heparin

(HEP ah rin)

What is the most important information I should know about heparin?

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Notify your doctor immediately if you develop a nosebleed; black, bloody, or tarry stools; prolonged bleeding; or unexplained bruising or bleeding.

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Do not inject this medication intramuscularly (into the muscle).

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Do not take aspirin, ibuprofen (Motrin, Advil, Nuprin, others), ketoprofen (Orudis KT, Orudis, Oruvail), naproxen (Aleve, Naprosyn, Anaprox, others), indomethacin (Indocin), or any other nonsteroidal anti-inflammatory medication. These medicines may lead to bleeding when taken with heparin. Ask your pharmacist or doctor before taking any prescription or over-the-counter medication.

What is heparin?

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Heparin is an anticoagulant (blood thinner). Heparin prevents the formation of blood clots.

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Heparin is used to treat and prevent blood clot formation in patients with active blood clots in an artery, vein, or lung; prior to surgery if the risk of a blood clot is high; in patients with atrial fibrillation (irregular heartbeats); and in patients with chronic blood clotting disorders.

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Heparin may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before using heparin?

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You cannot use this medication if you have a very low level of platelets in your blood, if you have uncontrolled bleeding, or if accurate blood testing cannot be done prior to and during dosing.

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Before using this medication, tell your doctor if you

have bacterial endocarditis,

high blood pressure that is not being controlled,

need to have major surgery,

have hemophilia or another blood disorder,

have a stomach ulcer, or

have liver disease.

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You may not be able to use heparin, or you may require a lower dose or special monitoring during therapy if you have any of the conditions listed above.

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Heparin is in the FDA pregnancy category C. This means that it is not known whether heparin will harm an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant.

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Heparin does not pass into breast milk. Do not use this medication without first talking to your doctor if you are breast-feeding a baby.

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Heparin may be more effective in females patients over 60 years of age. A lower dose may be needed to prevent side effects.

How should I use heparin?

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Use heparin exactly as directed by your doctor. If you do not understand these directions, ask your doctor, nurse, or pharmacist to explain them to you.

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Heparin is generally used as an injection, either intravenously (into a vein), or subcutaneously (under the skin). Heparin may also be used as a "flush" when it is used to clear (flush) IV lines or catheters to keep them open and flowing between medication administrations. Heparin is not effective if given by mouth.

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Do not inject this medication intramuscularly (into the muscle).

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Your doctor or nurse will give you detailed instructions on how to inject heparin. Do not inject this medication if you do not understand these instructions.

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Do not use this medication if it is very discolored or if it has particles in it.

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Do not stop using this medication without first talking to your doctor.

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Store heparin at room temperature away from moisture and heat.

What happens if I miss a dose?

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Use the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the dose you missed and use only your next regularly scheduled dose. Do not use a double dose of this medication.

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Notify your doctor if you miss a dose of heparin.

What happens if I overdose?

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Seek emergency medical attention.

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The main symptom of a heparin overdose is bleeding: nosebleeds; black, bloody, or tarry stools; blood in the urine; and easy or unexplained bruising or bleeding.

What should I avoid while using heparin?

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Do not take aspirin, ibuprofen (Motrin, Advil, Nuprin, others), ketoprofen (Orudis KT, Orudis, Oruvail), naproxen (Aleve, Naprosyn, Anaprox, other), indomethacin (Indocin), or any other nonsteroidal anti-inflammatory medication. These medicines may lead to bleeding when taken with heparin. Ask your pharmacist or doctor before taking any prescription or over-the-counter medication.

What are the possible side effects of heparin?

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If you experience any of the following serious side effects, stop using heparin and seek emergency medical attention:

an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

any prolonged or unexplained bleeding; or

pain, warmth, or redness in an arm or leg, or difficulty breathing, which could indicate a blood clot.

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Other less serious side effects may be more likely to occur. Continue to use heparin and talk to your doctor if you experience

mild pain, redness, warmth, or ulceration at the injection site;

hair loss;

prolonged, painful erection; or

osteoporosis (following long-term use).

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Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect heparin?

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Do not take any of the following medicines during treatment with heparin:

aspirin or choline salicylate and magnesium salicylate (Trilisate, Tricosal, Doan's, Bayer Select Backache Pain Formula, Magan, Arthropan, others);

salsalate (Disalcid, Salflex, Salsitab, others); or

ibuprofen (Motrin, Advil, Nuprin, others), ketoprofen (Orudis KT, Orudis, Oruvail), naproxen (Aleve, Naprosyn, Anaprox, others), indomethacin (Indocin), diclofenac (Cataflam, Voltaren), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), ketorolac (Toradol), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), or tolmetin (Tolectin).

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The medicines listed above may lead to bleeding when taken with heparin. Ask your pharmacist or doctor before taking any prescription or over-the-counter medication.

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Before taking this medication, tell your doctor if you are taking any of the following medicines:

warfarin (Coumadin);

ticlopidine (Ticlid) or clopidogrel (Plavix);

dipyridamole (Persantine);

digoxin (Lanoxin, Lanoxicaps);

a tetracycline antibiotic such as tetracycline (Sumycin, others), minocycline (Minocin), or doxycycline (Vibramycin, Doryx);

an antihistamine such as diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton, others), brompheniramine (Dimetapp, others), and others; or

nicotine (in tobacco products and nicotine withdrawal products.

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The drugs listed above may increase or decrease the effects of heparin, both of which could become dangerous.

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Drugs other than those listed here may also interact with heparin. Talk to your doctor and pharmacist before using any prescription or over-the-counter medicines.

Where can I get more information?

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Your pharmacist has additional information about heparin written for health professionals that you may read.

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Remember, keep this and all other medicines out of the reach of children, never share your medicines with other, and use this medication only for the indication prescribed.

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Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.