Pull back the plunger of the syringe to put as much air in the syringe as the dose of medicine you want. Available for Android and iOS devices. Table 1: Recommended Adult Full-Dose Heparin Regimens for Therapeutic Anticoagulant Effect, We comply with the HONcode standard for trustworthy health information -, 5,000 units by intravenous injection, followed by 10,000 to 20,000 units of a concentrated solution, subcutaneously, 8,000 to 10,000 units of a concentrated solution, 15,000 to 20,000 units of a concentrated solution, 10,000 units, either undiluted or in 50 to 100 mL of 0.9% Sodium Chloride Injection, USP, 5,000 to 10,000 units, either undiluted or in 50 to 100 mL of 0.9% Sodium Chloride Injection, USP, 20,000 to 40,000 units/24 hours in 1,000 mL of 0.9% Sodium Chloride Injection, USP (or in any compatible solution) for infusion, 75 to 100 units/kg (IV bolus over 10 minutes), Adjust Heparin to maintain aPTT of 60 to 85 seconds, assuming this reflects an anti-Factor Xa level of 0.35 to 0.70, ANALYSIS(71839-117), MANUFACTURE(71839-117). A.D.A.M. Geriatric patients 's editorial policy editorial process and privacy policy. Pediatric patients, including neonates, have died as a result of medication errors in which Heparin sodium injection vials have been confused with “catheter lock flush” vials [see Warnings and Precautions (5.1)]. • Prevention of clotting in arterial and cardiac surgery; Inform patients that generalized hypersensitivity reactions have been reported. Heparin therapy may then be discontinued without tapering [see Drug Interactions (7.1)]. Dry them well. Cary, NC 27511. Each mL of the 1,000 units per mL preparation contains: 1,000 USP Heparin units (porcine); 9 mg sodium chloride; Water for Injection q.s. • Hematologic - Conditions associated with increased bleeding tendencies, such as hemophilia, thrombocytopenia and some vascular purpuras. Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. What is heparin injection? Heparin Sodium Injection is supplied in vials containing various strengths of heparin, including vials that contain a … There are no available data on Heparin sodium use in pregnant women to inform a drug-associated risk of major birth defects and miscarriage. The site you choose for the injection should be clean and dry. Push the needle all the way into the skin. Heparin sodium may prolong the one-stage prothrombin time. When there are no bubbles, take the syringe out of the bottle. Resistance to Heparin is frequently encountered in fever, thrombosis, thrombophlebitis, infections with thrombosing tendencies, myocardial infarction, cancer, in postsurgical patients, and patients with antithrombin III deficiency. • Atrial fibrillation with embolization; Do not shake it. • HIT and HITT, including delayed onset cases [see Warnings and Precautions (5.3)]. It is to be administered by intravenous or deep subcutaneous routes. The following clinically significant adverse reactions are described elsewhere in the labeling: Pull the needle out at the same angle it went in. Check with your doctor or nurse immediately if any of the following side effects occur while taking heparin: Heparin Sodium Injection, USP Rx only DESCRIPTION Heparin is a heterogeneous group of straight-chain anionic mucopolysaccharides, called glycosaminoglycans, having anticoagulant properties. Heparin does not have fibrinolytic activity; therefore, it will not lyse existing clots. • Local Irritation – Local irritation, erythema, mild pain, hematoma or ulceration may follow deep subcutaneous (intrafat) injection of Heparin sodium. Duplication for commercial use must be authorized in writing by ADAM Health Solutions. Push the bubbles back into the heparin bottle, then pull back to get the right dose. The dosing recommendations in Table 1 are based on clinical experience. The patient was transfused with one unit of packed red blood cells. Your doctor prescribed a medicine called heparin. • Cardiovascular -Subacute bacterial endocarditis, severe hypertension. HEPARIN SODIUM INJECTION is not intended for intramuscular (IM) use [see Adverse Reactions (6.1)]. Heparin-induced thrombocytopenia (HIT) is a serious antibody-mediated reaction. The Hardeytacks from the Weatherford College demonstrate how to administer a Heparin injection subcutaneously. If you are not going to give the shot right away, carefully put the cover over the needle. There is no information regarding the presence of Heparin sodium injection in human milk, the effects on the breastfed infant, or the effects on milk production. Although not all of these side effects may occur, if they do occur they may need medical attention. Risk Summary If it bleeds or oozes, hold it longer. Distributed by: Last updated on Jan 1, 2021. Generic Name: Heparin sodium Check the heparin bottle label. Heparin is contraindicated in the following conditions. Write down the date, time, and place on the body where you put the injection. Careful monitoring of partial thromboplastin time and adjustment of Heparin dosage are recommended during coadministration of Heparin and intravenous nitroglycerin. