In this article, you can read the instructions for using the drug Heparin. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Heparin in their practice are presented. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Heparin in the presence of existing structural analogues. Use for the treatment of thrombophlebitis, hemorrhoids, varicose veins in adults, children, as well as during pregnancy and lactation. The composition of the drug.

Heparin- anticoagulant of direct action, belongs to the group of medium molecular weight heparins. In blood plasma, it activates antithrombin 3, accelerating its anticoagulant action. Violates the transition of prothrombin to thrombin, inhibits the activity of thrombin and activated factor 10, to some extent reduces platelet aggregation.

For unfractionated standard heparin, the ratio of antiplatelet activity (antifactor 10a) and anticoagulant activity (APTT) is 1:1.

Increases renal blood flow; increases the resistance of cerebral vessels, reduces the activity of cerebral 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 adrenaline, 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, pepsin.

There is evidence of immunosuppressive activity in heparin.

In patients with coronary artery disease (in combination with ASA) reduces the risk of acute thrombosis of the coronary arteries, myocardial infarction and sudden death. Reduces the frequency of recurrent heart attacks and mortality in patients with myocardial infarction. In high doses, it is effective for pulmonary embolism and venous thrombosis, in small doses it is effective for the prevention of venous thromboembolism, incl. after surgical operations.

With intravenous administration, blood coagulation slows down almost immediately, with intramuscular injection - after 15-30 minutes, with subcutaneous injection - after 20-60 minutes, after inhalation, the maximum effect is after a day; the duration of the anticoagulant action, respectively, is 4-5, 6, 8 hours and 1-2 weeks, the therapeutic effect - prevention of thrombosis - lasts much longer. Deficiency of antithrombin 3 in plasma or at the site of thrombosis may reduce the antithrombotic effect of heparin.

When applied externally, it has a local antithrombotic, antiexudative, moderate anti-inflammatory effect. Blocks the formation of thrombin, inhibits the activity of hyaluronidase, activates the fibrinolytic properties of the blood. Heparin penetrating the skin reduces inflammatory process and has an antithrombotic effect, improves microcirculation and activates tissue metabolism, thereby accelerating the processes of resorption of hematomas and blood clots and reducing tissue swelling.

Compound

Heparin sodium + Excipients(injections).

Heparin sodium + Benzocaine + Benzyl nicotinate + excipients (heparin ointment).

Sodium heparin 1000 IU + excipients (gel Akrikhin 1000).

Other forms such as tablets do not exist.

Pharmacokinetics

Heparin does not cross the placenta well due to its high molecular weight. Not excreted in breast milk.

Indications

Prevention and therapy:

• deep vein thrombosis;
• thromboembolism of the pulmonary artery (including in diseases of peripheral veins);
• thrombosis of the coronary arteries;
• thrombophlebitis;
• unstable angina;
• acute myocardial infarction;
• atrial fibrillation (including accompanied by embolism);
• DIC;
• prevention and therapy of microthrombosis and microcirculation disorders;
• thrombosis of the renal veins;
• hemolytic uremic syndrome;
• mitral heart disease (prevention of thrombosis);
• bacterial endocarditis;
• glomerulonephritis;
• lupus nephritis;
• prevention of blood coagulation during operations using extracorporeal methods of blood circulation;
• preparation of non-clotting blood samples for laboratory purposes and blood transfusion
• prevention and treatment of thrombophlebitis of superficial veins;
• post-injection and post-infusion phlebitis;
• external hemorrhoids;
• inflammation of postpartum hemorrhoids;
• trophic ulcers of the lower leg;
• elephantiasis;
• superficial periphlebitis;
• lymphangitis;
• superficial mastitis;
• localized infiltrates and edema;
• injuries and bruises without violating the integrity of the skin (including muscle tissue, tendons, joints);
• subcutaneous hematoma.

Release forms

Ointment for external use.

Solution for intravenous and subcutaneous administration (injections in ampoules for injection).

