home Auditorium 7 Drug fever to heparin in hemodialysis patients. Heparin injections: instructions for use

Drug fever to heparin in hemodialysis patients. Heparin injections: instructions for use

Solution for injection Heparin is an anticoagulant direct action. The drug is primarily used for the prevention and treatment of pathologies of cardio-vascular system associated with platelet aggregation disorders. The medication can be taken by children over 3 years of age. The product has an extensive list of contraindications and side effects.

Dosage form

One of the forms of release of Heparin is a solution for intravenous and subcutaneous administration.

The liquid is produced in ampoules and bottles, then packaged in cardboard packs of 5, 10, 50 and 100 units.

Description and composition

Heparin injection solution is a colorless liquid that may have a light yellow tint.

The active substance of the drug is sodium heparin. Among the auxiliary ones:

phenylcarbinol;
sodium chloride;
water for injections.

Pharmacological group

The drug is classified as a direct-acting anticoagulant.

Heparin binds to antithrombin III, causing changes in its molecular structure. As a result, there is an acceleration of the binding of antithrombin III to the following types of blood coagulation factors: IIa, Xa, IXa and XIIa, which manifests itself in the inhibition of their activity.

The active component of the drug reduces the level of blood viscosity, vascular permeability and the likelihood of developing stasis. The substance is capable of adsorption on the surface of endothelial membranes and blood cells. This interferes with the adhesion and gluing of platelets. The substance helps slow down smooth muscle hyperplasia and lipoprotein lipase activity. This produces a hypolipidemic effect and reduces the likelihood of atherosclerosis.

Sodium heparin acts as an obstacle to the cooperation of lymphocytes and the formation of immunoglobulins; the substance also provokes the binding of serotonin and histamine, which produces an antiallergic effect.

When the substance enters the body, the following is observed:

intensification of renal blood flow;
decreased activity of brain hyaluronidase;
decreased surfactant activity in the lungs;
suppression of excessive production of aldosterone in the adrenal cortex;
adrenaline binding;
modulating the ovarian response to hormonal stimuli;
increased activity of parathyroid hormone.

Due to pharmacological interactions active component When using a medicine with various enzymes, an increase in the activity of DNA polymerase, TG (tyrosine hydroxylase) and pepsinogen is observed. In turn, sodium heparin can provoke a decrease in the activity of RNA polymerase, myosin ATPase, as well as pepsin and pyruvate kinase.

At unstable angina, as well as in myocardial infarction without ST segment elevation on the ECG, the use of heparin reduces the likelihood of myocardial infarction and death.

If the patient has a disorder in the form of myocardial infarction with ST segment elevation on the ECG active substance The drug is effective exclusively during primary revascularization in combination with glycoprotein IIb/IIIa receptor blockers and fibrinolytic therapy with the enzyme streptokinase.

Upon admission to high dosages Heparin is effective against thromboembolism pulmonary artery And venous thrombosis, in particular after surgery.

After administering the solution intravenously, the effect occurs within 10-15 minutes and lasts for 3-6 hours. After subcutaneous administration, the effect occurs after 40 minutes and lasts about 8 hours. A lack of antithrombin III in the blood serum or in the area of thrombosis can reduce the anticoagulant effect of the drug.

The maximum concentration of the active substance is achieved within 2-4 hours. The ability to form bonds with serum proteins is up to 95%.

Penetration through the placental barrier and entry into breast milk mother does not happen.

There is also intense uptake by endothelial cells and mononuclear macrophage cells. Concentration occurs in the liver and spleen.

Subject to hepatic metabolism. The half-life can range from 1 to 6 hours. Excretion is carried out mainly through the kidneys (50%). The remaining 50% is displayed unchanged. With hemodialysis, elimination is not possible.

Indications for use

Solution for injection Heparin is primarily used for the prevention of diseases of the cardiovascular system, characterized by disorders of platelet aggregation.

for adults

In adult patients, Heparin is used for the prevention and treatment of the following disorders:

venous thrombosis;
pulmonary embolism;
thromboembolic complications characterized by atrial fibrillation;
peripheral arterial thromboembolism;
disseminated intravascular coagulation of acute and chronic courses;
unstable angina;
myocardial infarction (in the case of ST segment elevation on the ECG: with thrombolytic therapy, with primary coronary revascularization through the skin, as well as with a high risk of arterial or venous thrombosis and thromboembolism);
microthrombosis.

The drug is also used for prophylactic purposes against blood clotting during blood transfusion, as well as in extracorporeal circulation systems and hemodialysis.

It is also used in the treatment of venous catheters.

for children

For children over three years of age, the indications for use are similar to those presented for patients in the adult age group.

Despite the fact that sodium heparin does not cross the placental barrier and does not pass into breast milk, pregnant women are advised not to use this tool. This is justified by the considerable number of risks that the drug poses to pregnant and lactating women.

Contraindications

Exist the following contraindications to use Heparin injection solution:

individual intolerance to the constituent components medication;
heparin-induced thrombocytopenia (including history);
external hemorrhage.

