HEPARIN (Systemic)

Some commonly used brand names are:

In the U.S.?

• Calciparine
• HEP-LOCK U/P
• Liquaemin

In Canada?

• Calcilean
• Calciparine
• Hepalean
• Heparin Leo

Generic name product may be available in the U.S. and Canada.

Category

• Anticoagulant

Description

Heparin (HEP-a-rin) is an anticoagulant. It is used to decrease theclotting ability of the blood and help prevent harmful clots from formingin the blood vessels. This medicine is sometimes called a blood thinner, althoughit does not actually thin the blood. Heparin will not dissolve blood clotsthat have already formed, but it may prevent the clots from becoming largerand causing more serious problems.

Heparin is often used as a treatment for certain blood vessel, heart, andlung conditions. Heparin is also used to prevent blood clotting during open-heartsurgery, bypass surgery, and dialysis. It is also used in low doses to preventthe formation of blood clots in certain patients, especially those who musthave certain types of surgery or who must remain in bed for a long time.

Heparin Lock Flush solution is used to prevent clots from forming in avenous catheter. This maintains access to veins in the body when multipleinjections or blood samples are required.

Heparin is available only with your doctor's prescription, in the followingdosage form:

Parenteral
• Injection (U.S. and Canada)

Before Using This Medicine

In deciding to use a medicine,the risks of taking the medicine must be weighed against the good it willdo. This is a decision you and your doctor will make. For heparin, the followingshould be considered:

Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to heparin, to beef, or to pork. Also tell your health careprofessional if you are allergic to any other substances, such as foods, preservatives,or dyes.

Pregnancy?Heparin has not been shown to cause birth defectsor bleeding problems in the baby. However, use during the last 3 months ofpregnancy or during the month following the baby's delivery may cause bleedingproblems in the mother.

Breast-feeding?Heparin does not pass into the breast milk. However,heparin can rarely cause bone problems in the nursing mother. This effecthas been reported to occur when heparin is used for 2 weeks or more. Be sureto discuss this with your doctor.

Children?Heparin has been tested in children and, in effectivedoses, has not been shown to cause different side effects or problems thanit does in adults.

The 100 unit/mL concentration of heparin Lock Flush solution should notbe used in children weighing less than 10 kg. The 10 unit/mL concentrationof heparin Lock Flush solution should be used with caution in children weighingless than 1 kg.

Older adults?Bleeding problems may be more likely to occur inelderly patients, especially women, who are usually more sensitive than youngeradults to the effects of heparin.

Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. When you are takingheparin, it is especially important that your health care professional knowif you are taking any of the following:

• Aspirin or
• Carbenicillin by injection (e.g., Geopen) or
• Cefamandole (e.g., Mandol) or
• Cefoperazone (e.g., Cefobid) or
• Cefotetan (e.g., Cefotan) or
• Dipyridamole (e.g., Persantine) or
• Divalproex (e.g., Depakote) or
• Medicine for inflammation or pain, except narcotics, or
• Medicine for overactive thyroid or
• Pentoxifylline (e.g., Trental) or
• Plicamycin (e.g., Mithracin) or
• Probenecid (e.g., Benemid) or
• Sulfinpyrazone (e.g., Anturane) or
• Ticarcillin (e.g., Ticar) or
• Valproic acid (e.g., Depakene)?Using any of these medicinestogether with heparin may increase the risk of bleeding

• Also, tell your doctor if you are now receiving any kind of medicineby intramuscular (IM) injection.

Other medical problems?The presence of other medicalproblems may affect the use of heparin. Make sure you tell your doctor ifyou have any other medical problems, especially:

• Allergies or asthma (history of)?The risk of an allergic reactionto heparin may be increased

• Blood disease or bleeding problems or
• Colitis or stomach ulcer (or history of) or
• Type 2 diabetes mellitus(severe) or
• High blood pressure (hypertension) or
• Kidney disease or
• Liver disease or
• Tuberculosis (active)?The risk of bleeding may be increased

Also, tell your doctor if you have received heparin before and had a reactionto it called thrombocytopenia, or if new blood clots formed while you werereceiving the medicine.

In addition, it is important that you tell your doctor if you have recentlyhad any of the following conditions or medical procedures:

• Childbirth or
• Falls or blows to the body or head or
• Heavy or unusual menstrual bleeding or
• Insertion of intrauterine device (IUD) or
• Medical or dental surgery or
• Spinal anesthesia or
• X-ray (radiation) treatment?The risk of serious bleeding maybe increased

Proper Use of This Medicine

If you are using these injections at home, make sure your doctor has explainedexactly how this medicine is to be given.