Gel for external use.

Instructions for use and dosage

Ampoules

Intravenous (infusion or injection) or subcutaneous (famous injections in the abdomen), the initial dose is intravenous (injection) 5000 IU, maintenance: continuous IV infusion - 1000-2000 IU / h (20000-40000 IU / day), previously diluted in 1000 ml of isotonic NaCl solution; regular intravenous injections - 5000-10000 IU every 4-6 hours; subcutaneously (deeply) - 15000-20000 IU every 12 hours or 8000-10000 IU every 8 hours.

Ointment

Apply externally. The ointment is applied in a thin layer to the affected area (at the rate of 0.5-1 g (2-4 cm of ointment) per area with a diameter of 3-5 cm) and the ointment is gently rubbed into the skin. The ointment is applied 2-3 times a day daily until the inflammation disappears, on average from 3 to 7 days. The possibility of a longer course of treatment is determined by the doctor.

In case of thrombosis of external hemorrhoids, the ointment is applied to a calico or linen pad, which is applied directly to the thrombosed nodes and fixed. The ointment should be applied daily until the symptoms disappear, on average from 3 to 14 days, for the same purpose, you can use a swab soaked in heparin ointment, which is inserted into the anus.

Side effect

• bleeding of the gastrointestinal tract and urinary tract;
• bleeding at the injection site, in areas subjected to pressure, from surgical wounds;
• hemorrhages in organs;
• hematuria;
• thrombocytopenia;
• nausea, vomiting;
• loss of appetite;
• diarrhea;
• skin hyperemia;
• medicinal fever;
• hives;
• rhinitis;
• skin itching and feeling of heat in the soles;
• bronchospasm;
• collapse;
• anaphylactic shock;
• thrombocytopenia (may be severe up to death) with the subsequent development of skin necrosis, arterial thrombosis, accompanied by the development of gangrene, myocardial infarction, stroke;
• osteoporosis;
• spontaneous fractures;
• soft tissue calcification;
• irritation, pain, hyperemia, hematoma and ulceration at the injection site;
• transient alopecia;
• hypoaldosteronism.

Contraindications

• bleeding;
• diseases accompanied by a violation of blood coagulation processes;
• suspicion of intracranial hemorrhage;
• aneurysm of cerebral vessels;
• hemorrhagic stroke;
• dissecting aortic aneurysm;
• antiphospholipid syndrome;
• malignant arterial hypertension;
• subacute bacterial endocarditis;
• erosive and ulcerative lesions of the gastrointestinal tract;
• severe lesions of the liver parenchyma;
• cirrhosis of the liver with varicose veins of the esophagus;
• malignant neoplasms in the liver;
• shock conditions;
• recent surgery on the eyes, brain, prostate, liver and biliary tract;
• condition after spinal cord puncture;
• menstruation;
• threatened miscarriage;
• childbirth (including recent);
• hypersensitivity to heparin.

Use during pregnancy and lactation

Use during pregnancy is possible only under strict indications, under close medical supervision.

May be used during lactation breastfeeding) according to indications.

special instructions

Use with caution in patients suffering from polyvalent allergies (including with bronchial asthma), at arterial hypertension, dental procedures, diabetes, endocarditis, pericarditis, in the presence of an intrauterine contraceptive, with active tuberculosis, radiotherapy, liver failure, chronic renal failure, in elderly patients (over 60 years, especially women).

Use with caution externally for bleeding and conditions of increased bleeding, thrombocytopenia.

During treatment with heparin, monitoring of blood coagulation parameters is necessary.

For dilution of heparin, only physiological saline is used.

With the development of severe thrombocytopenia (a decrease in the number of platelets by 2 times from the original number or below 100,000 / µl), it is necessary to urgently stop the use of heparin.

The risk of bleeding can be minimized with careful evaluation of contraindications, regular laboratory monitoring of blood clotting, and adequate dosing.