Heparin should be used with caution in such pathologies as:

acute endocarditis of an infectious nature;
complicated hypertension;
aortic dissection;
local dilatation of cerebral vessels;
erosions and ulcers in organs gastrointestinal tract;
haemorrhoids;
varicose veins of the esophagus;
ulcerative colitis;
leukemia;
thrombocytopenia;
hemorrhagic;
injuries in the craniocerebral region;
hemorrhagic stroke;
malignant neoplasms;
antithrombin III deficiency.

Other conditions in which it is better to avoid using Heparin:

period of menstrual bleeding;
early postpartum period;
liver disorders associated with problems with protein synthesis function;
chronic renal failure;
recent surgical interventions;
age up to three years;
age over 60 years;
proliferative stage of diabetic retinopathy;
vasculitis.

Applications and dosages

The medication Heparin is prescribed in the form of intravenous infusions, regular injections intravenously and subcutaneously.

Subcutaneous injection is usually carried out in the abdominal area with a thin needle perpendicular to the fold of skin formed by two fingers. Injections should not be made in the same place.

for adults

The initial dosage of Heparin used for therapeutic purposes is usually 5000 IU (predominantly intravenous administration is used).

Maintenance doses are 1000-2000 IU/hour at infusion administration(Heparin is diluted in a solution of 0.9% sodium chloride) and 5000-10000 IU with periodic injections every 4 hours.

Due to the wide range of indications for use, it is not possible to establish a single dosage regimen. The dosage and injection schedule are determined by the doctor, based on the disease that gave rise to the use of the drug, as well as all accompanying pathologies and characteristics of the individual patient.

for children

Application in childhood Possible only for persons over three years of age. The dosage and regimen of use of the drug should be established qualified specialist. This process takes into account the age, indications for use and medical history of the individual child.

for pregnant women and during lactation

Women carrying a child and those who are in the lactation period are not recommended to use Heparin injection solution. There is a risk of developing pathologies in the child and problems with bearing it.

Side effects

Main adverse reactions are the following manifestations:

In patients with severe thrombocytopenia, consumptive coagulopathy (fibrinogen deficiency) may occur.

If a patient has heparin-induced thrombocytopenia, there is a risk of a number of extreme negative manifestations: skin necrosis, myocardial infarction, arterial thrombosis and stroke.

As a result of using Heparin, your biochemical composition blood.

Interaction with other drugs

Heparin in the form of an injection solution is compatible only with 0.9% saline sodium chloride solution. It is incompatible with solutions of other drugs.

The active component displaces the following substances from the sites of their binding to blood proteins: phenytoin, quinidine, and benzodiazepine derivatives. This makes it possible to intensify the effects of these substances. Protamine sulfate, polypeptides, tricyclic antidepressants contribute to the inactivation of sodium heparin.

The anticoagulating properties of the active component of the drug are enhanced when its use is combined with the use of antiplatelet agents, anticoagulants indirect action, non-steroidal anti-inflammatory drugs, glucocorticosteroids and dextran. With this combination of drugs, the risk of bleeding increases. The following agents also enhance the anticoagulant effect of heparin:

valproic acid;
hydroxychloroquine;
cytostatics;
propylthiouracil;
cefamandole.

The following list of agents contains those that reduce the intensity of the anticoagulant effect:

adrenocorticotropic hormone;
antihistamines;
nicotine;

Before treatment with heparin, it is necessary to undergo a coaculogram.

Overdose

If doses are exceeded, bleeding may occur. In such cases, discontinue use and, if necessary, carry out therapy using agents that neutralize excess heparin in the body.

Storage conditions

The drug must be stored in a place protected from light, out of reach of children, at a temperature not exceeding 25 °C. The medication can be stored for 3 years. When purchasing the product, you must provide a prescription.

Analogs

The following list of drugs includes Heparin analogues:

Lavenum (gel, direct anticoagulant);
Thrombophobe (ointment, gel, active ingredient – sodium heparin);
Trombless (gel with heparins as an active ingredient);
Viatromb (gel-spray, direct-acting anticoagulant).
Price

The cost of Heparin is on average 231 rubles. Prices range from 36 to 554 rubles.

Release form: Liquid dosage forms. Solution for infusion.

General characteristics. Compound:

Active ingredient: 5000 IU of heparin sodium (heparin sodium salt).

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

Pharmacological properties:

Pharmacodynamics.Direct acting anticoagulant. Belongs to the group of medium molecular heparins, slows down the formation of fibrin. The anticoagulant effect is detected in vitro and in vivo and occurs immediately after intravenous administration.

The mechanism of action of heparin is based primarily on (binding with antithrombin III, which serves as a physiological inhibitor of activated blood coagulation factors IXa, Xa, XIa, XIIa and thrombin. Particularly important is the ability to inhibit activated factor X, which is involved in the internal and external coagulation system (this action manifests itself against the background of much lower doses of heparin than required to suppress the activity of thrombin, which promotes the formation of fibrin from fibrinogen, which justifies the possibility of subcutaneous administration of small doses of heparin for the prevention of veins and large doses. Heparin also has the ability to suppress platelet aggregation (extends the time).

