Improvement of blood properties - Heparin. Heparin sodium (Heparin sodium)

Formula, chemical name: mucopolysaccharide of polysulfuric acid ester.
Pharmacological group: hematotropic agents / anticoagulants
Pharmachologic effect: anticoagulant.

Pharmacological properties

Heparin, binding with antithrombin III, causes conformational changes in its molecule and accelerates its complexation with serine proteases of the coagulation system; this leads to blocking of thrombin, enzymatic activity of activated factors IX, X, XI, XII, kallikrein and plasmin. Heparin binds thrombin; this process has an electrostatic origin and depends, to a greater extent, on the length of the heparin molecule; only a small part of the heparin molecule has similarities with antithrombin III, which mainly provides the anticoagulant activity of heparin. Inhibition of thrombin by antithrombin is a slow process; the formation of the heparin-antithrombin III complex is greatly accelerated due to the direct binding of heparin by gamma-aminolysyl components of antithrombin III and due to the interaction through serine between thrombin and through arginine by the heparin-antithrombin III complex; upon completion of the thrombin inhibition reaction, heparin leaves the heparin-antithrombin III complex and can be used again by the body, and the complexes that remain are removed by the endothelial system.
Heparin reduces blood viscosity, reduces vascular permeability, which is stimulated by histamine, bradykinin and others endogenous factors, and thus prevents the development of stasis. For endogenous analogues of heparin, special receptors have been identified on the surface of endothelial cells. Heparin is capable of surface shaped elements blood and endothelial membranes to be sorbed, increasing their negative charge, this prevents the aggregation and adhesion of platelets, leukocytes, erythrocytes.
Heparin molecules, which have low affinity for antithrombin III, inhibit hyperplasia smooth muscle, including by slowing down the adhesion of platelets with inhibition of the liberation of the growth factor of these cells, inhibit the activation of lipoprotein lipase, thereby preventing the development of atherosclerosis.
Heparin also binds part of the components of the complement system, reducing its activity, prevents the formation of immunoglobulins and the association of lymphocytes, binds serotonin, histamine - due to all this, an antiallergic effect is possible.
Heparin reacts with surfactant, reducing its activity in the lungs.
Heparin affects endocrine system- binds adrenaline, suppresses excessive production of aldosterone in the adrenal cortex, enhances the activity of parathyroid hormone, modulates the ovarian response to hormonal stimuli.
Heparin, as a result of reaction with enzymes, can increase the activity of pepsinogen, brain tyrosine hydroxylase, DNA polymerase and reduce the activity of pyruvate kinase, myosin ATPase, pepsin, RNA polymerase.
Heparin in patients with ischemic disease hearts (together with acetylsalicylic acid) reduces the risk of developing sudden death, myocardial infarction and acute thrombosis coronary arteries. Heparin reduces mortality among patients who have had myocardial infarction and the frequency of recurrent heart attacks.
In high doses, heparin is effective in venous thrombosis and pulmonary embolism, in small doses for the prevention of venous thromboembolism, including after surgical operations.
Heparin, when administered intravenously, slows down blood clotting almost immediately, when administered intramuscularly - after 15-30 minutes, when administered subcutaneously - after 40-60 minutes, after inhalation, the maximum effect is after a day; respectively, the duration of the anticoagulant effect is 4–5 hours, 6 hours, 8 hours, 1–2 weeks, prevention of thrombosis ( therapeutic effect) - lasts much longer. The antithrombotic effect of heparin may limit the deficiency of antithrombin III at the site of thrombosis or plasma. The highest bioavailability of heparin is observed after intravenous administration; when administered subcutaneously, bioavailability is low. The maximum plasma concentration is reached after 2 to 4 hours. The half-life of heparin from blood serum is 1-2 hours. In plasma, heparin is found mainly in a protein-bound state. Heparin is intensively captured by cells of the mononuclear-macrophage system and endothelial cells, accumulates in the spleen and liver. When inhaled, heparin is absorbed by the endothelium of capillaries, large lymphatic and blood vessels, alveolar macrophages: these cells are the main site of accumulation of heparin, from which it is gradually released, maintaining a certain concentration in serum. Heparin undergoes desulfurization under the action of heparinase and platelet N-desulfamidase, which at later stages are included in the metabolism of heparin. Desulfated heparin molecules under the influence of renal endoglycosidase are converted into low molecular weight fragments. The excretion of heparin occurs in the form of metabolites through the kidneys; unchanged excretion is possible only with the introduction of high doses of heparin. Heparin is not released from breast milk does not cross the placental barrier. When applied externally a small amount of heparin is absorbed into the systemic circulation from the surface of the skin. The maximum concentration in the blood after application is noted after 8 hours.