Ointment or gel is not applied to open wounds, on the mucous membranes, do not apply in ulcerative necrotic processes.

drug interaction

The anticoagulant effect of heparin is enhanced with the simultaneous use of anticoagulants, antiplatelet agents and non-steroidal anti-inflammatory drugs (NSAIDs).

Heparin is a drug that prevents blood clotting. It is available as a solution for injection, as well as in dosage forms for outdoor use. Once in the human body, it inhibits the formation of a substance such as fibrin.

The action of heparin begins immediately after it enters the body. It activates cerebral circulation and also reduces the action of some enzymes. Its appointment after myocardial infarction reduces the number of deaths. It is used for pulmonary embolism. The fastest effect of the drug occurs when it is used parenterally, in particular when administered intravenously.

For example, with an intramuscular injection, the effect occurs in about thirty minutes, and if the injection is made under the skin, then the effect of the drug will begin to appear somewhere in sixty minutes.

Compound

Solution for injections

The main substance of the solution is sodium heparin. Additional substances: water for injection, sodium chloride, benzyl alcohol.

The basis is sodium heparin. Complementary substances: carbomer, rectified ethyl alcohol from food raw materials, dimethyl sulfoxide, propylene glycol, propylparaben, methylparaben, lavender oil, diethanolamine, purified water.

Heparin sodium and anesthesin

When is heparin prescribed?

The drug heparin is indicated for the following diseases: deep vein and coronary artery thrombosis, thrombophlebitis, in order to prevent the serious consequences of these conditions. It is also used for angina pectoris, arrhythmia, coronary disease heart, with impaired blood circulation in the kidneys.

It also applies during surgical interventions to prevent blood from clotting too quickly. It is also prescribed for some heart defects, with lupus nephritis, with glomerulonephritis, as well as with bacterial endocarditis.

Contraindications to the appointment of heparin

Its use is prohibited for persons with poor blood coagulation factor, it cannot be used for aneurysms of vessels of various localization, with hypertension with gastric ulcer or duodenum in severe liver disease.
You can not use the drug to the fair sex during menstruation, as well as in the postpartum period, after surgical interventions. During gestation, the use of heparin should be carried out under the strict supervision of a physician.

And also the doctor should control the administration of this drug to patients suffering from endocrine diseases, and in particular, in diabetes mellitus, and it is also necessary to monitor the patient with tuberculosis, pericarditis, and in old age.

About side effects

During the use of heparin, quite a variety of side effects. For example, the human body may react to its introduction with the appearance of allergic reactions. Potential disruption to work digestive tract, coordination of movements may suffer, migraine-like pain often occurs.

Often, all of these unpleasant symptoms disappear immediately as soon as a person stops treatment with this drug. But with its long-term use, the development of more serious consequences is possible, for example, osteoporosis occurs, the body's absorption of such an important mineral matter like calcium.

At the injection site, there may be discomfort, for example, these can be symptoms such as pain, slight swelling of tissues and hyperemia of the skin. Sometimes there is bleeding from the excretory organs.

About the dosage of heparin

This drug is prescribed either as a solution in droppers or in the form of periodic injections under the skin or into a vein. As a preventive measure, five thousand units of heparin are used per day. Between injections, it is necessary to observe the time interval, which should be at least eight hours and not more than twelve.

It is worth knowing that it is not worth doing at the same injection site. For therapeutic purposes, different doses of the drug are used, which depend directly on the existing disease and the individual characteristics of the patient. You can not inject yourself with heparin, remember - this is a drug, and its appointment is the prerogative of the doctor, otherwise, you can greatly harm your health.

When it is used simultaneously with any other drugs, it is recommended to notify your doctor, since heparin is able to interact with many drugs, causing negative effects on the body.

As for vitamins and various biologically active additives, heparin can be used together with them without fear that any negative phenomena will occur on the part of the body. But, nevertheless, it is better to inform the doctor.

