;
• bleeding of various etiologies;
• hemorrhagic diathesis;
• acute and chronic leukemia;
• hypoplastic anemia;
• cardiac aneurysm;
• ulcerative formations in the digestive tract;
• exhaustion of the body.

Side effects

If you follow the Heparin treatment regimen, the symptoms of the disease gradually decrease, but situations arise when taking the medicine causes side effects:

• allergic reaction;
• migraine headaches;
• osteoporosis;
• dysfunction digestive tract;
• diarrhea;
• hyperthermia;
• skin rashes;
• bleeding;
• impaired renal function.

The most common complications of taking the medication are nausea and vomiting.

Usually, side effects occur against the background of uncontrolled or prolonged use of medication. To reduce the risk of negative effects, it is necessary to observe the dosage of the solution and adhere to the treatment regimen.

What can be replaced

An analogue of Heparin is also a solution of a drug, but from a different production.

The following solution analogues exist:

• Sodium Brown.
• Richter.
• Frayn.

The use of these funds should be carried out after consultation with a specialist.

Thus, Heparin is good drug to thin the blood and prevent the development of blood clots inside the vessels. However, during its use it is necessary to carefully monitor blood clotting parameters and follow the chosen therapeutic course.

Thank you

What kind of drug is heparin? When is it prescribed, who can and cannot use heparin?
Answers to these and other questions, as well as instructions for use heparin The medical college website (www.site) will help you find it in this article.

What kind of drug is heparin?

In what cases is heparin prescribed?

Heparin is also used during surgical interventions to prevent the blood from clotting too quickly. Heparin is prescribed for certain types of heart defects, glomerulonephritis, bacterial endocarditis, lupus nephritis.

Who should not be prescribed heparin?

Only under the supervision of a doctor can heparin be used during pregnancy for patients suffering from diabetes, tuberculosis, pericarditis, as well as elderly women.

Are there any unwanted side effects with heparin treatment?

But with long-term use of heparin, more serious consequences are possible, such as the development of osteoporosis and impaired calcium distribution.
You may also see discomfort such as pain, redness and swelling. Sometimes bleeding from the excretory organs may occur.

In what quantities is heparin used?

If you use any other medications, be sure to tell your doctor, as heparin interacts with many medications. You can safely use heparin together with

The substance has a direct anticoagulant effect, promotes the lysis of blood clots, and also has a hypocholesterolemic effect. Its weak immunosuppressive effect allows it to be prescribed as part of combination therapy autoimmune diseases.

Why are heparin injections given in the stomach?

Heparin injections are made into the anterior surface of the abdomen with an insulin syringe with a thin needle. This is very convenient because the patient usually gives the injections on his own. Moreover, the intensity pain weak in this area. Since injections have to be given frequently, the large surface of the anterior abdominal wall makes it possible not to inject the drug into the same place and avoid the appearance of subcutaneous hematomas and painful infiltrates.

Heparin is administered intravenously at a dosage of 5 thousand IU (contents of one ampoule). Then you can inject the medicine intramuscularly or subcutaneously. The dosage regimen and frequency of administration are determined by the doctor on an individual basis.

Instructions for administering heparin injections into the abdomen

The developed algorithm will help minimize discomfort and possible local complications:

• Clean hands are the main rule that a patient should know. If an injection is given to another person, it makes sense to use medical gloves.
• Take out the ampoule, wipe it with alcohol or a disinfectant wipe, and open it. Prepare a syringe with a needle and have a supply of alcohol wipes.
• Draw the medicine into the syringe.
• Handle alcohol solution the area of ​​future injection, retreating two centimeters to the side from the navel. Pull back the skin fold (the thicker it is, the less painful the injection will seem) and stick a needle into it, inject the medicine.
• Pull out the needle, simultaneously applying a napkin with alcohol to the puncture area, hold until the bleeding stops.
• Injections are given in different areas of the umbilical region. Before making the injection, palpate the skin and check that there are no unresolved infiltrates or “bumps”.

Indications for use

Heparin injections into the stomach are given for:

• acute inflammatory lesion myocardium;
• life-threatening arrhythmias;
• some heart abnormalities;
• myocardial infarction;
• Consumption coagulopathies;
• Gasser's disease;
• autoimmune kidney diseases;
• infectious inflammation of the inner lining of the heart;
• to prevent coagulopathy during hemodialysis and blood transfusion;
• to prevent thrombosis of any location, regardless of the cause;
• for postoperative therapy of patients prone to blood clotting defects.

Contraindications

A ban on the use of the drug in the form of injections with an insulin syringe into the stomach is imposed in the following conditions:

• In pathological conditions characterized by a reduced blood clotting rate.
• Ulcerative lesions of the digestive tract (gastric, duodenal or ileum, nonspecific ulcerative colitis, malignant tumors).
• Subacute infectious inflammation inner lining of the heart.
• Failure of liver or kidney function.
• Blood diseases.
• Aneurysms, aortic dissection.
• Bulging of the heart wall.
• Haemorrhoids.
• Diabetic retinopathy.
• Varicose veins
• In the prenatal period in postpartum women and during menstruation.

• Bleeding from mucous membranes, wounds, internal organs.
• Hives, itchy skin, angioedema.
• Decreased peripheral blood platelet count.
• Drowsiness, loss of appetite, decreased performance.
• Subcutaneous hemorrhages (bruises) at the injection site.

A number of patients develop a perverted reaction to Heparin - resistance. As a rule, these are those who have accompanying illnesses somatic nature, as well as due to a number of physiological conditions having reduced immunity(for example, during pregnancy and breastfeeding). This diagnosis is difficult to make due to vague symptoms and can lead to life-threatening bleeding.