Heparin is not able to dissolve a blood clot (it is not a fibrinolytic), but it can reduce the size of the blood clot, stopping its expansion, in which case part of the blood clot is dissolved under the action of natural fibrinolytic enzymes. Inhibits the activity of hyaluronidase and has a hypolipidemic effect. The anticoagulant effect with a single intravenous injection develops within a few minutes and lasts up to 4-5 hours. With subcutaneous administration, the effect begins after 20-30 minutes and lasts 12 hours or more (depending on the dose). For unfractionated standard heparin, the ratio of activity (antifactor Xa) to anticoagulant activity (APTT) is 1:1.

Pharmacokinetics.After subcutaneous injection maximum concentration in plasma is determined after 4-5 hours. Up to 95% of heparin binds to blood plasma proteins, the volume of distribution is very small - 0.06 l/kg (does not leave the vascular bed due to strong binding to blood plasma proteins). Does not penetrate the placenta or into breast milk. Metabolized in the liver with the participation of heparinase.

Participation in the metabolism of platelet factor IV, as well as the binding of heparin to the macrophage system explains the rapid biological inactivation and short duration of action. It is excreted in the urine, mainly in the form of inactive metabolites. T1/2 ranges from 23 min. until 5 o'clock

Indications for use:

Prevention and therapy: pulmonary artery (including peripheral venous disease), thrombosis coronary arteries; ; ; atrial fibrillation accompanied by embolization; (first phase).

Prevention of blood clotting during operations using extracorporeal blood circulation methods, during blood transfusions, during blood collection for research.

Important! Get to know the treatment

Directions for use and dosage:

For therapeutic purposes, heparin is prescribed as a continuous IV infusion or as regular IV injections. For prophylactic purposes - subcutaneously, 5 thousand IU/day, at intervals of 8-12 hours. The usual place for subcutaneous injections is the anterolateral wall (in exceptional cases, injected into upper area shoulder or thigh), using a thin long needle, which should be inserted perpendicularly into a pinched fold of skin held between the large and index finger until the end of the solution administration. When administered subcutaneously, heparin should be injected deep into the adipose tissue, alternating injection sites (to avoid hematoma formation). The first injection must be performed 1-2 hours before the start of surgery; in the postoperative period - administered 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 subcutaneous injections or intravenous infusion.

Maintenance doses are determined depending on the route of administration:

For continuous intravenous infusion, 1000-2000 IU/hour (24000-48000 IU/day) is prescribed, diluting heparin in 1000 ml of isotonic sodium chloride solution;

With regular IV injections, 5000-10000 IU of heparin is prescribed every 4-6 hours;

For subcutaneous administration, 15,000-20,000 IU is administered every 12 hours or 8,000-10,000 IU every 8 hours.

Heparin doses are selected so that the activated partial thromboplastin time (aPTT) is 1.5-2.5 times greater than the control time. With subcutaneous administration of small doses: 5000 IU 2 times a day (prevention of thrombosis), regular monitoring of aPTT is not required, since it increases slightly. Continuous IV infusion is the most effective way the use of heparin is better than regular injections, as it provides more stable hypocoagulation and is less likely to cause bleeding. Intravenous injections are recommended only for initial doses or if for some reason IV infusion or subcutaneous administration cannot be used. Repeated intravenous injections cause significant fluctuations in hemostasis and increasingly cause dangerous bleeding, so they are prescribed only when absolutely necessary.

Adults with pulmonary thrombosis and moderate degree heaviness is administered intravenously, 40,000-50,000 IU/day for 3-4 injections; for severe thrombosis and embolism - iv 20,000 IU 4 times a day with an interval of 6 hours.

For health reasons, 25,000 IU is administered intravenously once, then 20,000 IU every 4 hours until daily dose 80000-120000 ME. Pry i.v. drip administration to daily volume infusion solution add at least 40,000 ME.

When performing extracorporeal circulation, a dose of 140-400 IU/kg or 1500-2000 IU per 500 ml of blood is administered. During hemodialysis, 10,000 IU is first administered intravenously, then in the middle of the procedure another 30,000-50,000 IU is administered. For older people, especially women, doses should be reduced.

For children, the drug is administered intravenously by drip: at the age of 1-3 months - 800 IU/kg/day, 4-12 months. 700 IU/kg/day, over 6 years old - 500 IU/kg/day; the dose should be selected so that the blood clotting time is 20 minutes.

The duration of heparin therapy depends on the indications and route of administration. When administered intravenously, the optimal duration of treatment is 7-10 days, after which therapy is continued with oral anticoagulants (it is recommended to prescribe oral anticoagulants starting from day 1 of treatment with heparin or from days 5 to 7, and stop using heparin on days 4-5 combination therapy). For extensive thrombosis of the iliofemoral veins, longer courses of treatment with heparin are advisable.

Features of application:

Heparin cannot be administered intramuscularly, as hematomas may form at the injection site.

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, only saline solution is used.

Can be used during pregnancy only under strict indications.

Although heparin does not pass into breast milk, its administration to nursing mothers has in some cases caused rapid (within 2-4 weeks) development and damage to the spine.