The use of heparin in the fight against cancer

To date, this anticoagulant drug is prescribed for cancer patients to prevent thrombosis. Recently, continuous research is underway to include it in chemotherapy. Conducted various tests that were aimed at identifying the relationship between taking this drug and slowing down tumor growth.

Its influence on the development of the tumor process has not yet been fully studied. But, nevertheless, this drug is quite often used in patients with oncopathology as a prevention of thrombosis, because cancer cells produce substances that contribute to the formation of blood clots.

Drug analogues

Viathromb, Lavenum, Lyoton 1000, Trombless, Thrombophobe

Conclusion

Anticoagulants, in particular heparin, should be prescribed by the attending physician, it is impossible to take it on your own.

Dosage form:  solution for intravenous and subcutaneous administration Composition: No information. Description: No information. Pharmacotherapeutic group:Direct acting anticoagulant ATX:  

B.01.A.B.01 Heparin

Pharmacodynamics: No information. Pharmacokinetics: No information. Indications: No information. Contraindications: No information. Carefully: No information. Pregnancy and lactation: No information. Dosage and administration:

Heparin is administered subcutaneously, intravenously, by bolus or drip.

Heparin is prescribed as a continuous intravenous infusion or as regular intravenous injections, as well as subcutaneously (in the abdomen).

Heparin should not be administered intramuscularly. The usual site for subcutaneous injections is the anterolateral abdominal wall (in exceptional cases, in the upper arm or thigh), using a thin needle that should be inserted deeply, perpendicularly, into a fold of skin held between the thumb and forefinger until the end of the injection solution. It is necessary to alternate injection sites each time (to avoid the formation of a hematoma).

The first injection must be carried out 1-2 hours before the start of the operation; in postoperative period to enter within 7-10 days, and in case of need - longer time.

Initial dose therapeutically administered sodium heparin is usually 5000 IU and administered intravenously, after which treatment is continued using subcutaneous injections or intravenous infusions.

maintenance doses determined depending on the method of application:

- with continuous intravenous infusion, 1000-2000 IU / h (24000-48000 IU / day) are prescribed, diluted in the following infusion solutions: in 0.9% sodium chloride solution, in 5% and 10% glucose solution, in 0.45 % sodium chloride solution and 2.5% glucose solution, in Ringer's solution;

- with regular intravenous injections, 5000-10000 are prescribedMEsodium heparin every 4-6 hours;

- when administered subcutaneously, administered every 12 hours, 15000-20000MEor every 8 hours for 8000-10000ME.

Before the introduction of each dose, it is necessary to conduct a study of the blood clotting time and / or aPTT in order to adjust the subsequent dose.

Doses of heparin sodium for intravenous administration are selected so that the APTT is 1.5-2.5 times greater than the control. The anticoagulant effect of heparin is considered optimal if the clotting time is 2-3 times longer than normal, APTT and thrombin time increase by 2 times (with the possibility of continuous monitoring of APTT).

With subcutaneous administration of small doses (5000ME2-3 times a day) for the prevention of thrombosis, regular monitoring of APTT is not required, since it increases slightly.

Continuous intravenous infusion is the most effective way the use of heparin sodium, better than regular (intermittent) injections, as it provides more stable hypocoagulation and less bleeding.

Adults with thrombosis of mild and moderate severity are administered intravenously at 40,000-50,000 IU / day for 3-4 injections; with severe thrombosis or embolism - intravenously 20000ME4 times a day with an interval of 6 hours.

According to vital indications, 25000 is administered intravenously onceME, then by 20000 MEevery 4 hours until a daily dose of 80,000-120,000 is reachedME.

With intravenous drip administration, at least 40,000ME.

When carrying out extracorporeal circulation, Heparin is administered at a dose of 140-400 IU / kg or 1500-2000MEper 500 ml of preserved blood (whole blood, erythrocyte mass).

For patients on dialysis, dose adjustment is carried out according to the results of a coagulogram.