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Inject the heparin slowly and steadily until it is all in. Patients over 60 years of age, following similar doses of Heparin, may have higher plasma levels of Heparin and longer activated partial thromboplastin times (aPTTs) compared with patients under 60 years of age [see Use in Specific Populations (8.5)]. Inject the heparin slowly and steadily until it is all in. Bleeding can occur at any site but certain specific hemorrhagic complications may be difficult to detect including: Neutralization of Heparin Effect These serious thromboembolic events include deep vein thrombosis, pulmonary embolism, cerebral vein thrombosis, limb ischemia, stroke, myocardial infarction, mesenteric thrombosis, renal arterial thrombosis, skin necrosis, gangrene of the extremities that may lead to amputation, and possibly death. Put the syringe down carefully so the needle does not touch anything. HEPARIN SODIUM IN SODIUM CHLORIDE INJECTION is a sterile preparation of heparin sodium (derived from porcine intestinal mucosa) for intravenous administration. Carefully examine all Heparin sodium injection vials to confirm the correct vial choice prior to administration of the drug. Put the syringe down and press the shot site with a piece of gauze for a few seconds. Heparin Sodium Injection USP, 2,000 Units per 2 mL-Vial Label, Heparin Sodium Injection USP, 2,000 Units per 2 mL-Carton Label, amlodipine, aspirin, lisinopril, metoprolol, carvedilol, clopidogrel, atenolol, Eliquis, propranolol, warfarin. Excretion Discard unused portion Heparin is mainly cleared from the circulation by liver and reticuloendothelial cells mediated uptake into extravascular space. • Hypersensitivity – Generalized hypersensitivity reactions have been reported, with chills, fever and urticaria as the most usual manifestations, and asthma, rhinitis, lacrimation, headache, nausea and vomiting, and anaphylactoid reactions, including shock, occurring less frequently. -The anticoagulant effect of Heparin is enhanced by concurrent treatment with antithrombin III (human) in patients with hereditary antithrombin III deficiency. Injections must be given 2 inches away from the umbilicus (see diagram). Because these complications are much more common after intramuscular use, the intramuscular route is not recommended. URAC's accreditation program is an independent audit to verify that A.D.A.M. Adjust the dosage of HEPARIN SODIUM INJECTION according to the patient's coagulation test results. When initiating treatment with Heparin sodium injection by continuous intravenous infusion, determine the coagulation status (aPTT, INR, platelet count) at baseline and continue to follow aPTT approximately every 4 hours and then at appropriate intervals thereafter. Inform patients that it may take them longer than usual to stop bleeding, that they may bruise and/or bleed more easily when they are treated with Heparin, and that they should report any unusual bleeding or bruising to their physician. Do not put a shot in a spot that is bruised, swollen, or tender. Do not use if solution is discolored or contains a precipitate. Hoboken, NJ: Pearson; 2017:chap 18. Advise patients to inform physicians and dentists that they are receiving Heparin before any surgery is scheduled [see Warnings and Precautions (5.2)]. If the count falls below 100,000/mm3 or if recurrent thrombosis develops, promptly discontinue Heparin, evaluate for HIT and HITT, and, if necessary, administer an alternative anticoagulant [see Warnings and Precautions (5.3)]. In: Smith SF, Duell DJ, Martin BC, Aebersold M, Gonzalez L, eds. Pinch the skin and put the needle in at a 45º angle. Known hypersensitivity to heparin or pork products. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for Heparin sodium injection and any potential adverse effects on the breastfed infant from Heparin sodium injection or from the underlying maternal condition [see Use in Specific Populations (8.4)]. Because fatal reactions often resembling anaphylaxis have been reported with protamine, it should be given only when resuscitation techniques and treatment of anaphylactoid shock are readily available. Select one or more newsletters to continue. This container closure is not made with natural rubber latex. Although others may be present, the main sugars occurring in heparin are: (1) α-L-iduronic acid 2-sulfate, (2) 2-deoxy-2-sulfamino-α-D-glucose 6- Because of the risk of hemorrhage, advise patients to inform their physicians and dentists of all medications they are taking, including non-prescription medications, and before starting any new medication [see Drug Interactions (7.1)]. Small amounts of Heparin inhibit Factor Xa, and larger amounts inhibit thrombin (Factor IIa). Thrombocytopenia in patients receiving Heparin has been reported at frequencies up to 30%. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Fatal hemorrhages have occurred. HIT occurs in patients treated with Heparin and is due to the development of antibodies to a platelet Factor 4-Heparin complex that induce in vivo platelet aggregation. Heparin sodium injection is indicated for: It is important to rotate heparin sites to avoid bruising in one location. Ask your provider for a chart. • An uncontrolled active bleeding state [see Warnings and Precautions (5.2)], except when this is due to disseminated intravascular coagulation. It contains no bacteriostatic or antimicrobial agent or added buffer. Due to its potentially serious impact on your body, Heparin should only be used under the guidance of a medical professional. Throw away the needle and syringe in a safe hard container (sharps container). Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Patients with documented hypersensitivity to Heparin should be given the drug only in clearly life-threatening situations [see Adverse Reactions (6.1)]. The bubbles will float to the top. Learn more about A.D.A.M. Lower doses of Heparin may be indicated in these patients [see Clinical Pharmacology (12.3)]. Keep the needle in the bottle and turn the bottle upside down. Inform patients of the risk of Heparin-induced thrombocytopenia (HIT). Heparin is strongly acidic because of its content of covalently linked sulfate and carboxylic acid groups. The bleeding time is usually unaffected by Heparin. 