Indications

Parenterally: acute infarction myocardium, unstable angina; thromboembolic complications during surgery blood vessels and heart, myocardial infarction, thrombosis cerebral vessels and coronary arteries, thromboembolism pulmonary artery(including in the pathology of peripheral veins), thrombophlebitis (therapy and prevention); syndrome of disseminated intravascular coagulation, treatment and prevention of microcirculation disorders and microthrombosis; thrombosis of the renal veins; deep vein thrombosis; hemolytic-uremic syndrome; mitral heart disease (prevention of thrombus formation), atrial fibrillation(including accompanied by embolization); bacterial endocarditis; lupus nephritis; glomerulonephritis; prevention of blood coagulation during forced diuresis, extracorporeal methods (hemodialysis, hemosorption, extracorporeal circulation during heart surgery, cytapheresis, peritoneal dialysis); flushing of venous catheters.
Externally: thrombophlebitis of superficial veins, migratory phlebitis (including those with varicose ulcers and chronic varicose disease), aseptic infiltration and local edema, subcutaneous hematoma(including during phlebectomy), complications during surgical operations on the veins, injuries, bruises of tendons, joints, muscle tissue.

Dosing and Administration of Heparin Sodium

Heparin is administered intravenously, subcutaneously, and is used externally. The dosage regimen is individual and depends on the indications used dosage form, clinical situation and age of the patient.
Cancellation of heparin should be carried out gradually. When using heparin, it is necessary to constantly monitor the clotting time. For dilution of heparin, use only saline. In severe thrombocytopenia (a decrease in the number of platelets by 2 times from the initial number or less than 100,000 / µl), the use of heparin should be urgently discontinued. When used externally, do not apply to mucous membranes, open wounds. Gel together with tetracyclines, non-steroidal anti-inflammatory drugs, antihistamines are not assigned.

Contraindications for use

Hypersensitivity; for parenteral use: hemophilia, hemorrhagic diathesis, vasculitis, bleeding, thrombocytopenia (including those caused by a history of heparin), leukemia, polyps, increased vascular permeability, ulcerative lesions and malignant neoplasms gastrointestinal tract, severe uncontrollable arterial hypertension, varicose veins esophageal veins, acute bacterial endocarditis, recent surgery on the eyes, spine, brain, trauma (especially craniocerebral), severe violations functional state kidneys and/or liver;
for outdoor use: traumatic injury skin, purulent, ulcerative-necrotic processes on the skin.

Application restrictions

Thrombocytopenia, increased tendency to bleeding, polyvalent allergy (including bronchial asthma), arterial hypertension, dental procedures, diabetes, endocarditis, pericarditis, the presence intrauterine contraceptive, active tuberculosis, radiation therapy, liver failure, chronic kidney failure, over 60 years of age.

Use during pregnancy and lactation

The use of heparin sodium during pregnancy and breastfeeding possible only under strict conditions.

Side effects of heparin sodium

System effects: nervous system: headache, dizziness;
circulatory and blood system: thrombocytopenia - early (2-4 days of therapy) and late (autoimmune), in rare cases fatal, hemorrhagic complications - bleeding from urinary tract or gastrointestinal tract, retroperitoneal hemorrhages in the adrenal glands (with the development of acute adrenal insufficiency), ovaries;
digestive system: nausea, loss of appetite, vomiting, increased levels of transaminases in the blood, diarrhea;
allergic reactions: drug fever, skin hyperemia, urticaria, pruritus, rash, bronchospasm, anaphylactic shock, anaphylactoid reactions; others: with prolonged use - alopecia, soft tissue calcification, osteoporosis, inhibition of aldosterone production;
injection reactions- hematoma, irritation, pain upon injection.
For outdoor use: allergic reactions, skin hyperemia.