In hemodialysis, 10,000 intravenous injections are first administeredMEper 500 ml of blood, then in the middle of the procedure - another 30,000-50,000ME. For elderly patients, especially women, doses should be reduced.

children the drug is administered intravenously drip: at the age of 1-3 months - 800 IU / kg / day, 4-12 months - 700 IU / kg / day, over 6 years - 500 IU / kg / day under the control of APTT.

The duration of therapy with Heparin depends on the indications and method of application. At intravenous use the optimal duration of treatment is 7-10 days, after which therapy is continued with oral anticoagulants (it is recommended to prescribe oral anticoagulants starting from day 1 of treatment with Heparin or from day 5 to 7, and stop using Heparin on day 4-5 of combined therapy). With extensive thrombosis of the iliac-femoral veins, it is advisable to conduct longer courses of treatment with Heparin.

Side effects: No information. Overdose: No information. Interaction: No information. Special instructions:

The platelet count should be monitored carried out before the start of treatment, on the first day of treatment and at short intervals during the entire period of use of heparin sodium, especially between 6 and 14 days after the start of treatment. You should immediately stop treatment with a sharp decrease in the number of platelets (see section "Side Effects").

A sharp decrease in the number of platelets requires further investigation to identify heparin-induced immune thrombocytopenia. If this occurs, the patient should be advised that he should not use heparin preparations in the future (even low molecular weight heparin). If there is a high probability of heparin-induced immune thrombocytopenia, the drug should be discontinued immediately.

With the development of heparin-induced immune thrombocytopenia in patients receiving heparin for thromboembolic disease or in the event of thromboembolic complications, other anticoagulants should be used.

Patients with heparin-induced immune thrombocytopenia (white thrombus syndrome) should not undergo hemodialysis with heparinization. If necessary, they should use alternative treatments for kidney failure.

To avoid overdose, you must constantly monitor clinical symptoms indicating possible bleeding (bleeding of mucous membranes, hematuria, etc.). Patients not responding to heparin or requiring high doses of heparin should be monitored antithrombin III.

In women over 60 years of age, heparin may increase bleeding.

When using the drug in patients with arterial hypertension, blood pressure should be regularly monitored.

A coagulogram should always be performed prior to initiation of sodium heparin therapy, except use of low doses.

Patients who are transferred to oral anticoagulant therapy, administration of sodium heparin should be continued until the results of blood clotting time and aPTT are in the therapeutic range.

Intramuscular injections contraindicated. Puncture biopsies, infiltration and epidural anesthesia and diagnostic lumbar punctures during the use of heparin.

If massive bleeding occurs, the drug should be discontinued and the coagulogram parameters should be examined. If the results of the analysis are within the normal range, then the likelihood of developing this bleeding due to the use of heparin sodium is minimal. Changes in the coagulogram tend to normalize after discontinuation of heparin.

Protamine sulfate is specific antidote for sodium heparin. One ml of protamine sulfate neutralizes 1000MEheparin. Doses of protamine sulfate should be adjusted depending on the results of the coagulogram, since an excessive amount of this drug itself can provoke bleeding.

Sodium heparin solution may acquire a yellow tint, which does not change its activity or tolerability.

Physical and chemical stability after dilution of heparin in the above solutions for infusion is maintained for 48 hours at room temperature (25+2°C). If the drug is not used immediately, it can be used no later than 24 hours after dilution, while it is allowed to store it during this period at a temperature of 2 to 8 ° C, only if aseptic conditions are observed during its dilution.

The drug "Heparin" is able to slow down the ability of blood to clot. Release medication in ampoules and glass bottles of 5 ml. They contain an injection solution in which the activity active substance is 5000 IU.

Pharmacological properties

The drug "Heparin" (injections) is an anticoagulant. It is able to slow down the process of fibrin formation, reduce the rate of factors and, in high concentrations, reduce thrombin activity. Even small doses of the drug are enough to increase the fibrinolytic activity of the blood.