Side effects:

Heparin is usually well tolerated. Allergic reactions may develop: skin hyperemia, drug fever, rhinitis, asthma, and a feeling of heat in the soles, anaphylactic shock.

Dizziness, headaches, loss of appetite,.

Thrombocytopenia (6% of patients) may occur due to the direct effect of heparin or immune reaction, in which antibodies react with platelets and endothelium. Reactions of the first type usually manifest themselves in soft form and disappear after cessation of therapy, and reactions of the second type are severe and can be fatal.

Against the background of heparin-induced skin necrosis and arterial thrombosis ("white blood clots") may develop, accompanied by the development of myocardial infarction. If severe thrombocytopenia develops (a decrease in the platelet count by 2 times the original number or below 100,000), it is necessary to stop using heparin.

On the background long-term use heparin has described cases of osteoporosis, spontaneous bone fractures, hypoaldosteronism, transient alopecia and increased activity of liver transaminases (ALT and AST).

From the locals side effects Irritation, pain, erythema, and ulceration at the injection site are possible.

Bleeding is also a common complication of heparin therapy (the risk can be minimized with careful assessment of contraindications, regular laboratory monitoring of blood coagulation and accurate dosing).

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).

Interaction with other drugs:

The effect of heparin is enhanced by: antibiotics (reduce the formation of vitamin K intestinal microflora), acetylsalicylic acid, dipyridamole, non-steroidal anti-inflammatory drugs and other drugs that reduce platelet aggregation (which remains the main mechanism of hemostasis in patients treated with heparin), indirect anticoagulants; drugs that block tubular secretion.

The effect of heparin is reduced by: antihistamines, phenothiazines, cardiac glycosides, a nicotinic acid, ethacrynic acid, tetracyclines, ergot alkaloids, nicotine, nitroglycerin (iv administration), thyroxine, ACTH, alkaline amines and polypeptides, protamine. renal failure

Overdose:

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 quickly eliminated, and if protamine sulfate is prescribed 30 minutes after the previous dose of heparin, only half the required dose should be administered; maximum dose protamine sulfate is 50 mg.

Storage conditions:

List B. In a dry place, protected from light and out of reach of children, at a temperature of 12 to 15 ° C. Shelf life - 3 years. Do not use after the expiration date stated on the package.

Vacation conditions:

On prescription

Package:

Solution for intravenous and subcutaneous administration 5000 IU/ml. 1 ml, 5 ml in ampoules or glass bottles, sealed with rubber stoppers and rolled aluminum caps. 5 or 10 ampoules (bottles) are placed in packs or cardboard boxes with instructions for use, an ampoule knife or a scarifier. When packaging ampoules that have a ring or opening point, an ampoule knife or scarifier is not inserted. 5 or 10 ampoules (bottles) are placed in a blister pack. 1 or 2 contour packages with instructions for use, an ampoule knife or scarifier (if necessary) in a cardboard pack.

Heparin gets its name from the Greek name for liver - “hepar”, from where it was first obtained. Medicine It is customary to use it in treatment practice as a coagulant that reduces the process of thrombus formation and blood clotting. So, today let's talk about heparin, instructions for its use, average prices for the drug, reviews about it and analogues.

Features of the drug

It is used for preventive purposes for diseases and consequences and, during surgical interventions into blood vessels and the heart, during hemodialysis and artificial blood flow, preventing blood clotting during laboratory tests.

Place of education in human body– liver, walls blood vessels and pulmonary alveoli. The listed structures contain groups of mast cells.

Compound

The substance is represented by glycine and serine amino acid residues that can bind to polysaccharide chains. Heparin molecules have several poles that are negatively contaminated due to sulfate and carboxyl residues.

Such chemical structure allows molecules to actively enter into binding complexes with cations. For this reason, the active ingredient of the drug is sodium heparin. In addition to the active substance, an active environment is created for it Excipients: distilled water, sodium chloride and phenylcarbinol.

Dosage forms of Heparin

Heparin is available in the form of ampoules with a solution that is administered intravenously or subcutaneously. Cardboard packs can contain 10 or 50 ampoules. Recently, pharmaceuticals began to produce packages of heparin containing 100 ampoules.

Large ampoules contain 5 ml of heparin solution, small ones - 1 ml. Small ampoules are produced abroad based on the calcium salt of heparin.

pharmachologic effect

The basis of the resulting blood clot is a high-molecular blood protein that is in a soluble state - fibrin. The main role of heparin is to inhibit fibrin synthesis.

Heparin increases resistance cerebral vessels, blood flow in the kidneys increases, the enzyme that breaks down lipoproteins is activated, and the general content lipids in the blood due to destruction individual species, the deactivation of hyaluronidase, an enzyme in brain structures, increases. Heparin normalizes the secretion of the hormone aldosterone in the adrenal cortex, inhibits the activity of the pulmonary substance surfactant, enhances the exchange of calcium and phosphorus due to the activation of parathyroid hormone, inhibits the activity of catecholamines and forms the reaction of the egg to the influence of hormones.