Prescription of Heparin injections for pregnant women

In general, the drug is not prohibited for use in this group of patients. The injections are intramuscular, the dosages are small, and the courses of treatment are short. When breastfeeding, the drug is not contraindicated, since it does not penetrate into breast milk.

The risk group includes children under 3 years of age and elderly patients.

Overdose

Exceeding the dose of the drug can be fatal due to the development heavy bleeding that are difficult to stop. The antidote for Heparin is protamine sulfate. It requires very slow administration, and to avoid complications this procedure must be performed in a hospital setting.

The drug must be dosed carefully and the state of blood clotting must be monitored. Therefore, self-medication in this case is contraindicated. Even if the patient is well acquainted with the characteristics of his disease and has been treated with Heparin and its substitutes for a long time, he should still be under the supervision of his doctor.

What are Heparin injections used for and how to administer them correctly

The instructions classify heparin injections as anticoagulant drugs. They are used to thin the blood and prevent the formation of blood clots. In addition, Heparin slows down the process of blood clotting, inhibits the formation of fibrin and reduces thrombin activity. Like any other medicine, Heparin injections have indications and contraindications for use, side effects and features of use. Possession of such information will help make treatment as effective as possible.

general information

As an injection Heparin is available in single dose vials. Each bottle contains ED of active ingredient. Its molecules have a negative charge, due to which they can interact with proteins that are actively involved in the process of blood clotting. And Heparin is also available in the form of an ointment (gel). This drug is not available in other forms.

How Heparin affects humans:

1. Blood clots less intensively.
2. Slows down the process of platelet adhesion.
3. Dilates blood vessels.
4. Inhibits the process of formation of immunoglobulins.
5. Reduces cholesterol and blood lipids.
6. Prevents the formation of fibrin lump.

Heparin injections, according to the instructions, begin to act immediately after administration. The effect lasts approximately 5 hours. If administered subcutaneously, improvement is observed within an hour, and the effect will last up to 12 hours.

The maximum level of the active substance is observed after approximately 2-4 hours. The liver is responsible for its processing, and the kidneys for excretion.

It is worth noting that this remedy does not have the ability to penetrate the placenta to the child. Likewise, it does not pass into breast milk.

When is it necessary and when is it not necessary to use the drug in treatment?

Heparin injections into the stomach are indicated in several cases:

1. Acute stage of coronary syndrome.
2. Thrombosis and embolism affecting the veins and arteries of the brain and eyes.
3. A condition of atrial fibrillation leading to subsequent embolism.
4. As a preventive measure for the appearance of blood clots and embolism in the lungs. Such disorders often develop after surgery.
5. To reduce the risk of thromboembolism.
6. To prevent blood clotting during laboratory blood tests, dialysis procedures, or surgical operations on the heart and blood vessels.
7. In the process of blood transfusion directly from the donor to the patient.
8. Glomerulonephritis.
9. Nephritis.
10. Unstable angina.
11. Arrhythmia.
12. Poor circulation in the kidney area.
13. Rheumatism.
14. Asthma.
15. Heart disease.

Injections of this drug help relieve the symptoms of serious diseases and, in some situations, completely cure them.

But it also happens that doing them is strictly prohibited:

1. Individual intolerance to the main active ingredient.
2. Thrombocytopenia.
3. Encephalomalacia. This is a pathology in which wet necrosis of brain tissue begins.
4. Visceral carcinoma (malignant neoplasm).
5. Severe diseases of the pancreas.
6. Internal bleeding. An exception is hemorrhage that occurs due to high permeability of the vascular walls.
7. Hypertension.
8. Stroke.
9. Problems with the kidneys and liver.
10. Problems with pregnancy.
11. Excessive consumption of alcoholic beverages.

And also Heparin should not be injected:

• intramuscularly;
• with leukemia;
• for anemia;
• if there is an acute aortic aneurysm;
• as a means of pain relief during childbirth.

Dosage and rules of use of the drug

Heparin is administered in several ways:

• subcutaneously;
• jet;
• into the vein intermittently.

Before the injection is given, you need to find out:

• blood clotting time;
• thrombin time;
• platelet level.

The dosage of the medicine depends on the specific situation:

1. In acute thrombosis, it is necessary to administer 1-2 ml of the drug 4-6 times a day. In this case, the first dose should be slightly larger than all the others - 2-3 ml.
2. To prevent thrombosis, it is necessary to give injections every 7 hours (1 ml). If the first one appeared internal combustion engine phase, the drug is administered subcutaneously in an amount of 0.5-1 ml. Over time, the dose is reduced.
3. During heart surgery, Heparin is administered by injection according to a special scheme. Initially, the dose is 1500 units per 10 kg of patient weight. The longer the operation lasts, the higher the dose should be. And it is also necessary to administer 1 ml of the drug approximately 60 minutes before the operation and the same amount three times a day after it.
4. The instructions for use indicate that Heparin can be used to treat young children. To make an intravenous injection, you need to take 50 units of medication per 1 kg of the child’s weight. To maintain the effect, inject 100 units every 4 hours. It is worth remembering that the maximum permissible dose of Heparin for young children is 300 units per 1 kg of their weight.
5. When repeated myocardial infarction occurs, 1 ml of medication is injected in a stream. Afterwards they put in an IV. Its rate should not exceed 1000 units of Heparin per hour.

Rules for drug administration and side effects

Most often you have to inject Heparin into the stomach. It's easy to do.