To reduce the viscosity of the main biological fluid of the body, Heparin injections are used. Application (doses for injections are selected by the doctor individually) is based on the fact that this agent accumulates on the endothelium, blood elements and increases their negative charge. Due to this property, the adhesion of both leukocytes and erythrocytes decreases.

In addition, "Heparin" prevents the development of atherosclerosis, has an anti-allergic and weak vasodilating effect. This is due to the fact that it binds a number of elements and reduces its activity. Also, the drug prevents the formation of immunoglobulins, cooperation of lymphocytes, binds serotonin and histamine.

Indications for use

As a rule, if there are problems with blood clotting, injections of the drug "Heparin" are prescribed. Injections or intravenous infusions are recommended in such cases:

To prevent thrombosis, the drug can be administered subcutaneously in 1 ml (5000 IU) twice a day. The need for this is indicated by the instructions for use attached to the Heparin preparation. Injections, as a rule, are made in the abdomen, in its anterolateral wall. To do this, take a thin needle and insert it deep into the fold of the skin. It is formed by pressing the abdomen between the thumb and forefinger near the navel. Injection sites must be alternated. In exceptional cases, injections can be made in the upper thigh or shoulder.

Dosage selection

Intravenous infusions are often prescribed for therapeutic purposes in hospital inpatient settings. For adult patients, the dosage of the drug is 1000 IU / hour. But before installing a dropper, to achieve the maximum effect, it can be injected into a vein in an amount of 5000 IU. The selection of the exact dose is carried out by the doctor depending on the situation and the weight of the patient.

If intravenous infusion is not possible, then the drug can be administered subcutaneously: 2 ml of the drug (which corresponds to 10,000 IU) 4 times a day. In the maximum dosage, as a rule, the drug is used for up to 10 days.

The required amount of medication is selected after evaluating the results of the tests. Particular attention is paid to APTT (activated partial thromboplastin time).

When transfusing blood, the donor, as a rule, is injected with 7.5-10 thousand IU of Heparin.

Therapy in special cases

In acute myocardial infarction, 10-15 thousand IU are immediately administered intravenously, and then they continue to use it in such a way that the patient receives about 40,000 IU on the first day, but the exact dose is selected depending on the patient's weight. This is necessary in order for the blood to clot 2.5-3 times slower. Starting from the second day, the dosage is reduced. It is important that the clotting time is 1.5-2 times higher than the norm. Treatment with this drug is continued for up to 8 days. To cancel it, the daily dose is reduced by 5-10 thousand IU, but the intervals between injections are not increased. After withdrawal, switch to anticoagulants indirect action. It can be such means as "Fenilin", "Neodicumarin" and others.

Acute arterial or venous obstruction also requires a special approach. For treatment, intravenous administration of heparin is prescribed for 3-5 days at a dosage of 400-450 IU for each kg of the patient's weight. That is, a patient of average build and height should receive about 30-40 thousand IU of the drug "Heparin" per day. Then they switch to its fractional administration, but the dosage increases to 600 IU / kg, while 100 IU / kg should enter the body for one injection. Treatment can last up to 16 days. A few days before the drug is discontinued, its amount is gradually reduced. The treatment continues with the action.

special instructions

Despite the fact that some talk about the possibility of intramuscular injection of the drug, this is not recommended due to the fact that hematomas often form at the injection site. To dilute the drug, use a solution of 0.9% NaCl.

It is also important to know that during treatment with "Heparin" you should not do any intramuscular injections and perform organ biopsies. When using it, it is necessary to control the state of hemocoagulation. In the first week of therapy, blood is checked every two days, starting from the second week, this can be done every 3 days.

Although the agent does not pass into breast milk, it is advisable to stop lactation during therapy. It was found that the drug leads in some cases to damage to the spine and the development of osteoporosis. Problems begin after 2-4 weeks of taking the drug.