Heparin is a drug for the prevention of recurrent heart attacks, coronary thromboembolism, and prevents the unexpectedness of a heart attack and death. After radical treatment, for prevention purposes and in the presence of blood clots in the veins, heparin is used in small dosages.

The video below will tell you how blood clotting occurs with heparin:

Pharmacodynamics

Exogenous heparin is identical to the substance produced in the body naturally. The mechanism of action is associated with the transformation into active form inhibitor of the coagulation factor thrombin - antithrombin.

Under the influence of heparin, the synthesis of the antilipid enzyme, lipoprotein lipase, is enhanced.

Pharmacokinetics

The therapeutic effect of the drug begins the faster the method chosen for its entry into the human body. After intravenous injection The effect of the drug begins 5 minutes after the end of administration. 15 to 20 minutes required to start active action drug after injection into the muscle.

Heparin is absorbed most slowly into the bloodstream when administered subcutaneously - up to 1 hour. The inhibitory effect of blood clots continues for 5 hours after heparin administration.

If a longer effect is desired, prescribe intramuscular injection heparin sodium (calcium). Subcutaneous injections allow the inhibitory effect of thrombus formation to remain in the blood for 8 hours.

Indications for use

For the purpose of prevention or therapeutic treatment heparin is introduced into the body when:

acute;
thrombosis of the pulmonary, deep and renal veins, coronary arteries;
coronary heart disease by type and;
glomerulonephritis and nephritis caused by lupus;
(mandatory - when);
DVS and hemolyticourimic syndromes.

Contraindications

The drug is not prescribed for:

diseases with inhibition of blood clotting,
bleeding of all types,
serious liver and kidney pathologies,
hereditary or acquired hematological syndrome with the threat of blood leaking out or in.

Side effects

The effect of heparin can have undesirable effects on somatic systems:

cutaneous allergic reactions: hives, redness and itching of the skin;
from the gastrointestinal tract, some patients experience nausea, vomiting, appetite suppression, and loose stools;
long-term exposure to the drug causes sudden fractures and osteoporosis;
Heparin overdose increases the risk of hemorrhage during internal organs, internal bleeding, prolonged non-clotting of blood during operations and injection sites of the drug.

special instructions

Small doses of heparin are administered as in clinical settings, and outpatient. Large dose can only be administered in a clinical setting. After injection of the drug, the patient is subject to observation and regular blood sampling for analysis of platelet concentration.

It is recommended to avoid intramuscular injections. In the presence of arterial hypertension Periodic measurements are necessary after heparin administration systolic pressure. Before administering the drug, it must be dissolved only in an isotonic sodium chloride solution.

– effective remedy aimed at thinning the blood. The effect of the drug is to block thrombin biosynthesis and reduce platelet aggregation.

In addition, it helps improve blood circulation and normalizes blood properties.

Sold in the form of ampoules and bottles for injections and infusions, tablets, ointments, gels. You can purchase Heparin in pharmacies either with a prescription (ampoules) or without it (ointment, gel, suppositories).

This article will help you understand why Heparin is prescribed, and will also tell you about its features and the algorithm for its use. Moreover, reviews of patients who have already used Heparin in treatment are presented here, as well as a calculation of the average price level of the drug.

Pharmacological properties

Pharmacological group - direct acting anticoagulant. The mechanism of action of Heparin is aimed at reducing blood clotting and treating thrombosis. For achievement maximum effect the drug is used in combination with fibrizilin. It has a positive effect on lipemic plasma and removes chylomicrons from the blood. After taking the drug, a decrease in blood cholesterol levels is observed, but if there is a danger of bleeding, this drug does not apply.

The active substances of the drug have a binding effect on some components of the complement system and help reduce their activity. They slow down the cooperation of lymphocytes and the formation of immunoglobulins by binding histamine and serotonin (has antihistamine properties).

Most quick way onset of action of the drug - intramuscular or intravenous administration , after which the composition of the blood changes for a short period of time.

With the intravenous route of Heparin administration, the effect of the drug lasts 4 hours. When administered intramuscularly, the active substances are absorbed into the blood within 30 minutes. In this case, the therapeutic effect lasts 6 hours. With the subcutaneous route of Heparin administration, an improvement in blood composition is observed within an hour. The effect of the drug lasts 10-12 hours.

Experts pay attention that to treat blood clotting problems it is necessary to undergo a course of treatment. For this purpose, intravenous injection is used. To prevent blood clotting problems, intramuscular and subcutaneous method administration of the drug. In all cases, the dose of the drug is determined only by the attending physician, having previously full examination patient.

Composition of the drug

Depending on the form, the Heparin drug has the following composition:

Injections containing the active ingredient sodium heparin;
An ointment containing the active ingredient benzocaine, auxiliary components, sodium heparin and benzyl nicotinate;
Gel based on sodium heparin 1000 IU.