The main thing is to follow the instructions for Heparin injections:

1. First of all, you should wash your hands thoroughly with soap. Dry them with a towel. If the injection needs to be given to another person, it is recommended to wear sterile rubber gloves.
2. Prepare everything you might need in advance. This is an ampoule with Heparin, a syringe of the required volume, alcohol or calendula/hawthorn tincture to disinfect the injection site and a piece of sterile cotton wool.
3. Open the ampoule with the medicine. Carefully draw it into the syringe.
4. Moisten a cotton swab with alcohol and wipe the skin with it. Measure a distance equal to two fingers on one side of the navel. Grasp the skin with your fingers. It is desirable that the fold be thicker. Then it is easier to insert the needle.
5. Insert the needle into the skin while injecting Heparin. The rate of administration of the medicine can be adjusted depending on your feelings.
6. Pull out the needle.
7. Wipe the injection site with a cotton swab moistened with alcohol.

For one it is worth administering as much medicine as the doctor prescribed. The same applies to the duration of treatment.

If you use Heparin uncontrolled, side effects may develop:

1. Most often there is an allergy.
2. The level of liver enzymes increases.
3. Thrombocytopenia develops.
4. Necrosis of the skin at the site where the injection was given.
5. Hives.
6. Allergic runny nose.
7. Spasms in the bronchi.
8. Bleeding of various natures.
9. Hematomas. Most often they appear when the drug is administered intramuscularly.
10. Osteoporosis.
11. From the gastrointestinal tract - nausea and vomiting.
12. Headache and even migraine.
13. Digestive problems.
14. Stomach upset.
15. Feverish condition.
16. Hyperemia or redness of the skin.

Overdose and interaction with other drugs

An overdose condition is a consequence of the administration of too large doses of Heparin or a prolonged course of treatment. Its main symptom is bleeding. In most cases, it is necessary to reduce the dosage or stop treatment with Heparin.

In more complex situations, you should act differently:

1. Completely exclude the drug from prescriptions.
2. Start administering the antidote. In this case, its role is played by a solution of protamine sulfate. To neutralize 85 units of Heparin, you need to administer 1 mg of an antidote substance.

The correct dosage is not the only thing you should pay close attention to.

It is also important to study the rules for combining Heparin with other medications:

1. All anticoagulants increase the effect of taking the drug.
2. Allergy medications, vitamin C, Nitroglycerin and some antibiotics reduce the effectiveness of Heparin.
3. If you inject Heparin at the same time as taking Aspirin, Ticlopidine, Ibuprofen, Ketorolac and other similar drugs, the risk of bleeding increases.
4. The simultaneous use of tetracyclic antidepressants and Heparin greatly reduces the effectiveness of both.
5. When using Heparin with ACE inhibitors and angiotensin 2 antagonists, hyperkalemia may develop.

Injections with Heparin perfectly thin the blood and prevent the formation of blood clots. The drug is usually administered subcutaneously (injections in the abdomen). It must be used with extreme caution in treatment. Why? It has contraindications for use and side effects. In addition, when it is used together with other medications, the effectiveness of both itself and the drugs with which it is combined may decrease.

Heparin injections: instructions for use

Compound

Excipients: benzyl alcohol, sodium chloride, water for injection.

Description

Indications for use

Contraindications

Pregnancy and lactation

Directions for use and doses

For prophylactic purposes - subcutaneously, 5000 IU/day, at intervals of 8-12 hours.

The usual site for subcutaneous injections is the anterolateral abdominal wall (in exceptional cases it is injected into the upper region of the shoulder or thigh), using a thin needle that should be inserted deeply, perpendicularly, into a fold of skin held between the large and index finger until the end of the solution administration. The injection sites should be alternated each time (to avoid the formation of a hematoma). The first injection must be performed 1-2 hours before the start of surgery; V postoperative period administer for 7-10 days, and if necessary, for a longer time. The initial dose of heparin administered into medicinal purposes, is usually 5000 IU and is administered intravenously, after which treatment is continued using intravenous infusions.

Maintenance doses are determined depending on the route of administration:

For continuous intravenous infusion, prescribe IU/hour IU/day), diluting heparin in a 0.9% sodium chloride solution;

With periodic intravenous injections Prescribe 0 IU heparin every 4 hours.

For adults with thrombosis of mild to moderate severity, the drug is prescribed intravenously at a dose of 00 IU/day, divided by 3-4 times; for severe thrombosis and embolism - intravenously in a dose of IU/day, divided into 4 times with an interval of 6 hours. For health reasons, a single IU (5 ml) is administered intravenously, then IU every 4 hours until a daily dose of 20,000 IU is reached. For intravenous drip infusion, at least IU of heparin must be added to the daily volume of infusion solution.

Doses of heparin for intravenous administration are selected so that the activated partial thromboplastin time (aPTT) is 1.5-2.5 times greater than the control. With subcutaneous administration of small doses (5000 IU 2-3 times a day) for the prevention of thrombus formation, regular monitoring of aPTT is not required, because it increases slightly. Continuous intravenous infusion is the most effective way the use of heparin is better than regular (periodic) injections, because provides more stable hypocoagulation and is less likely to cause bleeding.

When performing extracorporeal blood circulation, it is administered in a dose of IU/kg or IU per 500 ml of blood. During hemodialysis, ME is first administered intravenously, then another 00 ME is administered in the middle of the procedure. For older people, especially women, doses should be reduced.

For children under 2 years old this dosage form cannot be prescribed.

For children over 2 years of age, the drug is administered intravenously at a dose of 500 IU/kg/day under APTT monitoring.

Side effect

Allergic reactions: skin hyperemia, drug fever,

urticaria, rhinitis, skin itching and feeling of heat in the soles, bronchospasm, collapse, anaphylactic shock. Dizziness, headaches, nausea, loss of appetite, vomiting, diarrhea.

Thrombocytopenia (6% of patients). Reactions of the first type are usually

manifest themselves in soft form and disappear after cessation of therapy; thrombocytopenia has severe course and can be fatal.