Separately, it should be noted that medicinal solution may turn yellow, but this does not affect it in any way pharmacological properties or on the tolerability of Heparin. Injections, the price of which can significantly affect the budget when administered in high dosages, can even be done on your own at home.

Contraindications

Like any other means, you can not use the drug "Heparin" with individual intolerance. It is not prescribed for any bleeding. The exception is hemorrhages that occur with a heart attack of the lung (expressed in the form of hemoptysis) or kidneys (accompanied by hematuria).

Contraindications also include:

Hemorrhagic diathesis and other diseases in which blood clotting is impaired;

Increased vascular permeability, for example, with Werlhof's disease;

Bacterial endocarditis;

Bleeding history;

Hypoplastic and aplastic anemias, chronic and acute leukemias;

Severe violations of the liver and kidneys;

venous gangrene;

Acute development of cardiac aneurysm.

Precautionary measures

In addition to direct contraindications, there is a list of situations in which it is necessary to assess all possible risks when taking the drug "Heparin". Injections and intravenous administration are done only in exceptional cases and under the supervision of specialists for tumor and ulcerative lesions of the gastrointestinal tract, high pressure, in the postpartum and postoperative period, with the exception of operations on the vessels.

A few words about the therapy of expectant mothers. Despite the fact that the treatment of women in an interesting position with the remedy we are considering is undesirable (this can lead to the development of complications), Heparin injections into the stomach are prescribed in some cases during pregnancy. The probability of occurrence of adverse effects ranges from 10 to 21%. Although for a normal pregnancy, the risk of complications does not exceed 3.6%.

It is worth noting that the consequences of a possible thromboembolism in expectant mothers are more life-threatening than taking Heparin. Injections during pregnancy are done only under medical supervision and only if there are absolute indications. But the medication can cause bleeding, osteoporosis and thrombocytopenia. The drug does not cross the placenta.

Possible analogues and patient reviews

Often, for those who have been prescribed the drug "Heparin" (injections in the stomach), the price seems too high. But when used for prophylactic purposes, 1 vial may last for several days. This means that a package containing 5 bottles can last for a couple of weeks. And in high doses, the drug is usually used for no more than 10-14 days.

Nevertheless, many people want to know from other patients whether it is worth buying this medicine, they are looking for reviews about the Heparin drug. They are also interested in analogues of this medication. So, if there are problems with blood clotting, then the remedy is very effective and allows you to achieve the desired therapeutic effect very quickly. This is confirmed by both doctors and their patients.

But instead of it, anticoagulants "Troparin", "Heparin Sandoz", "Heparin Sodium Brown", "Heparin-Ferein" and other analogues can also be prescribed. The dosage of these drugs should be selected only by a doctor, taking into account the results of the patient's tests, his state of health and the indications for which the medicine is prescribed.

In certain cases, doctors recommend, for example, Fraxiparin, Fragmin, Cibor, Enixum, Fraxiparin forte. The effect of their use, as evidenced by patient reviews, is almost the same as that of the drug we are considering.

Heparin gets its name from the Greek name for the liver, hepar, from where it was first obtained. medicinal product It is customary to use in the practice of treatment as a coagulant that reduces the process of thrombosis and blood clotting. So, let's talk today about heparin, instructions for its use, average prices for the drug, reviews about it and analogues.

Features of the drug

It is used for prophylactic purposes in case of diseases and consequences and, during surgical interventions in the vessels and heart, with hemodialysis and artificial blood flow, preventing blood clotting during laboratory tests.

Place of education in human body- liver, walls blood vessels and pulmonary alveoli. These structures contain groups of mast cells.

Compound

The substance is represented by amino acid residues of glycine and serine, capable of binding to polysaccharide chains. Heparin molecules have several negatively contaminated poles due to sulfate and carboxyl residues.

Such a chemical structure allows molecules to actively enter into binding complexes with cations. For this reason, the active ingredient medicinal product- heparin sodium. In addition to the active substance, auxiliary substances create an active medium for it: distilled water, sodium chloride and phenylcarbinol.

