Pronunciation:

HEP-a-rin

Brand Names:

• Hepflush-10
• Hep-Lock
• Hep-Lock U/P
• Vasceze Heparin Lock Flush

Dosage Forms:

• Solution
• Kit

Classifications:

Therapeutic—

Anticoagulant

Pharmacologic—

Heparin (class)

Uses of This Medicine:

Heparin is an anticoagulant. It is used to decrease the clotting ability of the blood and help prevent harmful clots from forming in the blood vessels. This medicine is sometimes called a blood thinner, although it does not actually thin the blood. Heparin will not dissolve blood clots that have already formed, but it may prevent the clots from becoming larger and causing more serious problems.

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

Heparin is available only with your doctor's prescription.

Before Using This Medicine:

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

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Heparin has been tested in children and, in effective doses, has not been shown to cause different side effects or problems than it does in adults.

Older adults—

Bleeding problems may be more likely to occur in elderly patients, especially women, who are usually more sensitive than younger adults to the effects of heparin.

Pregnancy—

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Other medicines—

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Abciximab
• Acenocoumarol
• Alprostadil
• Alteplase, Recombinant
• Anisindione
• Anistreplase
• Ardeparin
• Argatroban
• Aspirin
• Bivalirudin
• Cefamandole
• Cefoperazone
• Certoparin
• Cilostazol
• Citalopram
• Clopidogrel
• Dalteparin
• Danaparoid
• Defibrotide
• Dermatan Sulfate
• Desirudin
• Desvenlafaxine
• Dextran
• Dicumarol
• Duloxetine
• Enoxaparin
• Eptifibatide
• Escitalopram
• Fluoxetine
• Fluvoxamine
• Fondaparinux
• Garlic
• Ginkgo
• Heparin
• Indomethacin
• Lamifiban
• Moxalactam
• Nadroparin
• Papaya
• Parnaparin
• Paroxetine
• Phenindione
• Phenprocoumon
• Reteplase, Recombinant
• Reviparin
• Sertraline
• Sibrafiban
• St John's Wort
• Streptokinase
• Tan-Shen
• Tenecteplase
• Tinzaparin
• Tirofiban
• Urokinase
• Venlafaxine
• Warfarin
• Xemilofiban

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Allergies or asthma (history of)—The risk of an allergic reaction to heparin may be increased.

• Blood disease or bleeding problems or
• Colitis or stomach ulcer (or history of) or
• 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 reaction to it called thrombocytopenia, or if new blood clots formed while you were receiving the medicine.

In addition, it is important that you tell your doctor if you have recently had 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 an intrauterine device (IUD) or
• Medical or dental surgery or
• Spinal anesthesia or
• X-ray (radiation) treatment—The risk of serious bleeding may be increased.

Proper Use of This Medicine:

If you are using these injections at home, make sure your doctor has explained exactly 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 you are using the right amount of heparin, and that you follow a schedule. Be especially careful that you do not use more of it, do not use it 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 on a regular basis to see how fast your blood is clotting. This helps your doctor decide on the proper amount of heparin you should be receiving each day.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Doubling the dose may cause bleeding. Instead, go back to your regular dosing schedule. It is best to keep a record of each dose as you use it to avoid 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—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using This Medicine:

Do not take aspirin while using this medicine. Many nonprescription (over-the-counter [OTC]) medicines and some prescription medicines contain aspirin. Check the labels of all medicines you take. Also, do not take ibuprofen unless it has been ordered by your doctor. There are many other medicines that may change the way heparin works or increase the chance of bleeding if they are used together with heparin. It is best to check with your doctor before taking any other medicine while you are using heparin.

You may bleed and bruise more easily while you are using this medicine. Stay away from rough sports or other situations where you could be bruised, cut , or injured. Tell your doctor about any falls, blows to the body or head, or other injuries, since serious bleeding may occur inside the body with this medicine. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers. Avoid nose picking and forceful nose blowing.

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

It is recommended that you carry identification stating that you are using heparin. If you have any questions about what kind of identification to carry, check with your doctor.

Side Effects of This Medicine:

Since many things can affect the way your body reacts to this medicine, you should always watch for signs of unusual bleeding. Unusual bleeding may mean that your body is getting more heparin than it needs. Serious side effects can occur, even up to several weeks after you have stopped using this medicine. Check with your doctor right away if you have any unusual side effects while you are using heparin and after you stop using it.

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

Check with your doctor or nurse immediately if any of the following side effects occur:

Less common

Abdominal or stomach pain or swelling

back pain or backaches

bleeding from the gums when brushing teeth

blood in the urine

constipation

coughing up blood

dizziness

headaches (severe or continuing)

heavy bleeding or oozing from cuts or wounds

joint pain, stiffness, or swelling

unexplained bruising or purplish areas on the skin

unexplained nosebleeds

unusually heavy or unexpected menstrual bleeding

vomiting of blood or material that looks like coffee grounds

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

collection of blood under skin (blood blister) at the place of injection

decrease in height (with long-term use only)

fast or irregular breathing

fever

frequent or persistent erection

irritation, pain, redness, or ulcers at the place of injection

itching and burning feeling, especially on the bottom of the feet

nausea and/or vomiting

numbness or tingling in the hands or feet

pain, coldness, or blue color of the skin on the arms or legs

peeling of the skin

puffiness or swelling of the eyelids or around the eyes

runny nose

shortness of breath

skin rash, hives, and/or itching

tearing of the eyes

tightness in the chest

trouble with breathing

unusual hair loss (with long-term use only)

wheezing

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

Black, tarry stools

bleeding gums

blood in the urine or stools

pain in chest, groin, or legs, especially calves of legs

pinpoint red spots on the skin

severe headaches of sudden onset

sudden loss of coordination

sudden shortness of breath for no apparent reason

sudden slurred speech

sudden vision changes

unusual bleeding or bruising

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.