Indications for use of the drug

To achieve maximum effect in treatment, the doctor selects the method of treatment and dosage of the drug. Heparin is prescribed for the treatment of the following diseases:

Treatment of thromboembolic diseases;
Prevention of vascular blockage;
For the treatment of thrombosis during myocardial infarction;
Therapy of vascular thrombosis;
With severe blockage of blood vessels;
To improve blood clotting in the veins, arteries and vessels of the eye;
Suitable for heart and blood vessel surgery;
Used to maintain blood fluid in special devices;
Used to purify blood.

In addition, Heparin is used in combination with enzyme preparations. This technique is effective for thinning the blood in the treatment of thrombosis.

Use of ampoules for heart attack

Depending on the severity of the disease, the doctor prescribes the method and dosage individually.
For myocardial infarction Heparin urgently administered intravenously in the amount of 15,000 units. The drug is then prescribed in a hospital setting under the supervision of a physician.

Dosage of the drug: 40,000 units per day in several doses with an interval of 4 hours. This therapy is carried out for 6 days. After each injection, the doctor must analyze blood clotting indicators. Coagulability indicators should be 2 times higher than normal. Cancellation of treatment is accompanied by a gradual reduction in the dosage of the drug by 5,000 units with each injection. After finishing taking Heparin, the patient is prescribed anticoagulants, switching to which is completely possible on the 4th day after stopping the Heparin drug.

The use of ampoules for the treatment of pulmonary artery thrombosis

Heparin is also used to treat pulmonary thrombosis. In this case, the drug is administered by droppers at a dosage of 40,000 units over 6 hours. After which it is possible to administer the drug intramuscularly in an amount of 40,000 per day.

note, only the attending physician can prescribe the method and dosage of the drug!

Use of ampoules for venous thrombosis

For venous thrombosis, Heparin is prescribed intravenously at a dosage of 20,000 units. After which it is possible to administer 60,000 units of the drug with monitoring of blood clotting indicators by the attending physician.

In addition, for this type of disease, the intravenous method of administering Heparin is indicated, as well as the use of the solution as inhalation. But such methods do not differ in the speed of onset of effect. The effect of the medicine will be noticeable a day after administration. The medical effect in this case will be to thin the blood, remove blood clots, and dilate blood vessels. A few days before the end of Heparin treatment, it is necessary to start taking anticoagulants and continue taking them after the end of Heparin treatment.

For the prevention of thrombophlebitis are prescribed intramuscular injections Heparin at a dosage of 5,000 units 2 times a day. In this case, the effect of the medicine lasts for 12 hours. This procedure can also be done before and after surgery.

The drug is also prescribed during a blood transfusion to slow down the blood clotting process. It is administered intravenously at a dosage of 7,000 units.

Please note that Heparin therapy must be accompanied by regular analysis of blood clotting indicators, which is carried out every 2 days.

Release forms

Heparin is available in the following forms:

Ampoules and vials;
Ointment;
Candles;
Features of the use of ampoules.

Features of using ampoules

Heparin in ampoules is prescribed only by a doctor and monitors the progress of treatment for the following diseases:

Stomach ulcer;
During the period of cachexia;
With high blood pressure;
IN postoperative period prescribed only in case of vital necessity.

Side effects Heparin ampoules

The use of Heparin may be accompanied by: unpleasant symptoms, and some complications of chronic diseases.

Allergic reactions to the components of the drug, which can lead to anaphylactic shock;
hives or fever;
The appearance of ulcers at the site of application;
The appearance of bleeding;
Reduced blood clotting, so the medicine should be used only in a hospital setting;
Exacerbation of asthma or rhinitis;
Exacerbation of osteoporosis.

According to statistics, complications associated with increased bleeding are observed in 6% of cases of taking the drug. The result of bleeding can be necrosis of the skin, the appearance of thrombosis in the arteries, the development of gangrene, the onset of stroke and death. If signs of thrombocytopenia appear, the drug should be taken cancel immediately.

Contraindications for the use of ampoules

Hemorrhagic diathesis, accompanied by sudden bleeding;
Diseases accompanied by slow blood clotting;
Vascular weakness;
During any bleeding in the body;
Subacute endocarditis;
Inflammation of the heart;
Impaired kidney and liver function;
Malignant tumors, leukemia;
Reduced hemoglobin level;
Aneurysm in the acute stage;
Venous gangrene.

The use of the drug for these diseases in the form of injections and infusions can lead to serious complications and even fatal outcome, so it's forbidden use without a doctor's prescription.

Overdose when using ampoules

Administration of an incorrect dose of Heparin to a patient may be accompanied by the following side effects:

Hemorrhagic complication;
The appearance of bleeding.

In such situations, the doctor reduces the dosage of the drug or cancels its administration. If bleeding does not stop after stopping the drug, then protamine sulfate is administered intravenously.
If signs of allergy appear, Heparin is discontinued and desensitizing agents are prescribed.

Important to remember: how to inject, how to dilute the drug can only be decided by the attending physician!

Features of using the ointment

Heparin ointment is prescribed by doctors in the following cases:

Therapy of thrombophlebitis of the extremities;
Treatment of inflammation of the veins;
Treatment of Phlebitis;
After intravenous injection;
Therapy of thrombosis in the hemorrhoidal vein;
Treatment of ulcers on the extremities.