Interaction of sodium heparin with other substances

The effectiveness of sodium heparin is enhanced by dextran, acetylsalicylic acid, phenylbutazone, indomethacin, ibuprofen, dipyridamole, warfarin, hydroxychloroquine, dicumarol - the risk of bleeding increases (with simultaneous use, care must be taken), weakened by tetracyclines, antihistamines, cardiac glycosides, nicotine, changes - nicotinic acid. The simultaneous use of heparin sodium (including in the form of a gel) with indirect anticoagulants may increase the prothrombin time. Clopidogrel increases the risk of bleeding with simultaneous use. The risk of bleeding increases with the simultaneous use of heparin with ketorolac and diclofenac with parenteral administration(avoid this combination including low-dose heparin).

Overdose

Heparin overdose causes bleeding varying degrees gravity. At slight bleeding it is necessary to reduce the dose or stop the use of heparin, if heavy bleeding 1% solution of protamine sulfate is slowly injected intravenously.

Trade names of drugs with the active substance heparin sodium

Combined drugs:
Heparin sodium + Benzocaine: Nigepan®;
Heparin sodium + Benzocaine + Benzyl nicotinate: Heparin ointment;
Allantoin + Heparin sodium + Dexpanthenol: Gepalpan, Gepatrombin;
Heparin sodium + Dexpanthenol + Troxerutin: Venolife®, Troxevasin® Neo;
Escin + Essential phospholipids + Heparin sodium: Venabos®, Essaven®;
Heparin sodium + Escin: Venitan® forte, Ellon gel;
Allantoin + Heparin sodium + Onion bulb extract: Contractubex;
Heparin sodium + Lidocaine + Prednisolone: ​​Hepasolone;
Heparin sodium + Dexpanthenol + Dimethyl sulfoxide: Hepatrombin C, Dolobene;
Mometasone + [Heparin Sodium]: Skinlight®;
Heparin sodium + Prednisolone + Lauromacrogol 600: Hepatrombin G.

B.01.A.B.01 Heparin

When ingested, it is destroyed in the digestive tract, so heparin is used only parenterally. Does not bind to plasma proteins. Refers to anticoagulants of direct action; when administered parenterally, it inhibits blood clotting due to the inactivation of thrombin, V, VII, IX factors and the Hageman factor. Activates the process of fibrinolysis. Inhibits the activity of certain enzymes: hyaluronidase, phosphatase, trypsin. Reduces the inhibitory effect of prostacyclin on platelet aggregation due to the action of adenosine diphosphate. By activating lipoprotein lipase, it slightly reduces the level of cholesterol and lipoproteins in the blood.

The half-life is 1.321.72 hours. The anticoagulant effect of heparin appears immediately after administration and lasts for 23 hours. Does not penetrate into breast milk.

Indications

Systemic use treatment of thrombophlebitis, phlebitis and thromboembolism; early therapy for myocardial infarction; prevention of vein thrombosis and thromboembolism of the branches of the pulmonary artery in the postoperative period and with prolonged immobilization; catheterization of the cavities of the heart; DIC syndrome (first phase); heparinization of blood during renal dialysis and other interventions using extracorporeal circulation, preparation of non-clotting blood samples for laboratory studies;

topical application varicose veins, phlebothrombosis, thrombophlebitis (mainly superficial), superficial periphlebitis, phlebitis after intravenous injections, thrombosis of hemorrhoidal veins, varicose ulcers of the extremities, postoperative varicose phlebitis, complications after removal of the saphenous veins of the lower extremities, bruises, infiltrates, local limited swelling, subcutaneous hematomas, injuries of muscles, tendons and joints.

