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Heparin Sodium

Heparin sodium Prescription
Class: Heparins
CAS Number: 9041-08-1
Brands: HepFlush
Heparin Sodium reference guide for safe and effective use from the American Society of Health-System Pharmacists (AHFS DI).

Average Savings for heparin sodium (generic): 72.25%
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Heparin Sodium Drug Information:

Anticoagulant; a heterogeneous group of anionic, sulfated glycosaminoglycans. Unless otherwise specified in this monograph, the term “heparin” refers to “unfractionated heparin”, not low molecular weight heparin (LMWH) or both types of heparin. Treatment of DVT and PE. Recommended by the American College of Chest Physicians (ACCP) as an appropriate choice of anticoagulant for initial treatment of acute proximal DVT or PE. LMWHs or fondaparinux generally preferred over heparin for initial treatment of acute venous thromboembolism; however, heparin may be preferred in patients with renal impairment. IV heparin also may be preferred over sub-Q therapies in patients with PE in whom thrombolytic therapy is being considered or if there is concern about adequate sub-Q absorption. Learn more

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Y-Site CompatibilityHID

Compatible

Acyclovir sodium

Allopurinol sodium

Amifostine

Aminophylline

Ampicillin sodium

Ampicillin sodium–sulbactam sodium

Anidulafungin

Atracurium besylate

Atropine sulfate

Aztreonam

Bivalirudin

Bleomycin sulfate

Calcium gluconate

Cefazolin sodium

Cefotetan disodium

Ceftazidime

Ceftriaxone sodium

Chlorpromazine HCl

Cisplatin

Cladribine

Clindamycin phosphate

Cyanocobalamin

Cyclophosphamide

Cytarabine

Daptomycin

Dexamethasone sodium phosphate

Dexmedetomidine HCl

Digoxin

Diphenhydramine HCl

Docetaxel

Dopamine HCl

Doripenem

Doxapram HCl

Doxorubicin HCl liposome injection

Edrophonium chloride

Enalaprilat

Epinephrine HCl

Ertapenem

Erythromycin lactobionate

Esmolol HCl

Estrogens, conjugated

Ethacrynate sodium

Etoposide phosphate

Famotidine

Fenoldopam mesylate

Fentanyl citrate

Fluconazole

Fludarabine phosphate

Fluorouracil

Foscarnet sodium

Furosemide

Gallium nitrate

Gemcitabine HCl

Granisetron HCl

Hetastarch in lactated electrolyte injection (Hextend)

Hydralazine HCl

Hydrocortisone sodium succinate

Hydromorphone HCl

Hydroxyethyl starch 130/0.4 in sodium chloride 0.9%

Insulin, regular

Isoproterenol HCl

Leucovorin calcium

Lidocaine HCl

Linezolid

Lorazepam

Magnesium sulfate

Melphalan HCl

Meperidine HCl

Meropenem

Methotrexate sodium

Methoxamine HCl

Methyldopate HCl

Methylergonovine maleate

Metoclopramide HCl

Metronidazole

Micafungin sodium

Midazolam HCl

Milrinone lactate

Mitomycin

Morphine sulfate

Nafcillin sodium

Neostigmine methylsulfate

Nitroglycerin

Norepinephrine bitartrate

Ondansetron HCl

Oxacillin sodium

Oxaliplatin

Oxytocin

Paclitaxel

Palonosetron HCl

Pancuronium bromide

Pemetrexed disodium

Penicillin G potassium

Pentazocine lactate

Phytonadione

Piperacillin sodium–tazobactam sodium

Potassium chloride

Procainamide HCl

Prochlorperazine edisylate

Propofol

Propranolol HCl

Pyridostigmine bromide

Ranitidine HCl

Remifentanil HCl

Sargramostim

Scopolamine HBr

Sodium bicarbonate

Sodium nitroprusside

Succinylcholine chloride

Tacrolimus

Theophylline

Thiopental sodium

Thiotepa

Ticarcillin disodium–clavulanate potassium

Tigecycline

Tirofiban HCl

Trimethobenzamide HCl

Vasopressin

Vecuronium bromide

Vinblastine sulfate

Vincristine sulfate

Warfarin sodium

Zidovudine

Incompatible

Alteplase

Amiodarone HCl

Amphotericin B cholesteryl sulfate complex

Amsacrine

Caspofungin acetate

Ciprofloxacin

Clarithromycin

Diazepam

Doxycycline hyclate

Ergotamine tartrate

Filgrastim

Gentamicin sulfate

Haloperidol lactate

Idarubicin HCl

Isosorbide dinitrate

Levofloxacin

Nesiritide

Phenytoin sodium

Tobramycin sulfate

Variable

Aldesleukin

Antithymocyte globulin (rabbit)

Cisatracurium besylate

Dacarbazine

Diltiazem HCl

Dobutamine HCl

Doxorubicin HCl

Droperidol

Drotrecogin alfa (activated)

Labetalol HCl

Methylprednisolone sodium succinate

Nicardipine HCl

Promethazine HCl

Quinidine gluconate

Vancomycin HCl

Vinorelbine tartrate

Actions

  • Acts as a catalyst to markedly accelerate the rate at which antithrombin III (heparin cofactor) neutralizes thrombin and activated coagulation factor X (Xa). Low-dose therapy neutralizes Xa which prevents the conversion of prothrombin to thrombin. Low doses of heparin have very little effect on thrombin and exert a measurable antithrombogenic effect only if thrombin formation has not already occurred.

  • Full-dose therapy neutralizes thrombin, which prevents the conversion of fibrinogen to fibrin. Also prevents the formation of a stable fibrin clot by inhibiting activation of fibrin stabilizing factor. Low-dose or full-dose therapy inhibits thrombus formation when stasis is induced. Full-dose therapy may prevent extension of existing thrombi.