Pharmacological properties ointments

The effect of heparin ointment is to reduce inflammatory process. It promotes the resorption of blood clots, reducing pain. The heparin contained in the ointment penetrates through the skin into the blood, providing an antithrombotic effect. The function of benzyl ether is to dilate blood vessels, which leads to quick effect from the action of the ointment.

Studies have shown that topical use of heparin ointment does not affect blood clotting. The ointment is recommended to be used at home on your own.

When using the ointment, the elements of the drug are removed from the blood after 1.5 hours.

How to use the ointment

The need and dosage of using the ointment is prescribed by the attending physician. At home, apply heparin ointment in a thin layer of 1 g per skin covering 5 cm. The medicine must be used 3 times a day. For inflammation of the veins of the rectum, the ointment is applied to the hemorrhoids with a piece of tissue or a tampon in the anus.

The use of ointment is contraindicated in the following cases:

the presence of ulcerative-necrotic processes;
decreased level of blood clotting;
the presence of ulcers with tissue necrosis.

In order to achieve therapeutic effect from treatment with heparin ointment and not cause harm to health, must be observed following rules use of medicine:

The use of the ointment is possible after consulting a doctor who regulates the duration of the course of treatment, analyzes blood clotting indicators, and monitors side effects;
Treatment with ointment by people over 65 years of age must also be carried out with regular supervision by the attending physician;
It is forbidden to apply ointment to open wounds;
Treatment with heparin ointment during pregnancy is prohibited;
During lactation, therapy may be prescribed in cases of extreme necessity. In such a situation, you should stop breastfeeding.

Features of using the gel

Heparin Gel is prescribed by doctors for therapy in the following conditions:

Thrombophlebitis of the extremities;
When veins expand;
With elephantiasis of the legs;
For phlebitis after a course of injections;
With superficial breast mastitis;
In the presence of a subcutaneous hematoma;
For bruises, injuries;
For swelling of the limbs.

Gel application algorithm

For thrombophlebitis of the extremities, Heparin gel is prescribed after completing a course of injections given medicine. The dosage and period of use are prescribed only by the attending physician. The gel is applied with a light massaging motion to the affected area.

For the treatment of hemorrhoidal vein thrombosis, a course of treatment is usually prescribed for 3-12 days after full diagnostics body.

The treatment technology in this case is as follows: heparin gel is applied to gauze, which must be applied to the treatment site, and then secured with a bandage. It is also recommended to use a gel-soaked tampon, which is inserted into the anus. This technology is used 3 times a day at regular intervals. Treatment is carried out until signs of inflammation completely disappear.

Side effects and contraindications

Observations during therapy with Heparin gel showed a lack of body response to the medicine. It is only possible that allergic reactions to some components of the gel may occur in case of individual intolerance. It is also noted that an overdose of the drug has no effect on the patient’s body. Nevertheless, important Before using the gel, consult a doctor who will choose the right dosage.

Gel treatment is contraindicated in the following cases:

If there are ulcers at the site of thrombophlebitis;
In case of skin damage, cuts;
At reduced level blood clotting;
During the period of thrombocytopenia;
Cancelled if allergic reactions occur.

Forbidden Apply the gel to damaged areas of the skin. If the gel gets on the mucous membrane, rinse thoroughly with water. Contraindicated apply gel if available purulent formations on the skin.

Features of using candles

In most cases, Heparin suppositories are prescribed by doctors for the treatment of hemorrhoids. The effect of candles is that there is a decrease in adhesion blood cells and vascular permeability. The anesthetics included in the suppositories quickly cope with pain and discomfort, which makes the suppositories operational means hemorrhoid therapy.

Heparin suppositories help:

Improving blood circulation in blood vessels;
Relieving pain and swelling;
Relieving inflammation.

Heparin suppositories are used to treat hemorrhoids during thrombosis. Active elements the drug quickly enters the bloodstream, which starts the regeneration process.

Suppositories have no side effects, so they can be used without restrictions. There are rare cases individual intolerance to some components of the drug, which may be accompanied by itching and irritation.

Technique for using Heparin suppositories

For getting maximum benefit from therapy, Important rules must be followed:

It is necessary to begin the procedure with a bowel movement and a shower;
Open the package;
To prevent the candle from melting, you can moisten it with water in advance;
For easy insertion of the suppository, you need to relax as much as possible;
In a standing position, you need to lean forward and insert the candle into anus. It is better to perform this procedure lying on your side - this way the medicine does not leak out and works faster;
To obtain the maximum effect from the introduction of a suppository, it is advisable to lie down for 1 hour, so it is advisable to carry out the procedure before bedtime or at night;
In case of bleeding, you should stop using the suppositories and consult a specialist.

A course of irradiation with Heparin suppositories is usually carried out for 2 weeks. In some mild forms of the disease, suppositories are used for no more than a week.

Interaction with other drugs

When using Heparin simultaneously with other medications, the effect of enhancing or weakening the effect of the drugs may occur.