Against the background of heparin-induced thrombocytopenia, skin necrosis and arterial thrombosis occur, accompanied by the development of gangrene, myocardial infarction, and stroke. If severe thrombocytopenia develops (a decrease in the platelet count by 2 times from the initial number or below 100 thousand / μl), it is necessary to urgently stop using heparin.

On the background long-term use- osteoporosis, spontaneous bone fractures, soft tissue calcification, hypoaldosteronism, transient alopecia, increased activity of “liver” transaminases.

Local reactions: irritation, pain, hyperemia, hematoma and ulceration at the injection site, bleeding (the risk can be minimized with careful assessment of contraindications, regular laboratory monitoring of blood coagulation and accurate dosage).

Bleeding from the gastrointestinal tract and urinary tract, bleeding at the injection site, in areas exposed to pressure, from surgical wounds, as well as hemorrhages in other organs (adrenal glands, corpus luteum, retroperitoneal space).

Overdose

Treatment: for minor bleeding caused by an overdose of heparin, it is enough to stop using it. In case of extensive bleeding, excess heparin is neutralized with protamine sulfate (1 mg of protamine sulfate per 100 IU of heparin). It must be borne in mind that heparin is rapidly eliminated, and if protamine sulfate is prescribed 30 minutes after the previous dose of heparin, only half the required dose should be administered; The maximum dose of protamine sulfate is 50 mg. Hemodialysis is ineffective.

Interaction with other drugs

Do not mix with other medications in the same syringe.

Features of application

The heparin solution may turn yellow, but this does not change its activity or tolerability.

When prescribing heparin for therapeutic purposes, its dose is selected depending on the aPTT value.

While using heparin, other drugs should not be administered intramuscularly and organ biopsies should not be performed.

To dilute heparin, use only 0.9% sodium chloride solution. Features of the effect of the drug on the ability to drive vehicle or potentially dangerous mechanisms:

The ability of a drug to influence behavior or functional indicators body, interaction with tobacco, alcohol, food:

Precautionary measures

Persons suffering from polyvalent allergies (including bronchial asthma); arterial hypertension, dental procedures, diabetes mellitus, endocarditis, pericarditis, ICH, active tuberculosis, radiation therapy, liver failure, chronic renal failure, elderly age(over 60 years old, especially women).

Release form

5 bottles with instructions for use are placed in a cardboard pack.

Storage conditions

Keep out of the reach of children.

Best before date

Do not use after expiration date.

Conditions for dispensing from pharmacies

You should consult your doctor and read the instructions before use.

Heparin - injections

Heparin is a drug that is a direct anticoagulant, that is, it inhibits blood clotting. This medicine is produced in the form of forms for external use and liquid for injection. But most often a Heparin solution is used, since it begins to slow down the formation of fibrin more quickly.

Indications for use of Heparin

After the administration of Heparin, blood flow in the kidneys is activated, cerebral circulation changes and the effect of certain enzymes is reduced. That is why these injections are very often used for the treatment and prevention of myocardial infarctions. This drug is also prescribed in increased quantities for pulmonary embolism.

Indications for the use of Heparin are also:

• deep vein thrombosis;
• angina pectoris;
• coronary artery thrombosis;
• arrhythmia;
• thrombophlebitis;
• poor blood flow in the kidneys;
• some types of heart defects;
• lupus nephritis;
• glomerulonephritis;
• bacterial endocarditis.

In reduced doses, this medicine is used to prevent venous thromboembolism and in the first phase of DIC syndrome.

Heparin injections are also used during surgical interventions to prevent the patient’s blood from clotting too quickly.

How to use Heparin

The fastest effect occurs after intravenous injection of Heparin. For those who have received an intramuscular injection, the medicine will begin to act only after fifteen to thirty minutes, and if the injection is made under the skin, the effect of Heparin will begin in about an hour.

When this drug is prescribed as a precautionary measure, it is most often given subcutaneous injection five thousand units in the stomach. Between such injections there should be intervals of 8 to 12 hours. It is strictly forbidden to inject Heparin subcutaneously into the same place.

For treatment, different doses of this drug are used, which are selected by the doctor depending on the nature and type of the disease and the individual characteristics of the patient’s body. You cannot prescribe Heparin injections into the stomach yourself, nor use the drug with other medications without warning your doctor, since this anticoagulant interacts with many medications. But at the same time use Heparin and vitamins or biologically active additives possible without fear.

To dilute the drug use saline, since it cannot be mixed with other medications in the same syringe. Features of the administration of Heparin are that after intramuscular administration, the formation of hematomas is possible, and with long-term treatment with this medicine, side effects may appear:

• allergic reactions;
• Digestion or coordination problems;
• disturbance of calcium distribution;
• migraine-like pain.

Contraindications to the use of Heparin

Heparin should be used with caution during pregnancy and while breastfeeding. Only after consulting a doctor can this drug be used by those who suffer from polyvalent allergies.

Heparin injections are not given in the abdomen, intravenously or intramuscularly if the patient has:

• stomach ulcer;
• nonspecific ulcerative colitis;
• liver dysfunction;
• malignant neoplasms in the gastrointestinal tract;
• subacute bacterial endocarditis;
• renal dysfunction;
• arterial hypertension;
• hemorrhagic stroke;
• hypersensitivity to the drug.

Also, you should not use the drug for those who have recently undergone surgery on the eyes, brain, liver, or prostate gland.

How and why is Heparin injection used?

Heparin injections are prescribed to patients by medical professionals mainly for the purpose of thinning and preventing the formation of blood clots. In addition, Heparin injections are used for a number of diseases. Let us consider in more detail the principle of action of this drug, indications and features of its use.

