Composition
Active ingredient:
heparin sodium
Pharmacological action
Heparin is a direct-acting anticoagulant that belongs to the group of medium-molecular-weight heparins. In the blood plasma, it activates antithrombin III, accelerating its anticoagulant effect. It disrupts the prothrombin-to-thrombin transition, inhibits the activity of thrombin and activated factor X, and reduces platelet aggregation to some extent.
For unfractionated standard heparin, the ratio of antiplatelet activity (Xa factor) to anticoagulant activity (APTT) is 1: 1.
Increases renal blood flow; increases the resistance of brain vessels, reduces the activity of brain hyaluronidase, activates lipoprotein lipase and has a hypolipidemic effect. Reduces the activity of surfactant in the lungs, suppresses excessive synthesis of aldosterone in the adrenal cortex, binds epinephrine, modulates the ovarian response to hormonal stimuli, increases the activity of parathyroid hormone. As a result of interaction with enzymes, it can increase the activity of brain tyrosine hydroxylase, pepsinogen, DNA polymerase, and reduce the activity of myosin ATPase, pyruvate kinase, RNA polymerase, and pepsin.
There are data on the presence of heparin immunosuppressive activity.
In patients with CHD (in combination with ASA), it reduces the risk of acute coronary artery thrombosis, myocardial infarction, and sudden death. Reduces the frequency of recurrent heart attacks and mortality in patients who have had a myocardial infarction. In high doses, it is effective for pulmonary embolism and venous thrombosis, in small doses-for the prevention of venous thromboembolism, including after surgery.
With intravenous use, blood clotting slows down almost immediately, with i/m-in 15-30 minutes, with subcutaneous injection-in 20-60 minutes, after inhalation, the maximum effect is in a day; the duration of anticoagulant action, respectively, is 4-5,6,8 hours and 1-2 weeks, the therapeutic effect-preventing thrombosis-persists much longer. A deficiency of antithrombin III in plasma or at the site of thrombosis may reduce the antithrombotic effect of heparin.
When applied externally, it has a local antithrombotic, anti-exudative, moderate anti-inflammatory effect. Blocks the formation of thrombin, inhibits the activity of hyaluronidase, activates the fibrinolytic properties of blood. Penetrating through the skin, heparin reduces the inflammatory process and has an antithrombotic effect, improves microcirculation and activates tissue metabolism, thereby accelerating the resorption of hematomas and blood clots and reducing tissue swelling.
Indications
- Unstable angina, acute myocardial infarction;
- thromboembolic complications of myocardial infarction, operations on the heart and blood vessels, pulmonary embolism (including in diseases of the peripheral veins), thrombosis of the coronary arteries and cerebral vessels, thrombophlebitis (prevention and treatment);
- DIC, prophylaxis and therapy macrothrombocytopenia and disturbance of microcirculation;
- deep vein thrombosis;
- thrombosis of renal veins;
- hemolytic uremic syndrome;
- atrial fibrillation (including accompanied by embolization), mitral heart disease (prevention of thrombosis);
- bacterial endocarditis;
- glomerulo-nephritis;
- lupus nephritis;
- prevention of clotting in the conduct of in vitro methods (extracorporeal circulation in heart surgery, the hemoperfusion, hemodialysis, peritoneal dialysis, Tifferet), forced diuresis;
- flushing intravenous catheters.
Contraindications
Hypersensitivity; hemorrhagic diathesis, hemophilia, vasculitis, thrombocytopenia (including those caused by heparin in the anamnesis), bleeding, leukemia, increased vascular permeability, polyps, malignant neoplasms and ulcerative lesions of the gastrointestinal tract, esophageal varicose veins, severe uncontrolled arterial hypertension, acute bacterial endocarditis, trauma (especially craniocerebral), recent eye surgery brain and spine, severe liver and/or kidney function disorders.
Side effects
Nervous system and sensory disorders: Â dizziness, headache.
Cardiovascular and blood disorders (hematopoiesis, hemostasis):  thrombocytopenia (6% of patients) — early (2-4 days of treatment) and late (autoimmune), in rare cases with a fatal outcome; hemorrhagic complications — bleeding from the gastrointestinal tract or urinary tract, retroperitoneal hemorrhages in the ovaries, adrenal glands (with the development of acute adrenal insufficiency).
From the digestive tract: Â decreased appetite, nausea, vomiting, diarrhea, increased levels of transaminases in the blood.
Allergic reactions: Â skin hyperemia, drug-induced fever, urticaria, rash, pruritus, bronchospasm, anaphylactoid reactions, anaphylactic shock.
Other services:  with prolonged use — alopecia, osteoporosis, calcification of soft tissues, inhibition of aldosterone synthesis; injection reactions-irritation, hematoma, soreness when administered.
Interaction
The anticoagulant effect of heparin is enhanced by the simultaneous use of anticoagulants, antiplatelet agents and NSAIDs.
Ergot alkaloids, thyroxine, tetracycline, antihistamines, and nicotine reduce the effects of heparin.
How to take, course of use and dosage
Intravenous (infusion or injection) or subcutaneous, starting dose-intravenous (injection) 5000 IU, maintenance:
continuous intravenous infusion-1000-2000 IU / h (20000-40000 IU/day), previously diluted in 1000 ml of isotonic NaCl solution; regular intravenous injections – 5000-10000Â IU every 4-6 hours; subcutaneously (deep)Â – by 15000-20000Â IU every 12 hours or 8000-10000Â IU every 8 hours.
Product form
solution for injection
Storage conditions
Store in a dry place, protected from light, at a temperature not exceeding 25 °C.
Shelf life
2 years
Active ingredient
Sodium Heparin
Conditions of release from pharmacies
By prescription
Dosage form
solution for injection and infusion
Description
Adults as prescribed by a doctor
Indications
Prevention of thromboembolism, Prevention of thrombosis, Prevention of acute myocardial infarction, Thrombophlebitis, Angina
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Side effects of Heparin solution for intravenous and subcutaneous injection 5000IU/ml 5ml ampoules, 5pcs.
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