Properties
What is it?
International Name - HEPARIN SODIUM Active Substance: Heparin Sodium Clinical-Pharmacological Group: Direct-acting anticoagulant. Composition and Dosage Form: Solution for injection: 25000 IU/5 ml vial 1 ml contains: Heparin Sodium ......... 5000 IU (obtained from porcine intestinal mucosa) Benzyl alcohol ............. 10 mg Sodium chloride .......... 3 mg Hydrochloric acid ............ 0.1 M or Sodium hydroxide ...... 0-0.1 M Water for injections ................ up to 1.0 ml Indications: Prevention and treatment of deep vein thrombosis; Prevention of postoperative thrombosis and pulmonary embolism in deep vein surgery; Atrial fibrillation with embolization; Unstable angina; Acute myocardial infarction; Pulmonary embolism; Prevention and treatment of thromboembolism in peripheral arterial disease; Use of extracorporeal circulation apparatus, blood transfusion, hemodialysis; As a stabilizer during blood collection. Method of Administration and Dosage: ♦ Heparin is administered subcutaneously, intravenously, and by electrophoresis. ♦ For therapeutic purposes, heparin is used as a continuous intravenous infusion or as regular intravenous injections. ♦ For prophylaxis, heparin is used subcutaneously at 8-12 hour intervals. The primary site for subcutaneous heparin injection is the anterior-lateral abdominal wall, alternating between the right and left sides. A thin, long needle should be inserted perpendicularly (not at an angle) into the skin fold grasped between the thumb and index finger until the solution is completely injected. Subcutaneous heparin injections are administered deep into the fatty tissue. To avoid hematoma formation, the injection site should be constantly alternated. ♦ Subcutaneous injection of concentrated heparin solution is often used, as it significantly improves the treatment process. The initial dose of heparin is usually 5000 IU. It is administered intravenously, followed by treatment with subcutaneous heparin injections or intravenous infusion. Maintenance doses of heparin depend on the method of administration: - During continuous intravenous infusion, 1000-2000 IU/hour is prescribed (20000-40000 IU per day). Heparin is dissolved in 100 ml of isotonic sodium chloride solution. - For regular intravenous injections, 5000-10000 IU of heparin is prescribed every 4-6 hours. - For subcutaneous injections, concentrated heparin solution is administered every 12 hours at 15000-20000 IU, or every 8 hours at 8000-10000 IU. ♦ Heparin doses are selected based on the activated partial thromboplastin time, which should be 1.5-2.5 times higher than the control values. ♦ With subcutaneous injections of small doses of the drug (prevention of thrombus formation), regular monitoring of activated partial thromboplastin time is not necessary, as it increases insignificantly. Continuous intravenous infusion of heparin is a more convenient method compared to regular injections, as it provides more significant hypocoagulation and is associated with a lower risk of bleeding. ♦ Intravenous injections of heparin are recommended only at the beginning of treatment, or when intravenous infusion of the drug or subcutaneous administration of concentrated heparin solution is not possible for any reason. Regular intravenous injections of the drug cause changes in hemostasis, accompanied by very dangerous bleeding, therefore, these injections are administered only in cases of extreme necessity. ♦ The duration of heparin treatment depends on the indication for its use and the method of administration. ♦ During intravenous injection, the optimal course of treatment is 7-10 days, followed by a switch to oral anticoagulants. ♦ It is recommended to use oral anticoagulants (warfarin and others) from the first day of heparin treatment, or on the 5th-7th day. Heparin treatment is discontinued 4-5 days after combined therapy.