Dosage forms of Heparin

Heparin is available in the form of ampoules with a solution that is administered intravenously or subcutaneously. Cardboard packs may contain 10 or 50 ampoules. Recently, pharmaceuticals began to produce packages of heparin in 100 ampoules.

Large ampoules contain 5 ml of heparin solution, small - 1 ml each. Small ampoules are produced abroad on the basis of calcium salt heparin.

pharmachologic effect

The basis of the resulting thrombus is a high molecular weight protein in the blood, which is in a soluble state - fibrin. The main role of heparin is to inhibit the synthesis of fibrin.

With the help of the drug heparin, the resistance of the cerebral vessels increases, blood flow in the kidneys increases, the enzyme that breaks down lipoproteins is activated, the total lipid content in the blood decreases due to the destruction of certain species, and the deactivation of hyaluronidase, an enzyme of brain structures, increases. Heparin normalizes the secretion of the hormone aldosterone in the cortical layer of the adrenal glands, inhibits the activity of the pulmonary substance of the surfactant, enhances the exchange of calcium and phosphorus by activating the parathyroid hormone, inhibits the activity of catecholamines and forms the response of the egg to hormones.

Heparin refers to the means of preventing recurrence of heart attacks, coronary thromboembolism, and prevents the unexpectedness of a heart attack and death. After a radical method of treatment, in order to prevent and in the presence of blood clots in the veins, heparin is used in a small dosage.

The video below will tell you how blood coagulation with heparin occurs:

Pharmacodynamics

Exogenous heparin is identical to the substance produced naturally in the body. The mechanism of action is associated with the transformation into active form thrombin clotting factor inhibitor - antithrombin.

Under the influence of heparin, the synthesis of the antilipid enzyme, lipoprotein lipase, is enhanced.

Pharmacokinetics

The therapeutic effect of the drug begins the faster the chosen method of its entry into the human body. After intravenous injection, the effect of the drug begins 5 minutes after the end of the injection. 15 to 20 minutes required to start active action drug after injection into a muscle.

Heparin is most slowly captured by the bloodstream when administered subcutaneously - up to 1 hour. The inhibitory effect of thrombus formation continues for 5 hours after the administration of heparin.

With the desired more long-term exposure appoint intramuscular injection heparin sodium (calcium). Subcutaneous injections allow you to keep the inhibitory effect of thrombosis in the blood for 8 hours.

Indications for use

For the purpose of prevention or therapeutic treatment, heparin is introduced into the body when:

• acute;
• thrombosis of pulmonary, deep and renal veins, coronary arteries;
• coronary heart disease by type and;
• glomerulonephritis and nephritis caused by lupus;
• (mandatory - with);
• DVS and hemolytic urimic syndromes.

Contraindications

The drug is not prescribed for:

• diseases with inhibition of blood clotting,
• all types of bleeding
• serious hepatic and renal pathologies,
• hereditary or acquired hematological syndrome with the threat of blood seepage out or in.

Side effects

The action of heparin can have an undesirable effect on the somatic systems:

• skin allergic reactions: urticaria, redness and itching of the skin;
• from the side gastrointestinal tract some patients have nausea, vomiting, appetite suppression, loose stools;
• prolonged exposure to the drug is the cause of sudden fractures and osteoporosis;
• Heparin overdose increases the risk of hemorrhage during internal organs, internal bleeding, prolonged non-coagulation during operations and injection sites of the drug.

special instructions

Small doses of heparin are administered both in clinical and outpatient settings. A large dose can only be administered in a clinical setting. After the injection of the drug, the patient is subject to observation and regular blood sampling for analysis of platelet concentration.

It is recommended to avoid intramuscular injections. In the presence of arterial hypertension after the introduction of heparin, periodic measurement is necessary systolic pressure. Before the introduction of the drug, it must be dissolved only in isotonic sodium chloride solution.