Pharmacological action and clinical properties

What is Heparin used for? This drug belongs to the pharmacological group of direct-acting anticoagulants. The presented drug prevents blood clotting and the formation of blood clots by slowing down the processes of fibrin formation and reducing thrombin activity. Heparin is characterized by the presence of the following clinical properties:

• increase in the negative charge of blood elements;
• reduction of blood clotting factors;
• decreased adhesion;
• decreased aggregation of blood cells (leukocytes, erythrocytes, platelets);
• antiallergic effect;
• vasodilating effect;
• blocking the processes of lymphocyte cooperation;
• obstacle to the formation of immunoglobulins;
• fibrinolytic property;
• anticoagulant effect;
• obstacle to stasis development;
• binding of histamine to serotonin.

Indications for use

Due to its clinical properties and characteristics, this drug is quite widespread in modern medicine. Heparin injections are prescribed to the patient for the following diseases:

1. Thrombophlebitis.
2. Acute myocardial infarction.
3. Glomerulonephritis.
4. Deep venous thrombosis.
5. Atrial fibrillation.
6. Disseminated intravascular coagulation syndrome.
7. Bacterial endocarditis.
8. Thrombosis of the coronary arteries.
9. Lupus nephritis.
10. Thromboembolism of the pulmonary arteries.
11. Unstable angina.
12. Pathological lesions of peripheral veins.
13. Embolization accompanying atrial fibrillation.
14. Arrhythmia.
15. Disorders of blood flow in the kidney area.
16. Disorders of blood microcirculation processes.
17. Bronchial asthma.
18. Rheumatism.
19. Some types of heart defects.
20. Hemolyticouremic syndrome.

Heparin reduces the risk of sudden death in patients suffering from myocardial infarction or coronary artery thrombosis.

Heparin injections have a good effect as a prophylactic agent that prevents the development of venous thrombophlebia after surgical interventions.

The drug is used in the case of so-called extracorporeal methods. In addition, this drug is widely used for blood transfusions, its selection for diagnostic studies, as well as for the purpose of washing venous catheters, during hemosorption and hemodialysis procedures.

Contraindications

Despite the fairly wide range of uses of the drug, in some cases the use of Heparin injections is highly discouraged and poses a serious danger to the patient’s health. The main contraindications to its use are:

1. Pulmonary infarction.
2. Individual intolerance to certain components of the drug.
3. Bleeding.
4. Thrombocytopenia (reduced blood clotting).
5. Hemorrhagic diathesis.
6. Hemophilia.
7. Increased permeability of blood vessels.
8. Werlhof's disease.
9. Aplastic anemia.
10. Leukemia in acute or chronic form.
11. Venous gangrene.
12. Hypoplastic anemia.
13. Kidney failure.
14. Liver pathologies.
15. Acute cardiac aneurysm.
16. Ulcerative lesions of the stomach and duodenum.
17. Arterial hypertension in severe form.
18. Previous surgical interventions in the area of ​​the brain, visual apparatus, prostate gland.
19. Hemorrhagic stroke.
20. Recent spinal cord puncture.
21. Polyvalent allergy.
22. Ulcerative colitis.
23. The presence of tumor neoplasms of an oncological nature in the gastrointestinal tract.
24. Varicose veins of the esophagus.
25. Traumatic brain injury.

This medicine is used with extreme caution during pregnancy and breastfeeding. Typically, the drug is prescribed only in exceptional cases, when its benefit to the mother greatly outweighs the possible harm to the child.

Side effects

In some cases, the use of Heparin injections can lead to the development of the following undesirable reactions:

• allergy;
• hives;
• thrombocytopenia;
• rhinitis;
• bronchial spasms;
• bleeding;
• formation of hematomas (especially in the case of intramuscular administration of Heparin);
• osteoporosis;
• nausea;
• bouts of vomiting;
• headaches reminiscent of migraine in nature;
• disruption of digestive processes;
• diarrhea;
• fever;
• necrosis of the skin;
• disruption of calcium distribution processes in the soft tissue area;
• hyperemia.

It is worth noting that in most cases, the development of the above side effects is observed with prolonged and uncontrolled use of Heparin. In order to minimize risks, the therapeutic course must be carried out exclusively as prescribed by a doctor and under his strict supervision.

Types of injections

The instructions for use of Heparin state that the dosage and duration of treatment depend on the disease, its severity and are prescribed individually in each specific case. The drug is administered intravenously, subcutaneously or intramuscularly. The fastest effect is observed with intramuscular injections (approximately after 30 minutes). In the case of subcutaneous administration, the effect occurs after 1 hour.

As a preventative measure, in most cases the patient is prescribed subcutaneous injections of Heparin in the abdomen, at time intervals of 8 to 12 hours. The dosage and frequency of Heparin injections in the stomach, used to combat certain diseases, are prescribed by the attending physician, taking into account factors such as the patient’s age, his diagnosis, general health, and the presence of concomitant ailments.

It is strictly contraindicated to give injections in the same place, as well as to take any medications without permission, since Heparin actively reacts with a wide range of drugs.

In the case of a long therapeutic course, it is necessary to monitor the clinical picture of the blood by conducting regular blood tests.

Heparin injections are a very effective drug that promotes the prevention and accelerated treatment of a number of diseases.

However, this drug, if taken uncontrolled, can provoke the development of numerous side effects and life-threatening bleeding. Therefore, therapy should be carried out under the strict supervision of the attending physician.

Heparin

Description current as of 08/04/2016

• Latin name: Heparin
• ATX code: C05BA03
• Active ingredient: Heparin sodium (Heparin sodium)
• Manufacturer: Synthesis OJSC, Murom Instrument-Making Plant, Tatkhimfarmpreparaty, Microgen NPO FSUE, Armavir Biofactory, Slavyanskaya Pharmacy FC LLC, Moscow Endocrine Plant (Russia), Belmedpreparaty RUP (Republic of Belarus)

Compound

The injection solution contains sodium heparin at a concentration of 5 thousand units/ml. The auxiliary components of the drug include sodium chloride, benzyl alcohol, and water.

