Heparin interacts with the naturally occurring plasma protein, Antithrombin III, to induce a conformational change, which markedly enhances the serine protease activity of Antithrombin III, thereby inhibiting the activated coagulation factors involved in the clotting sequence, particularly Xa and IIa. Small amounts of heparin inhibit Factor Xa, and larger amounts inhibit thrombin (Factor IIa). Heparin also prevents the formation of a stable fibrin clot by inhibiting the activation of the fibrin stabilizing factor. Heparin does not have fibrinolytic activity; therefore, it will not lyse existing clots.

HEPARIN SODIUM INJECTION is an anticoagulant indicated for:

• Prophylaxis and treatment of venous thrombosis and pulmonary embolism
• Prevention of postoperative deep venous thrombosis and pulmonary embolism in patients undergoing major abdominothoracic surgery or who, for other reasons, are at risk of developing thromboembolic disease
• Atrial fibrillation with embolization
• Treatment of acute and chronic consumptive coagulopathies (disseminated intravascular coagulation)
• Prevention of clotting in arterial and cardiac surgery
• Prophylaxis and treatment of peripheral arterial embolism
• Use as an anticoagulant in blood transfusions, extracorporeal circulation, and dialysis procedures

Recommended Adult Dosages:
Therapeutic Anticoagulant Effect with Full-Dose Heparin†

See package insert for complete information.

Most common adverse reactions are hemorrhage, thrombocytopenia, HIT and HITTS, injection site irritation, general hypersensitivity reactions, and elevations of aminotransferase levels.

• History of heparin-induced thrombocytopenia (HIT) or heparin-induced thrombocytopenia and thrombosis (HITTS)
• Known hypersensitivity to heparin or pork products 
• In whom suitable blood coagulation tests cannot be performed at appropriate intervals
• An uncontrolled bleeding state, except when this is due to disseminated intravascular coagulation

• Fatal Medication Errors: Confirm choice of correct strength prior to administration.
• Hemorrhage: Hemorrhage, including fatal events, has occurred in patients receiving heparin. Use caution in conditions with increased risk of hemorrhage.
• HIT and HITTS: Monitor for signs and symptoms and discontinue if indicative of HIT and HITTS.
• Benzyl Alcohol Toxicity: Use preservative-free formulation in neonates and infants.
• Monitoring: Blood coagulation tests guide therapy for full-dose heparin. Periodically monitor platelet count, hematocrit, and occult blood in stool in all patients receiving heparin.