Set of drug interaction rules:

The effect of Heparin is enhanced by anticoagulants;
Tetracyclines, corticotropin and nicotine have a weakening effect on Heparin;
With the simultaneous use of Heparin and drugs that reduce platelet aggregation, bleeding may occur;
You cannot take Heparin and ulcerogenic drugs at the same time;

If the doctor has prescribed treatment with Heparin, it is necessary to inform whether the patient is currently being treated with other drugs, in order to prevent mixing of drugs and the occurrence of complications.

Storage conditions

Heparin must be stored in a place protected from light under the following temperature conditions:

ampoules - no higher than 12-15 degrees (3 years), after opening the ampoule must be stored in the refrigerator for no more than 3 days;
ointment, gel – 8-15 degrees Celsius (shelf life – 3 years);
candles must be kept in the refrigerator.

Make sure that the drug is kept out of the reach of children!

Analogues of the drug

Pharmacologists have developed drugs similar in effect to Heparin or heparin-containing gels and ointments. Examples of such drugs are:

Prices for the drug

You can purchase Heparin in pharmacies either with a prescription (ampoules) or without it (ointment, gel, suppositories).
Average price of Heparin drug depending on the form of release:

1. Heparin for injection in bottles - 5 ml, 5 pieces cost 500-550 rubles;
2. Heparin in ampoules - average price - 340-379 rubles;
3. Heparin ointment – 50-70 rubles;
4. Heparin in the form of a gel – 250 – 280 rubles.

Heparin is an anticoagulant, a drug that affects blood clotting.

pharmachologic effect

Heparin sodium has a direct effect on blood clotting, blocks the production of thrombin, reduces platelet aggregation, improves coronary blood flow, activates the fibrinolytic properties of blood,

The administration of Heparin is accompanied by a decrease in serum cholesterol and a decrease in the amount of lipids in the blood.

The use of Heparin due to its ability to suppress protective function body, possibly with autoimmune diseases(glomerulonephritis, hemolytic anemia), to prevent kidney rejection during transplantation.

Release form

Heparin sodium is available as an injection solution.

Indications for use of Heparin

The instructions for Heparin indicate the following indications for use:

treatment and prevention of diseases associated with blockage of blood vessels by blood clots;
preventing the formation of blood clots during acute heart attack, thrombosis, embolism of the main arteries and veins, blood vessels of the brain, eyes;
operations on blood vessels and heart;
maintaining blood in a liquid state in hemodialysis machines and those providing artificial blood circulation;
preventing blood clotting during laboratory research.

Heparin solution is often used as additional remedy in therapy with fibrinolytic enzyme preparations.

Instructions for use of Heparin

Heparin is administered in the form of continuous intravenous infusion, intravenous, and subcutaneous injections.

For prevention they carry out subcutaneous injections 5t each IU/day with a break of 8-12 hours. To prevent hematomas, alternate sites of Heparin injection.

The initial dose of the drug is 5t IU, it is administered intravenously. Afterwards, treatment is continued by infusing Heparin using intravenous infusion. This method of administering the drug is more effective than periodic injections, because less likely opening of bleeding and it is possible to ensure more stable hypocoagulation.

When carrying out hemodialysis, 10t.IU is administered intravenously, in the middle of the process - another 30-50t.IU.

Dosages for older people should be reduced.

For children, the instructions for Heparin indicate the following dosages: 1-3 months. – 800IU/kg per day; 4-12 months – 700IU/kg per day; over 6 years old – 500IU/kg per day.

Side effects

Heparin can cause allergic reactions, dizziness, nausea, loss of appetite, headaches, vomiting, diarrhea, thrombocytopenia (rarely).

Due to long-term use of Heparin, osteoporosis, soft tissue calcification, sudden bone fractures, alopecia, hypoaldosteronism, and increased activity of liver transaminases may develop.

Administration of Heparin may cause local reactions: pain, hyperemia, skin ulcers, irritation, bleeding. Bleeding in the gastrointestinal tract is characteristic, urinary tract, surgical wounds, hemorrhages appear in corpus luteum, adrenal glands, retroperitoneal space.

An overdose of Heparin may also result in bleeding.. If they are small, to stop them it is enough to stop administering the drug. If the blood loss is extensive, then sodium heparin is neutralized with protamine sulfate ( average dose- for 100 IU of Heparin 1 mg of sulfate). When administering protamine sulfate, the time of the last administration of Heparin should be taken into account and the dosage adjusted.

Contraindications to the use of Heparin

As indicated in the instructions for Heparin, contraindications for its use are diseases that are accompanied by bleeding (for example, vasculitis, thrombocytopenia, hemophilia), existing bleeding, brain aneurysm, dissecting aortic aneurysm, hemorrhagic stroke, phospholipid syndrome, trauma, hypertension, ulcerative lesions Gastrointestinal tract, cirrhosis of the liver, which is accompanied by varicose veins of the esophagus.

Heparin is also contraindicated during radiation therapy, menstruation, pregnancy, after and during childbirth, lactation, after recent operations on the eyes, brain, prostate gland, biliary tract, liver, after spinal cord puncture.

Women who use it as contraception intrauterine device, the use of Heparin is also contraindicated.

Sincerely,