1 gram of gel contains 1 thousand units of sodium heparin, as well as auxiliary components: 96% ethanol, carbomer, dimethyl sulfoxide, propylene glycol, dietanolamine, methyl and propylparaben (additives E 218, E 216), lavender oil and purified water.

Release form

• Gel for external use 1 thousand units/g (ATC code - C05BA03). Tubes 30 g.
• Solution for 5 thousand units/ml, 1 and 2 ml in ampoules No. 10, 2 and 5 ml in ampoules No. 5, 5 ml in bottles No. 1 and No. 5.

pharmachologic effect

Pharmacological group: anticoagulants.

Group of the drug Heparin, produced in the form of a gel: drugs for the treatment of cardiovascular diseases.

Group of the drug Heparin, produced in injection form: agents affecting blood and hematopoiesis.

Pharmacodynamics and pharmacokinetics

What is Heparin?

Heparin (INN: Heparin) is an acidic mucopolysaccharide with Mr about 16 kDa. A direct anticoagulant that helps slow down the formation of fibrin.

The gross formula of heparin is C12H19NO20S3.

Pharmacodynamics

The mechanism of action of heparin is based primarily on its binding to AT III (its plasma cofactor). Being a physiological anticoagulant, it potentiates the ability of AT III to suppress activated coagulation factors (in particular, IXa, Xa, XIa, XIIa).

In case of use in high concentrations heparin also inhibits thrombin activity.

Suppresses activated factor X, which is involved in the internal and external blood coagulation system.

The effect occurs when significantly lower doses of heparin are used than are required to inhibit the activity of coagulation factor II (thrombin), which promotes the formation of fibrin from the plasma protein fibrinogen.

This justifies the possibility of using small doses of heparin (subcutaneously) for prophylactic purposes, and large doses for treatment.

Heparin is not a fibrinolytic (that is, it is capable of dissolving blood clots), but it can reduce the size of the blood clot and stop its expansion. Thus, the blood clot is partially dissolved under the action of fibrinolytic enzymes of natural origin.

Suppresses the activity of the enzyme hyaluronidase, helps reduce the activity of surfactant in the lungs.

Reduces the risk of developing MI, acute thrombosis of myocardial arteries and sudden death. In small doses it is effective for the prevention of VTE, in high doses it is effective against venous thrombosis and pulmonary embolism.

Deficiency of AT III at the site of thrombosis or plasma may reduce the antithrombotic effect of the drug

When applied externally, the product has a local anti-exudative, antithrombotic and moderate anti-inflammatory effect.

Promotes the activation of fibrinolytic properties of blood, inhibits the activity of hyaluronidase, and blocks the formation of thrombin. Gradually released from the gel and passing through the skin, heparin helps reduce inflammation and has an antithrombotic effect.

At the same time, the patient’s microcirculation improves and tissue metabolism is activated and, as a result, the processes of resorption of blood clots and hematomas are accelerated, and tissue swelling is reduced.

Pharmacokinetics

When used externally, absorption is negligible.

After injection under the skin TCmax hours. Up to 95% of the substance is in a state bound to plasma proteins, Vp - 0.06 l/kg (the substance does not leave the vascular bed due to strong binding to plasma proteins).

It does not penetrate the placental barrier or into breast milk.

Metabolized in the liver. The substance is characterized by rapid biological inactivation and short duration of action, which is explained by the participation of the antiheparin factor in its biotransformation and the binding of heparin to the macrophage system.

T1/minute. Excreted by the kidneys. Up to 50% of the substance can be excreted unchanged only if high doses are used. It is not excreted by hemodialysis.

Indications for use

Indications for use of the gel

Heparin gel is used for the treatment and prevention of thrombophlebitis of the superficial veins, phlebitis (post-injection and post-infusion), lymphangitis, superficial periphlebitis, elephantiasis, localized infiltrates, bruises, swelling and injuries (including muscles, joints, tendons), superficial mastitis, subcutaneous hematomas.

Indications for use of the solution

Heparin injections are prescribed for thrombosis of deep veins, myocardial arteries, renal veins, pulmonary embolism, thrombophlebitis, atrial fibrillation (including if the heart rate accompanied by embolization), unstable angina, disseminated intravascular coagulation syndrome, acute MI, mitral heart disease (prevention of blood clots), bacterial endocarditis, hemolyticouremic syndrome, lupus nephritis, glomerulonephritis, for the prevention and treatment of microthrombosis and microcirculation disorders.

For preventive purposes, the drug is used during surgical interventions that use extracorporeal blood circulation methods, during cytapheresis, peritoneal dialysis, hemodialysis, forced diuresis, hemosorption, and when washing venous catheters.

When Heparin is administered intravenously, blood clotting slows down almost immediately, when administered into a muscle - after a minute, when administered subcutaneously - after a minute, when administered by inhalation, the effect is most pronounced after a day.

Contraindications

Heparin gel (ointment) should be used with caution in case of thrombocytopenia and increased tendency to bleeding.

Contraindications for use injection form drug:

• hypersensitivity;
• diseases accompanied by increased bleeding (vasculitis, hemophilia, etc.);
• bleeding;
• aortic dissection, intracranial aneurysm;
• antiphospholipid syndrome;
• traumatic brain injury;
• hemorrhagic stroke;
• uncontrolled hypertension;
• liver cirrhosis accompanied by pathological change veins of the esophagus;
• threatened miscarriage;
• menstrual period;
• pregnancy;
• childbirth (including recent);
• lactation period;
• erosive and ulcerative lesions of the stomach and intestinal tract;
• transferred in the recent past surgical interventions on the prostate gland, brain, eyes, biliary tract and liver, as well as the condition after lumbar puncture.

