Hep Flush-10 (PF) (heparin sodium,porcine/PF)

Dosage of heparin sodium is expressed in USP units.

Dosage requirements for therapeutic heparin vary among individual patients and by indication, and dosage should be individualized based on clinical and laboratory findings in order to obtain optimum therapeutic effects without incurring hemorrhage. The generally accepted therapeutic range for the activated partial thromboplastin time (aPTT) during therapeutic IV or subcutaneous heparin therapy is 1.5-2 times the control value in seconds, and the generally accepted therapeutic range for the acitvated coagulation time (ACT) is 2.5-3 times the control value in seconds. However, in some patients at high risk for thromboembolic events (e.g., pregnant females with mechanical heart valves) an aPTT of at least 2 times the control value has been used.

Therapeutic heparin is administered by IV infusion, intermittent IV injection, or deep subcutaneous (intrafat) injection. For fixed low-dose therapy for prophylaxis, heparin is usually administered by subcutaneous injection. Heparin should not be administered IM because of the frequency of irritation, pain, and hematoma at the injection site.

Heparin solution has also been administered via nebulizer+ for inhalation injury in burn patients+.

Use preservative-free formulations in neonates and infants, and also in pregnant and nursing females, if available.

Store all heparin sodium products (including heparin sodium injection in 5% dextrose or in 0.45 or 0.9% sodium chloride injection) at 20-25degreesC. Some products permit excursions to 15-30degreesC. Protect heparin sodium injection in 5% dextrose or in 0.45 or 0.9% sodium chloride injection from freezing.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

*History of heparin-induced thrombocytopenia (HIT) and HIT with thrombosis.

*Known hypersensitivity to heparin or pork products (e.g., anaphylactoid reactions).

*Administration of therapeutic heparin in patients in whom suitable blood coagulation tests cannot be performed at appropriate intervals.

*Uncontrolled active bleeding (except in the case of disseminated intravascular coagulation (DIC)).

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

The most common adverse reactions include hemorrhage, thrombocytopenia, HIT or HIT with thrombosis, injection site irritation, general hypersensitivity reactions, and elevations of aminotransferase levels. Hyperkalemia may also occur.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

There are no adequate and well-controlled studies evaluating heparin use in pediatric patients.

Some commercially available heparin sodium products contain benzyl alcohol as a preservative. Although a causal relationship has not been established, administration of injections preserved with benzyl alcohol has been associated with serious toxicity (e.g., ''gasping syndrome'') in pediatric patients. In these cases, toxicity occurred following administration of large amounts (i.e., about 100-200 mg/kg daily) of benzyl alcohol, and may be more likely to occur in preterm, low-birthweight infants. When heparin sodium injection is required in neonates and infants, the manufacturer states that a preservative-free formulation should be used. If other benzyl alcohol-containing preparations are to be used in a pediatric patient, clinicians should take into account the total daily metabolic load of benzyl alcohol from all sources.

Fatalities have occurred in pediatric patients, including neonates, as a result of medication dispensing errors. Clinicians should take appropriate precautions when dispensing and administering the medication.

Increased fetal resorptions have been observed in animals when heparin was administered during the period of organogenesis in dosages approximately 10 times higher than the maximum human dosage; there are no adequate and well-controlled studies to date using heparin in pregnant females. Published reports have not shown any evidence of a teratogenic potential or other adverse fetal effects when the medicationis used during pregnancy.

Consider the potential benefits and risks to the fetus when prescribing heparin to a pregnant patient; if needed, use of a preservative (benzyl alcohol)-free formulation is recommended. When anticoagulant therapy is required in pregnant females, the American College of Chest Physicians (ACCP) generally recommends the use of a low molecular weight heparin because of a more favorable adverse effect profile.

Because of its high molecular weight, heparin is not likely to be distributed into human milk; any heparin that is ingested during breastfeeding would not be absorbed by a nursing infant. However, if benzyl alcohol is present in maternal serum, it is likely to distribute into human milk and be absorbed by a nursing infant. The developmental and health benefits of breast-feeding should be considered along with the mother's clinical need for heparin and any potential adverse effects on the breast-fed infant from heparin or from the underlying maternal condition. ACCP recommends heparin be continued in nursing females who are already receiving such therapy as indicated.

If heparin therapy is required in nursing females, use of a preservative (benzyl alcohol)-free formulation is recommended.

The manufacturer makes no specific dosage recommendations for geriatric patients; however, patients >60 years of age (especially women) may require lower doses of heparin due to a higher incidence of bleeding noted in this population.

A higher incidence of bleeding has been reported in patients older than 60 years of age, especially women. Clinical studies indicate lower dosages of heparin may be appropriate in these patients.