Heparin
- Atc Codes:B01AB01#C05BA03#S01XA14
- CAS Codes:9005-49-6
- PHARMGKB ID:9005-49-6
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Depot-Heparin Immuno, Heparin, Lioton, Thrombophob, Vetren, Viatromb; Belgium: Heparine; Bulgaria: Heparin-Natrium, Heparinum WZF, Lioton, Viatromb; Czech Republic: Heparin, Lioton, Viatromb; Denmark: Heparin; Estonia: Hepagel, Lioton; Finland: Heparin; France: Calciparine, Heparine; Germany: Calciparin, Essaven, Fucocux, Hepa-Gel, Hepa-Salbe, Hepacux, Heparin, Hepathromb, Hepathrombin, Liquemin, Sportino, Thrombareduct, Thrombocutan, Thrombophob, Venalitan, Venocux, Venofuc, Venoruton, Vetren; Greece: Heparin; Hungary: Heparibene, Heparin, Lioton; Ireland: Heparin; Italy: Ateroclar, Calciparina, Clarisco, Disebrin, Ecafast, Ecasolv, Eparina, Eparinlider, Eparinovis, Eparven, Flusolv, Epsoclar, Epsodilave, Heparin, Lioton, Pharepa, Reoflus, Sosefluss, Trombolisin, Zepac; Latvia: HepaGel, Heparin, Lioton, Venaruton; Lithuania: HepaGel, Heparin, Lioton, Venaruton; Malta: Calciparine, Hepsal, Monoparin, Lioton; Netherlands: Heparin; Poland: Coaparin, Heparin, Heparinum, Heparizen, Lioton; Portugal: Heparina; Spain: Heparina, Menaven; Sweden: Heparin; UK: Heparin, Hepsal.
North America
Canada: Hepalean, Heparin; USA: Heparin.
Latin America
Argentina: Cervep, Croneparina, Heparina, Hepatriet, Serianon, Sobrius, Sodiparin; Brazil: Actparin, Alimax, Disotron, Heparin, Heptar, Liquemine; Mexico: Heparina, Hep-Tec, Proparin.
Asia
Japan: Caprocin, Deribadex, Hepafilled, Hepaflush, Heparin, Heparin Na Lock, Pemiroc, Peseta.
Drug combinations
Heparin and Alpha-Bisabolol
Heparin and Dexpanthenol
Heparin and Zinc Sulfate
Heparin, Allantoin, and Cepae Extract
Heparin, Allantoin, and Onion
Heparin, Dexpanthenol, and Dimethyl Sulfoxide
Heparin, Escin (Horse Chestnut Tree extract), and Thiamine (Vitamin B~1~)
Heparin, Hydroxyethylsalicylate, and Levomenthol
Other Heparin combinations: Pantothenic Acid (Vitamin B~5~); Salicylic Acid
Chemistry
Heparin: C~26~H~41~NO~34~S~4~. Mw: 1039.85. (2S,3S,4R,5R,6R)-3-({(2R,3R,4R,5S,6R)-3-(acetylamino)-4,5-dihydroxy-6-[(sulfooxy)methyl]tetrahydro-2H-pyran-2-yl}oxy)-6-{[(2S,3S,4S,5R,6S)-6-{[(2R,3S,4S,5R)-2-carboxy-4,6-dihydroxy-5-(sulfooxy)tetrahydro-2H-pyran-3-yl]oxy}-2-hydroxy-4-(sulfomethyl)-5-(sulfooxy)tetrahydro-2H-pyran-3-yl]oxy}-4,5-dihydroxytetrahydro-2H-pyran-2-carboxylic acid. CAS-9005-49-6.
Pharmacologic Category
Anticoagulants; Heparins. (ATC-Code: B01AB01; C05BA03; S01XA14).
Mechanism of action
Potentiates action of antithrombin III and thereby inactivates thrombin (as well as activated coagulation factors IX, X, XI, XII, and plasmin) and prevents conversion of fibrinogen to fibrin.
Therapeutic use
Prophylaxis and treatment of venous thrombosis and its extension. Prophylaxis of postoperative deep-vein thrombosis and pulmonary embolism in patients undergoing major abdominal or thoracic surgery and at risk for thromboembolism. Prophylaxis and treatment of pulmonary embolism. Treatment of embolization associated with atrial fibrillation or atrial flutter and/or prosthetic heart valve replacement. Diagnosis and treatment of acute and chronic consumptive coagulopathy (DIC). Prophylaxis and treatment of peripheral arterial embolism. Also used to prevent activation of coagulation mechanism as blood passes through an extracorporeal circuit in dialysis procedures and during arterial and cardiac surgery.
Pregnancy and lactiation implications
Animal reproduction studies not conducted. Heparin does not cross placenta or enter breast milk.
Unlabeled use
Contraindications
Hypersensitivity to heparin or any component of the formulation. Severe thrombocytopenia. Uncontrolled active bleeding except when due to DIC. Suspected intracranial hemorrhage. Not for I.M. use. Not for use when appropriate monitoring parameters cannot be obtained.
Warnings and precautions
Bleeding might occur (use with extreme caution in increased risk of hemorrhage). May cause thrombocytopenia. Can cause hyperkalemia by suppressing aldosterone production. Hypersensitivity reactions (generally contraindicated in patients with hypersensitivity to drug). Use with caution in history of allergy (heparin is derived from animal tissue). May lead to severe thromboembolic complications including DVT, cerebral vein thrombosis, limb ischemia, mesenteric thrombosis, renal artery thrombosis, skin necrosis, gangrene of the extremities (possibly requiring amputation), MI, pulmonary embolism, stroke, and possibly, death. Increased resistance to antithrombotic effects of heparin reported. Risk of hemorrhage may be higher in patients >60 years of age, particularly women. Patients with renal failure may be at increased risk of bleeding complications. Osteoporosis might occur with prolonged use (>6 months) due to reduction in bone mineral density. Some preparations contain benzyl alcohol as preservative. In neonates, large amounts of benzyl alcohol (>100 mg/kg/day) associated with fatal toxicity («gasping syndrome»). Some preparations contain sulfite which may cause allergic reactions.