Heparin injections should be prescribed with caution to patients with polyvalent allergies (including bronchial asthma), diabetes mellitus, arterial hypertension, active tuberculosis, endo- and pericarditis, chronic renal failure, liver failure; patients undergoing dental procedures or radiation therapy; persons over 60 years of age (especially women); women using an IUD.

Side effects

When used externally, Heparin sodium can cause skin hyperemia and hypersensitivity reactions.

When administering the solution, the following are possible:

• Hypersensitivity reactions (drug fever, hyperemia skin, rhinitis, feeling of heat in the soles, urticaria, itching, collapse, bronchospasm, anaphylactic shock).
• Headaches, dizziness, diarrhea, loss of appetite, nausea, vomiting;
• Thrombocytopenia (in approximately 6% of patients), sometimes (rarely) - with fatal. Heparin-induced thrombocytopenia (HIT) is accompanied by: arterial thrombosis, skin necrosis and gangrene, stroke, myocardial infarction. In case of severe HIT (when the platelet count is reduced to half the original number or below 100 thousand/μl), heparin should be stopped immediately.
• Local reactions (hematoma, hyperemia, pain, ulceration, irritation at the injection site, bleeding).
• Bleeding. Typical ones are considered to be from the urinary tract and gastrointestinal tract, in areas that are subject to pressure, at the site of drug administration, from surgical wounds. Hemorrhages are also possible in various internal organs: in the retroperitoneal space, corpus luteum, adrenal glands, etc.

Against the background of long-term use of Heparin, intermittent alopecia, osteoporosis, hypoaldosteronism develop, and calcification occurs. soft fabrics, spontaneous bone fractures occur, and the activity of liver transaminases increases.

Instructions for use of Heparin (Method and dosage)

Heparin injections, instructions for use, administration features

Heparin in ampoules is prescribed in the form of:

• regular injections into a vein;
• continuous infusion;
• subcutaneously (injections in the stomach).

For preventive purposes, sodium heparin is administered subcutaneously at a dose of 5 thousand IU/day, leaving 8-12 hours between injections (to prevent thrombosis, the patient is injected with 1 ml of solution under the skin of the abdomen 2 times/day).

For medicinal purposes, the solution is infused intravenously (the method of administration is drip infusion). Dose - 15 IU/kg/h (that is, for an adult with average weight body is prescribed 1 thousand IU/hour).

To achieve a rapid anticoagulant effect, 1 ml of solution is injected intravenously into the patient immediately before infusion. If administration into a vein is impossible for some reason, then the medicine is injected under the skin 4 times a day. 2 ml.

Highest daily dosage thousand. ME. Use Heparin in specified dose more than 10 days are allowed only in exceptional cases.

For children, the solution is injected into a vein by drip. The dose is selected depending on age: at the age of 1 to 3 months, the daily dose is IU/kg, from 4 months to a year, IU/kg, children over 6 years of age are prescribed (under APTT monitoring) 500 IU/kg/day.

Technique for administering Heparin, preparation for manipulation and administration of solution

Subcutaneous injections are usually given into the anterolateral wall of the abdomen (if this is not possible, the medicine can be injected into the upper thigh/shoulder area).

A thin needle is used for injection.

The first injection is given 1-2 hours before the start of the operation; in the postoperative period, the drug continues to be administered for 7-10 days (if necessary, longer).

Treatment begins with a jet injection of 5 thousand IU of heparin into a vein, after which the solution is continued to be administered using an intravenous infusion (a 0.9% NaCl solution is used to dilute the drug).

Maintenance doses are calculated depending on the route of administration.

The algorithm for administering Heparin is as follows:

• One minute before administering the drug, apply cold to the injection site in the abdomen (this will reduce the likelihood of bruising).
• The procedure is performed in compliance with the rules of asepsis.
• The needle is inserted into the base of the fold (the fold is held between the thumb and forefinger until the end of drug administration) at an angle of 90°.
• Do not move the tip of the needle after insertion or retract the piston. Otherwise, tissue damage and hematoma formation may occur.
• The solution should be injected slowly (to reduce pain and avoid tissue damage).
• The needle is removed easily, at the same angle at which it was inserted.
• There is no need to wipe the skin; the injection site is lightly pressed with a sterile dry swab (the swab is held for a second).
• It is recommended to alternate anatomical sites for injection. The areas in which injections are given during the week should be 2.5 cm apart from each other.

Heparin ointment, instructions for use

The gel is used as an external agent. It should be applied to the affected area from 1 to 3 times a day. A single dose is a column 3 to 10 cm long.

For thrombosis of hemorrhoidal veins, the drug is used rectally.

Gel-impregnated cotton pads are applied to the inflamed nodes and secured with a bandage. Gel-soaked tampons are inserted into the anus. Treatment usually lasts 3-4 days.

For leg ulcers, the ointment is carefully applied to inflamed skin around the ulcer.

Multiplicity of applications / day. Treatment is continued until the inflammation disappears. Usually the course lasts from 3 to 7 days. The doctor decides whether a longer course is necessary.

Other heparin-containing ointments are used in a similar way (for example, the instructions for Heparin-Acrigel 1000 are practically no different from the instructions for Heparin gel or Lyoton 1000 gel).

For the treatment of hemorrhoids (external and internal), anal fissures, thrombophlebitis of the anal veins, as well as to relieve itching and eliminate eczema in the anal area, suppositories for hemorrhoids (for example, Hepatrombin G) can be used as an alternative to Heparin ointment.

Additional Information

Heparin is available only in the form of a solution, ointment or gel (gel, unlike ointment, contains a larger amount of the active substance and is better absorbed into the skin).

Heparin tablets are not available because heparin is practically not absorbed from the digestive tract.