Application

The dose is set taking into account the indicators of the coagulogram, the nature of the disease, the age, body weight and sensitivity of the patient. For the prevention of thromboembolism during surgical treatment, 50007500 IU of heparin is administered s / c 2 hours before surgery. After the operation, heparin in the same dose is administered every 6-8 hours until the patient is transferred to the active mode. For the prevention of thromboembolic complications in patients with prolonged immobilization, diseases with an increased risk of developing thrombosis, 50007500 IU is administered every 812 hours. 500 IU 2 times a day. In case of venous and arterial thrombosis and thromboembolism, it is administered intravenously. Adults are initially prescribed intravenously 500010,000 IU, then through a perfusor 25,00040,000 IU per day; children are first injected with 50 IU / kg intravenously, then through a perfusor 20 IU / kg at 1 hour. If prolonged intravenous administration is not possible, intermittent intravenous administration or s / c administration can be used. With DIC (first phase), the drug is administered in a daily dose of 25004000 IU, depending on the parameters of laboratory blood tests.

The gel or ointment is applied in a thin layer, gently rubbing into the affected areas of the skin 2-3 times a day. With thrombosis of hemorrhoidal veins, it is used either under a bandage (in the case of extraanal nodes), or injected into the rectum on a swab. Depending on the nature of the disease, the course of treatment is 13 weeks. Do not apply to open wounds, mucous membranes, the area of ​​the purulent process.

Contraindications

Hypersensitivity to heparin, diseases accompanied by a decrease in blood clotting (hemorrhagic diathesis, deficiency of blood clotting factors, thrombocytopenia), peptic ulcer of the stomach, duodenum or gastrojejunal anastomosis, ulcerative colitis, malignant neoplasms, uncorrectable hypertension, hemorrhagic stroke, recent surgery ( especially neurosurgical or ophthalmic), the presence of a stationary probe in the stomach or intestines, CNS trauma, retinopathy, vitreous hemorrhage, bacterial endocarditis, lumbar puncture, spinal anesthesia, epidural anesthesia, the threat of miscarriage, the presence of extensive wound surfaces and skin lesions, destructive pulmonary tuberculosis .

Side effects

Allergic reactions (erythema, urticaria, itching of the skin and mucous membranes, lacrimation, fever, bronchospasm), hemorrhages under the skin and mucous membranes, bleeding from wounds, urinary tract, genital organs, gastrointestinal bleeding, thrombocytopenia, increased serum transaminase activity blood, extremely rarely - transient alopecia, hypoaldosteronism.

special instructions

It is prescribed with caution if a malignant neoplasm is suspected, in patients with a tendency to bleeding, in the elderly, with urolithiasis, and chronic alcoholism.

When using heparin, control of the number of platelets in the peripheral blood should be carried out before administration, the next day after administration, every 3-4 days during the first 3 weeks of treatment, at the end of treatment. With the development of severe thrombocytopenia with a decrease in the number of platelets by 50% of the initial level, heparin is canceled. The number of platelets usually begins to decrease on the 6-14th day of therapy, however, in patients with hypersensitivity, this may occur several hours after the start of treatment.

When using heparin, it is possible to change some indicators of laboratory blood tests: ESR, complement fixation tests, prothrombin time, T3 and T4 levels.

Careful medical supervision is required when using heparin in pregnant women. Women who were treated with heparin during pregnancy are absolutely contraindicated for epidural anesthesia during the birth period.

Interactions

With simultaneous use with acetysalicylic acid, coumarin derivatives, fibrinolytics, dipyridamole, dextran, penicillins in a high dose, the risk of bleeding increases. Co-administration with NSAIDs potentiates the action of heparin. Parenteral administration of nitroglycerin weakens the effect of heparin. Solution of heparin sodium should not be mixed in the same syringe or dropper with solutions of any other medicines.

Overdose

With the development of life-threatening bleeding, protamine sulfate is used as an antidote for heparin (1 mg of protamine sulfate neutralizes the effect of 100 IU of heparin). Within 90 minutes after the on / in the use of heparin, 50% of the calculated dose of protamine should be administered; 25% of the dose in the next 3 hours.

When ingested, it is destroyed in the digestive tract, so heparin is used only parenterally. Does not bind to plasma proteins. Refers to anticoagulants of direct action; when administered parenterally, it inhibits blood clotting due to the inactivation of thrombin, V, VII, IX factors and the Hageman factor. Activates the process of fibrinolysis. Inhibits the activity of certain enzymes: hyaluronidase, phosphatase, trypsin. Reduces the inhibitory effect of prostacyclin on platelet aggregation due to the action of adenosine diphosphate. By activating lipoprotein lipase, it slightly reduces the level of cholesterol and lipoproteins in the blood.
The half-life is 1.32-1.72 hours. The anticoagulant effect of heparin appears immediately after administration and lasts for 2-3 hours. It does not penetrate into breast milk.