542/P, Biotech Park Phase-II, Editorial team. Close monitoring of coagulation tests is recommended in these cases. • Others - Osteoporosis following long-term administration of high doses of Heparin, cutaneous necrosis after systemic administration, suppression of aldosterone synthesis, delayed transient alopecia, priapism, and rebound hyperlipemia on discontinuation of Heparin sodium have also been reported. Check the syringe for air bubbles. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. Keep a chart of places you have used, so you do not put the heparin in the same place all the time. An unexplained fall in hematocrit, fall in blood pressure or any other unexplained symptom should lead to serious consideration of a hemorrhagic event. Risk Summary Digitalis, tetracyclines, nicotine or antihistamines may partially counteract the anticoagulant action of Heparin sodium. 203 New Edition Court Descriptions Heparin injection is an anticoagulant. You may take notes to remember the details. The hemoglobin (Hb) level dropped from 9.7 g/dL to 7.6 g/dL. • Histamine-like reactions – Such reactions have been observed at the site of injections. For additional information consult the labeling of Protamine Sulfate Injection. Do not use if solution is discolored or contains a precipitate. Heparin is highly bound to antithrombin, fibrinogens, globulins, serum proteases and lipoproteins. • Hypersensitivity [see Warnings and Precautions (5.8)]. Wipe the top of the bottle with an alcohol wipe. If available, preservative-free Heparin sodium injection is recommended when Heparin therapy is needed during lactation. Heparin Sodium (heparin sodium injection preservative free) Injection, USP is a sterile solution of heparin sodium (heparin sodium injection preservative free) derived from porcine intestinal mucosa, standardized for anticoagulant activity, in water for injection. The heparin needs to go into the fat layer under the skin. Bleeding is the chief sign of Heparin overdosage. Heparin is a widely used injectable anticoagulant (stops the formation of blood clots). Biological E. Limited • Known hypersensitivity to Heparin or pork products (e.g., anaphylactoid reactions) [see Adverse Reactions (6.1)]; Elimination Made isotonic with sodium chloride. Heparin Sodium Injection, USP (porcine), preservative free, is available as follows: Unit of Sale - Strength - Each - NDC 71839-117-25 - Unit of 25 - 2,000 USP units per 2 mL - (1,000... 17 PATIENT COUNSELING INFORMATION If you have a pre-filled syringe, make sure you have the right medicine at the right dose. Therefore, when Heparin sodium is given with dicumarol or warfarin sodium, a period of at least 5 hours after the last intravenous dose or 24 hours after the last subcutaneous dose should elapse before blood is drawn, if a valid prothrombin time is to be obtained. Never reuse needles or syringes. A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). Specifically it is also used in the treatment of heart attacks and unstable angina. Patients presenting with thrombocytopenia or thrombosis after discontinuation of Heparin sodium should be evaluated for HIT or HITT. Make sure it is the right medicine and strength and that it has not expired. These sugars are present in decreasing amounts, usually in the order (2)> (1)> (4)> (3)> (5), and are joined by glycosidic linkages, forming polymers of varying sizes. There was no evidence of teratogenic effects. To reduce the risk of bleeding, a reduced dosage of Heparin is recommended during treatment with antithrombin III (human). Adjustment of Heparin doses based on anti-Factor Xa levels may be warranted. • Hemorrhage−Hemorrhage is the chief complication that may result from Heparin therapy [see Warnings and Precautions (5.2)]. Let go of the pinched skin. When Heparin is added to an infusion solution for continuous intravenous administration, the container should be inverted at least six times to ensure adequate mixing and prevent pooling of the Heparin in the solution. • Retroperitoneal hemorrhage The most widely used dosage has been 5,000 units 2 hours before surgery and 5,000 units every 8 to 12 hours thereafter for 7 days or until the patient is fully ambulatory, whichever is longer. The blood coagulation system is composed of various steps and heparin acts at multiple sites in this process. There are limited adequate and well-controlled studies in patients 65 years and older, however, a higher incidence of bleeding has been reported in patients, particularly women, over 60 years of age [see Warnings and Precautions (5.2)]. To ensure continuous anticoagulation when converting from Heparin sodium injection to warfarin, continue full Heparin therapy for several days until the INR (prothrombin time) has reached a stable therapeutic range. The provider will watch you practice and answer your questions. • Prophylaxis and treatment of venous thrombosis and pulmonary embolism; Absorption How to plan and manage your Heparin injections The preferred site of injection is the abdominal area. • Ovarian (corpus luteum) hemorrhage developed in a number of women of reproductive age receiving short-or long-term Heparin therapy. The plasma half-life is dose-dependent and it ranges from 0.5 to 2 h. Avoid using Heparin in the presence of major bleeding, except when the benefits of Heparin therapy outweigh the potential risks. Ask your pharmacist how to store your heparin so it stays potent. In published reports, Heparin exposure during pregnancy did not show evidence of an increased risk of adverse maternal or fetal outcomes in humans.