Overdose

Symptoms of overdose with parenteral use are bleeding varying degrees gravity.

Treatment: for minor bleeding caused by an overdose of the drug, it is enough to stop using it. If bleeding is extensive, protamine sulfate (1 mg per 100 IU of heparin) is used to neutralize excess heparin.

Please note that heparin is eliminated quickly. Thus, if protamine sulfate is administered 30 minutes after the previous dose of heparin, it should be administered at half the dose; The highest dose of protamine sulfate is 50 mg.

It is not excreted by hemodialysis.

Cases of overdose with external use of the drug have not been described. Due to the low systemic absorption of the drug, an overdose is considered unlikely. With prolonged use on large surfaces, hemorrhagic complications are possible.

Treatment: discontinuation of the drug, if necessary, use of a one percent solution of protamine sulfate (heparin antagonist).

Interaction

Drugs that block tubular secretion indirect anticoagulants, reducing the formation of vitamin K intestinal microflora antibiotics, NSAIDs, dipyridamole, ASA and other drugs that reduce platelet aggregation enhance the effect of heparin.

Do not mix the solution in the same syringe with other medications.

When applied topically, the anticoagulant effect of the drug is enhanced when the gel is used in combination with antiplatelet agents, NSAIDs, and anticoagulants. Tetracycline, thyroxines, nicotine and antihistamines reduce the effect of heparin.

Terms of sale

The gel is an over-the-counter product; a prescription is required to purchase the solution.

Heparin recipe in Latin (sample):

S. IV food, first dilute the contents of the bottle in an isotonic NaCl solution.

Storage conditions

Ampoules with solution should be stored in a dry place, protected from light, out of the reach of children.

The gel should be stored out of the reach of children at a temperature below 25˚C. Shelf life after opening - 28 days.

Best before date

special instructions

Due to the risk of hematoma formation at the injection site, the solution should not be injected into the muscle.

The solution may acquire a yellowish tint, which does not affect its activity or tolerability.

When prescribing the drug for therapeutic purposes, the dosage should be selected taking into account the aPTT value.

During treatment with the drug, organ biopsies and other medications should not be administered intramuscularly.

To dilute the solution, only 0.9% NaCl solution can be used.

The gel should not be applied to mucous membranes or open wounds. In addition, it is not used in the presence of purulent processes. The use of ointment is not recommended for DVT.

Unfractionated Heparin

Unfractionated is called Heparin with an average molecular weight thousand daltons, which are isolated from bovine lung or the mucous membrane of the intestinal tract of pigs. It is used in the production of drugs that provide local and systemic action(heparin containing ointments and solutions for parenteral administration).

The drug, through interaction with AT III (indirectly), inhibits the main enzyme of the blood coagulation system, as well as other coagulation factors, and this in turn leads to antithrombotic and anticoagulation effects.

Endogenous heparin human body can be found in muscles, intestinal mucosa, and lungs. In structure, it is a mixture of glycosaminoglycan fractions, which consist of sulfatide residues of D-glucosamine and D-glucuronic acid with a molecular weight of 2 to 50 thousand daltons.

Fractionated Heparin

Fractionated (low molecular weight) heparins are obtained by enzymatic or chemical depolymerization of unfractionated heparins. This Heparin consists of polysaccharides with an average molecular weight of thousands. Dalton.

LMWHs are characterized as weak anticoagulants and highly effective direct-acting antithrombotics. The action of such drugs is aimed at compensating hypercoagulation processes.

LMWH begins to act immediately after administration, while its antithrombotic effect is pronounced and prolonged (the drug is administered only 1 time per day).

Classification of low molecular weight Heparins:

Analogs

Use during pregnancy and lactation

Heparin solution is not contraindicated for pregnant women. However, despite the fact that active substance the drug does not penetrate into milk, its use in nursing mothers is in some cases led to rapid (within 2-4 weeks) development of osteoporosis and spinal damage.

The feasibility of use should be decided individually, taking into account the risk to the fetus/benefit to the mother ratio.

There are no data on the use of the gel during pregnancy and lactation.

Heparin injections: instructions for use

Compound

Description

Indications for use

Contraindications

Pregnancy and lactation

Directions for use and doses

Side effect

Allergic reactions: skin hyperemia, drug fever,

urticaria, rhinitis, itching and feeling of heat in the soles, bronchospasm, collapse, anaphylactic shock. Dizziness, headaches, nausea, loss of appetite, vomiting, diarrhea.

Thrombocytopenia (6% of patients). Reactions of the first type are usually

appear in a mild form and disappear after cessation of therapy; thrombocytopenia is severe and can be fatal.

Against the background of heparin-induced thrombocytopenia, skin necrosis and arterial thrombosis occur, accompanied by the development of gangrene, myocardial infarction, and stroke. If severe thrombocytopenia develops (a decrease in the platelet count by 2 times from the initial number or below 100 thousand / μl), it is necessary to urgently stop using heparin.

With long-term use - osteoporosis, spontaneous bone fractures, soft tissue calcification, hypoaldosteronism, transient alopecia, increased activity of liver transaminases.

Local reactions: irritation, pain, hyperemia, hematoma and ulceration at the injection site, bleeding (the risk can be minimized with careful assessment of contraindications, regular laboratory monitoring of blood coagulation and accurate dosage).

Typical are bleeding from the gastrointestinal tract and urinary tract, bleeding at the injection site, in areas exposed to pressure, from surgical wounds, as well as hemorrhages in other organs (adrenal glands, corpus luteum, retroperitoneal space).

Overdose

Interaction with other drugs

Features of application

Precautionary measures

Release form

Storage conditions

Best before date

Conditions for dispensing from pharmacies

Heparin injections analogues, synonyms and group drugs

Self-medication can be harmful to your health.
You should consult your doctor and read the instructions before use.