To obtain the best results without causing serious bleeding, use this medicine exactly as directed by your doctor. Be certain that youare using the right amount of heparin, and that you use it according to schedule. Be especially careful that you do not use more of it, do not useit more often, and do not use it for a longer time than your doctor ordered.

Your doctor should check your progress at regular visits. A blood test must be taken regularly to see how fast your blood isclotting so that your doctor can decide on the proper amount of heparin youshould be receiving each day.

Dosing?The dose of heparin will be different for differentpatients and must be determined by your doctor. The dose you receive willbe based on the type of heparin you receive, the condition for which you arereceiving heparin, and your body weight.

Missed dose?If you miss a dose of this medicine, use it assoon as possible. However, if it is almost time for your next dose, do notuse the missed dose at all and do not double the next one. Doubling the dose may cause bleeding. Instead, go back to your regulardosing schedule. It is best to keep a record of each dose as you use it toavoid mistakes. Be sure to give your doctor a record of any doses you miss.If you have any questions about this, check with your doctor.

Storage?To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Keep the medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be surethat any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

Do not take aspirin while using this medicine. Many nonprescription(over-the-counter [OTC]) medicines and some prescription medicines containaspirin. Check the labels of all medicines you take. Also, do not take ibuprofenunless it has been ordered by your doctor. In addition, there are many othermedicines that may change the way heparin works or increase the chance ofbleeding if they are used together with heparin. It is best to check withyour health care professional before taking any other medicine while you areusing heparin.

Tell all medical doctors and dentists you visit thatyou are using this medicine.

It is recommended that you carry identification stating that you are usingheparin. If you have any questions about what kind of identification to carry,check with your health care professional.

While you are using this medicine, it is very important that you avoidsports and other activities that may cause you to be injured. Report to yourdoctor any falls, blows to the body or head, or other injuries, since seriousbleeding inside the body may occur without your knowing about it.

Take special care in brushing your teeth and in shaving. Use a soft toothbrushand floss gently. Also, it is best to use an electric shaver rather than ablade.

Side Effects of This Medicine

Since many things can affectthe way your body reacts to this medicine, you should always watch for signsof unusual bleeding. Unusual bleeding may mean that your body is getting moreheparin than it needs.

Along with its needed effects, a medicine maycause some unwanted effects. Although not all of these side effects may occur,if they do occur they may need medical attention.

Check with your doctorimmediately if any of the following signs and symptoms of bleedinginside the body occur:

Abdominal or stomach pain or swelling; back pain or backaches; blood in urine; bloody or black, tarry stools; constipation; coughing up blood; dizziness; headaches (severe or continuing); joint pain, stiffness, or swelling; vomiting of blood or material that looks like coffee grounds

Also, check with your doctor immediately if any of the following side effectsoccur, since they may mean that you are having a serious allergic reactionto the medicine:

Changes in the skin color of the face; fast or irregular breathing; puffiness or swellingof the eyelids or around the eyes; shortness of breath,troubled breathing, tightness in chest, and/or wheezing; skin rash, hives, and/or itching

Also, check with your doctor as soon as possible if any of thefollowing occur:

Bleeding from gums when brushing teeth; heavy bleeding or oozing from cuts or wounds; unexplainedbruising or purplish areas on skin; unexplained nosebleeds; unusually heavy or unexpected menstrual bleeding

Other side effects that may need medical attention may occur while youare using this medicine. Check with your doctor as soon as possible if anyof the following side effects occur:

Less common or rare

Back or rib pain (with long-term use only); change in skin color, especially near the place of injection or in the fingers,toes, arms, or legs; chest pain; chills and/or fever; collection of blood under skin(blood blister) at place of injection; decrease inheight (with long-term use only); frequent or persistenterection; irritation, pain, redness, or ulcers atplace of injection; itching and burning feeling,especially on the bottom of the feet; nausea and/orvomiting; numbness or tingling in hands or feet; pain, coldness, or blue color of skin of arms or legs; peeling of skin; runny nose; tearing of eyes; unusual hair loss (withlong-term use only)

Otherside effects not listed above may also occur in some patients. If you noticeany other effects, check with your doctor.