Heparin - Benefits, dosage and side effects

Heparin is a drug to treat and prevent blood clots caused by certain medical conditions or procedures. This drug is available in the form of gels and injections whose use must be according to a doctor's prescription.

Heparin works by inhibiting the work of proteins that play a role in the blood clotting process. So that the formation of clots and blood clots can be prevented. Keep in mind that this medicine cannot reduce the size of a blood clot that has already formed.

Injectable heparin is often used in the treatment of deep vein thrombosis (deep vein thrombosis), pulmonary embolism, or atrial fibrillation. In addition, this drug is also used to prevent blood clots from forming after surgery, during hemodialysis, or during transfusions.

Heparin trademark: Heparinol, Heparin Sodium, Hepagusan, Hico, Inviclot, Oparin, Thrombogel, Thrombophob, Thromboflash, Thromecon

What is Heparin

Precautions Before Using Heparin

Heparin should not be used carelessly. There are several things that must be considered before using this drug, including:

• Tell your doctor if you have a history of allergies. Heparin should not be used in patients who are allergic to this drug.
• Do not consume alcoholic beverages while on treatment with heparin because it can increase the risk of bleeding in the stomach.
• Do not smoke while on heparin treatment, because smoking can decrease the effectiveness of heparin in the body.
• Do not use heparin gel on open wounds and skin ulcers.
• Tell your doctor about your medical history, especially if you have or have ever had hemophilia, hypertension, heart attack, endocarditis, congestive heart failure, liver disease, peptic ulcers, or cancer.
• Tell your doctor if you have had bleeding that is difficult to stop.
• Tell your doctor if you are menstruating, have a fever, or have an infection.
• Tell your doctor if you have recently had surgery or certain medical procedures, including a lumbar puncture, or spinal anesthetic procedure.
• Tell your doctor if you are taking certain medications, supplements, or herbal products.
• Tell your doctor that you are taking heparin if you plan to have dental treatment or surgery.
• Tell your doctor if you are pregnant, breastfeeding, or planning a pregnancy.
• Tell your doctor right away if you have an allergic reaction to the drug, a more serious side effect, or an overdose, after using heparin.

Dosage and Instructions for Use of Heparin

The amount of heparin dose given by the doctor will be adjusted to the medical condition, body weight, and response of the patient's body to treatment, which is seen from the examination of clotting time called clotting time. activated partial thromboplastin time (aPTT).

Keep in mind that injectable heparin should only be given by a doctor or medical officer under the supervision of a doctor. The following are general doses of heparin based on the form of the drug, the age of the patient, and the condition being treated:

1. Heparin given by injection into a vein (IV/intravenous)

Condition: Post-cardiac arrest treatment with thrombolytic drugs

• Mature: 60 U/kg (maximum 4,000 U), or 5,000 U if using streptokinase. Followed by an infusion of 12 U/kgBW per hour. The maximum dose is 1000 U per hour, with a duration of treatment of 48 hours.

Condition: Peripheral arterial embolism, unstable angina, deep vein thrombosis (DVT)

• Mature: The initial dose is 75–80 U/kg or 5,000 U (10,000 U in patients with pulmonary embolism). Follow-up dose by infusion of 18 U/kg or 1,000–2,000 U per hour.
• seniors: A lower dose than the adult dose may be required.
• Children: The initial dose is 50 U/kgBW. Follow-up dose by infusion of 15–25 U/kg per hour.

2. Heparin given by injection under the skin (SC / subcutaneous)

Condition: Prevention of postoperative DVT

• Mature: 5,000 U administered 2 hours before surgery. Further doses are given every 8–12 hours, for 7 days or until the patient is able to move.

Condition: Deep vein thrombosis (DVT)

• Mature: 15,000–20,000 U per 12 hours or 8,000–10,000 U per 8 hours.
• seniors: Lower doses may be needed.
• Children: 250 U/kgBW, 2 times a day.

The dose and effectiveness of injectable heparin will be monitored through the aPTT value seen through blood tests.

3. Topical heparin in gel form

Heparin gel can be used by children, adults, and the elderly. This medicine can be used by applying it to the surface of the bruised skin, 2-3 times a day.

How to Use Heparin Correctly

Follow the doctor's recommendations and read the instructions for use listed on the packaging before using heparin. Do not increase or decrease the dose without consulting your doctor first.

Injectable heparin is only given by a doctor or medical staff under the supervision of a doctor. For heparin gel, apply a thin layer on the area of ​​​​the skin that has a blood clot or bruise. Before using heparin, double-check the expiration date and the presence or absence of physical changes from the drug, such as a change in color.

Use heparin gel at the same time every day for maximum effect. If you forget to use it, use this medicine as soon as you remember if the break with the next schedule is not too close. If it is close, ignore it and do not double the dose.

Sometimes, heparin may need to be used in combination with other antiplatelet drugs or anticoagulants, such as aspirin, clopidogrel, or warfarin. Do regular checkups as recommended by your doctor when using heparin along with these drugs.

Store heparin at room temperature. Do not store it in a humid place or in direct sunlight. Keep this medicine out of reach of children.

Heparin Interactions with Other Drugs

There are several types of interactions that can occur if heparin is used with other types of drugs, namely:

• Decreased effectiveness of heparin when used with nitroglycerin
• Increased risk of bleeding if used with iodine, NSAIDs, other anticoagulant drugs, such as warfarin, fibrinolytics, such as alteplase, or antiplatelet agents, such as tirofiban
• An increased risk of developing hyperkalemia is used with ACE inhibitor or angiotensin II . receptor blockers

Side Effects and Dangers of Heparin

Injectable heparin can cause side effects, such as pain, redness, bruising, sores, at the injection site. In addition, this drug can also cause hair loss. Check with your doctor if these side effects don't go away or get worse.

Immediately see a doctor if you experience an allergic reaction to the drug which can be characterized by an itchy rash on the skin, swelling of the lips and eyelids, or difficulty breathing. You should also see a doctor immediately if you have more serious side effects, such as:

• Easy bruising, bleeding gums, or other signs of bleeding, for no apparent reason
• Severe headache that appears suddenly and continuously
• Vomiting blood or vomit black like coffee
• Bloody or black stools
• The feeling of tiredness is getting worse
• Chest pain
• Dizzy and feel like passing out
• Numbness or tingling in the face, arms, or legs that occurs suddenly
• Severe pain or swelling in the abdomen, back, or groin
• Loss of balance and difficulty walking
• Difficulty speaking
• Visual disturbance
• Hard to breathe