Diparin

Indications

Heparin Sodium is an anticoagulant (blood thinner). As an injection it is used to prevent and treat blood clots in the veins of the legs (deep vein thrombosis) and lungs (pulmonary embolism), in heart attack and unstable angina, during heart surgery, dialysis and blood transfusion, and to keep intravenous lines open. Low strength gels and creams containing heparin are also used on the skin for bruises, superficial vein inflammation and swelling.

How It Works

Heparin boosts the action of antithrombin, a natural protein in the blood that switches off clotting factors, especially thrombin and factor Xa. This stops new clots from forming and prevents existing clots from growing, while the body slowly breaks them down. It does not dissolve clots directly.

Dosage and Administration

Injections are given by a doctor or nurse into a vein (as an injection or continuous drip) or under the skin. The dose is worked out for each patient and adjusted using blood clotting tests such as APTT. Skin gel: apply a thin layer to the affected area two to three times a day, or as directed on the label, and do not use on open wounds or bleeding areas.

Interactions

• Other blood thinners such as Warfarin, Apixaban and Rivaroxaban, antiplatelet medicines such as Aspirin and Clopidogrel, and NSAIDs such as Ibuprofen increase the risk of bleeding.
• Thrombolytic (clot dissolving) medicines add to bleeding risk.
• Glyceryl Trinitrate infusion may reduce its effect.
• Medicines that raise potassium, such as ACE inhibitors and potassium supplements, may add to high potassium levels.

Contraindications

• Allergy to Heparin or pork products.
• Current or past heparin induced thrombocytopenia (a serious drop in platelets caused by heparin).
• Active serious bleeding, severe bleeding disorders or very low platelets.
• Recent bleeding in the brain, or recent surgery on the brain, spine or eye.
• Severe uncontrolled high blood pressure.

Side Effects

Possible effects include bruising or pain at the injection site, bleeding from gums or nose, a drop in platelet count, raised liver enzymes and raised potassium. Long term use can weaken bones. Skin gels may cause mild redness or itching.

Get urgent medical help if you have unusual or heavy bleeding, blood in the urine or black stools, vomiting blood, a severe headache, sudden weakness, new painful swelling of a leg, chest pain or breathlessness, or swelling of the face or throat.

Pregnancy and Lactation

Heparin does not cross the placenta and is a preferred blood thinner during pregnancy when needed, under medical supervision. It does not pass into breast milk in meaningful amounts, so breastfeeding can continue.

Precautions and Warnings

• Regular blood tests (clotting tests, platelets and potassium) are needed during injection treatment.
• Tell every doctor and dentist that you are receiving Heparin before any procedure.
• Use with care in liver or kidney disease, older people and those with stomach ulcers.

Overdose

Overdose causes bleeding. It is treated in hospital, and Protamine Sulfate can reverse the effect of Heparin.

Therapeutic Class

Anticoagulant (unfractionated heparin).

Storage

Store below 25°C as directed on the pack, away from light and out of the reach of children. Do not freeze. Skin gels are stored below 30°C.