  • Full-dose therapy prolongs several coagulation assays including the ACT, aPTT, plasma recalcification time, PT, thrombin time, and whole blood clotting time. Clotting time is generally unaffected or only minimally prolonged by low-dose therapy.

Advice to Patients

  • Importance of reporting any unexplained bleeding or bruising to clinician.

  • Importance of patients informing clinician of existing or contemplated concomitant therapy, including prescription and OTC drugs, dietary and herbal supplements, and any concomitant illnesses.

  • Importance of women informing clinician if they are or plan to become pregnant or to breast-feed.

  • Importance of informing patients of other important precautionary information. (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

Effective May 1, 2013, a new USP labeling standard for Heparin Sodium Injection, USP and Heparin Lock Flush Solutions, USP was implemented. The labels for these products now state the strength of the entire container (amount of heparin per total volume of container), followed in close proximity by the strength per mL in parentheses.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Heparin Sodium

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Parenteral

Injection (porcine intestinal mucosa)

1000 units/mL*

Heparin Sodium Injection

5000 units/mL*

Heparin Sodium Injection

10,000 units/mL*

Heparin Sodium Injection

20,000 units/mL*

Heparin Sodium Injection

Solution, lock flush (porcine intestinal mucosa)

10 units/mL (10, 20, 30, 50, 100, 300 units)*

Heparin Lock Flush Solution

100 units/mL (100, 200, 300, 500, 1000, 3000 units)*

Heparin Lock Flush Solution

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Heparin Sodium (Preservative-free)

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Parenteral

Injection (porcine intestinal mucosa)

1000 units/mL*

Heparin Sodium Injection

10,000 units/mL*

Heparin Sodium Injection

Solution, lock flush (porcine intestinal mucosa)

10 units/mL (10, 30, 50, or 100 units)*

HepFlush-10

APP Pharmaceuticals

Heparin Lock Flush Solution

100 units/mL (100, 300 or 500 units)*

Heparin Lock Flush Solution

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Heparin Sodium in Dextrose

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Parenteral

Injection, for IV infusion (porcine intestinal mucosa)

40 units/mL (20,000 units) Heparin Sodium in 5% Dextrose*

Heparin Sodium 20,000 units in 5% Dextrose Injection

50 units/mL (12,500 units) Heparin Sodium in 5% Dextrose*

Heparin Sodium 12,500 units in 5% Dextrose Injection

50 units/mL (25,000 units) Heparin Sodium in 5% Dextrose*

Heparin Sodium 25,000 units in 5% Dextrose Injection

100 units/mL (10,000 units) Heparin Sodium in 5% Dextrose*

Heparin Sodium 10,000 units in 5% Dextrose Injection

100 units/mL (25,000 units) Heparin Sodium in 5% Dextrose*

Heparin Sodium 25,000 units in 5% Dextrose Injection

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Heparin Sodium in Sodium Chloride

Routes

Dosage Forms

Editorial References and Review

Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.

Source: Drugs.com Heparin Sodium (www.drugs.com/monograph/heparin-sodium.html).

Heparin Sodium Side Effects

Note: This document contains side effect information about heparin. Some of the dosage forms listed on this page may not apply to the brand name Heparin Sodium.

For the Consumer

Applies to heparin: solution

Along with its needed effects, heparin (the active ingredient contained in Heparin Sodium) 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 while taking heparin:

Less common

Rare

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:

For Healthcare Professionals

Applies to heparin: injectable kit, injectable solution, intravenous solution

General

The most common adverse reaction was hemorrhage.

Cardiovascular

Postmarketing reports: Hemorrhage, retroperitoneal hemorrhage

Hematologic

Very common (10% or more): Thrombocytopenia (up to 30%)

Frequency not reported: Plasma lipoprotein lipase increased

Postmarketing reports: Heparin (the active ingredient contained in Heparin Sodium) resistance

Hypersensitivity

Frequency not reported: Conjunctivitis, cyanosis, tachypnea, feeling of oppression, angioneurotic edema, anaphylactic shock

Postmarketing reports: Chills, fever, urticaria, asthma, rhinitis, lacrimation, headache, nausea, vomiting, anaphylactoid reactions, shock, itching, burning

Local

Frequency not reported: Erythematous nodules, infiltrated and sometimes eczema-like plaques

Postmarketing reports: Local irritation, erythema, mild pain, hematoma, ulceration, histamine-like reactions, skin necrosis

Immunologic

Frequency not reported: Allergic reactions, hypereosinophilia

Postmarketing reports: Heparin-induced thrombocytopenia, heparin-induced thrombocytopenia and thrombosis, generalized hypersensitivity reactions

Endocrine

Frequency not reported: Hypoaldosteronism

Postmarketing reports: Adrenal hemorrhage, acute adrenal insufficiency, fatal adrenal hemorrhage, aldosterone synthesis suppressed

Metabolic

Frequency not reported: Plasma potassium increased, hyperkalemia, metabolic acidosis

Postmarketing reports: Rebound hyperlipidemia

Musculoskeletal

Frequency not reported: Significant bone demineralization, spontaneous bone fracture

Postmarketing reports: Osteoporosis

Dermatologic

Frequency not reported: Ecchymoses

Postmarketing reports: Cutaneous necrosis, delayed transient alopecia

Hepatic

Frequency not reported: Serum transaminases increased

Postmarketing reports: ALT elevated significantly, AST elevated significantly

Genitourinary

Postmarketing reports: Ovarian hemorrhage, priapism

Renal

Frequency not reported: Renal function suppression

Editorial References and Review

Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.

Source: Drugs.com Heparin Sodium (www.drugs.com/monograph/heparin-sodium.html).

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