Indications for use of the drug Heparin sodium

Systemic use - treatment of thrombophlebitis, phlebitis and thromboembolism; early therapy for myocardial infarction; prevention of vein thrombosis and thromboembolism of the branches of the pulmonary artery in the postoperative period and with prolonged immobilization; catheterization of the cavities of the heart; DIC syndrome (first phase); heparinization of blood during renal dialysis and other interventions using extracorporeal circulation, preparation of non-clotting blood samples for laboratory studies;
topical application - varicose veins, phlebothrombosis, thrombophlebitis (mainly superficial), superficial periphlebitis, phlebitis after intravenous injections, thrombosis of hemorrhoidal veins, varicose ulcers of the extremities, postoperative varicose phlebitis, complications after removal of the saphenous veins of the lower extremities, bruises, infiltrates, local limited swelling, subcutaneous hematomas, injuries of muscles, tendons and joints.

The use of the drug Heparin sodium

The dose is set taking into account the indicators of the coagulogram, the nature of the disease, the age, body weight and sensitivity of the patient. For the prevention of thromboembolism during surgical treatment, 5000-7500 IU of heparin is administered s / c 2 hours before surgery. After surgery, heparin at the same dose is administered every 6-8 hours until the patient is transferred to the active mode. For the prevention of thromboembolic complications in patients with prolonged immobilization, diseases with an increased risk of thrombosis, 5000-7500 IU is administered every 8-12 hours. 500 IU 2 times a day. In case of venous and arterial thrombosis and thromboembolism, it is administered intravenously. Adults are first prescribed intravenously 5000-10,000 IU, then through a perfusor 25,000-40,000 IU per day; children are first injected with 50 IU / kg intravenously, then through a perfusor 20 IU / kg at 1 hour. If prolonged intravenous administration is not possible, intermittent intravenous administration or s / c administration can be used. With DIC (first phase), the drug is administered in a daily dose of 2500-4000 IU, depending on the parameters of laboratory blood tests.
The gel or ointment is applied in a thin layer, gently rubbing into the affected areas of the skin 2-3 times a day. With thrombosis of hemorrhoidal veins, it is used either under a bandage (in the case of extraanal nodes), or injected into the rectum on a swab. Depending on the nature of the disease, the course of treatment is 1-3 weeks. Do not apply to open wounds, mucous membranes, the area of ​​the purulent process.

Contraindications to the use of the drug Heparin sodium

Hypersensitivity to heparin, diseases accompanied by a decrease in blood clotting (hemorrhagic diathesis, deficiency of blood clotting factors, thrombocytopenia), peptic ulcer of the stomach, duodenum or gastrojejunal anastomosis, ulcerative colitis, malignant neoplasms, uncorrectable hypertension (arterial hypertension), recent surgery (especially neurosurgical or ophthalmic), the presence of a stationary probe in the stomach or intestines, CNS trauma, retinopathy, vitreous hemorrhage, bacterial endocarditis, lumbar puncture, spinal anesthesia, epidural anesthesia, the threat of miscarriage, the presence of extensive wound surfaces and skin lesions, destructive tuberculosis lungs.

Side effects of the drug Heparin sodium

Allergic reactions (erythema, urticaria, itching of the skin and mucous membranes, lacrimation, fever, bronchospasm), hemorrhages under the skin and mucous membranes, bleeding from wounds, urinary tract, genital organs, gastrointestinal bleeding, thrombocytopenia, increased serum transaminase activity blood, extremely rarely - transient alopecia, hypoaldosteronism.

Special instructions for the use of the drug Heparin sodium

It is prescribed with caution if a malignant neoplasm is suspected, in patients with a tendency to bleeding, in the elderly, in urolithiasis, and in chronic alcoholism.
When using heparin, control of the number of platelets in the peripheral blood should be carried out before administration, the next day after administration, every 3-4 days during the first 3 weeks of treatment, at the end of treatment. With the development of severe thrombocytopenia with a decrease in the number of platelets by 50% of the initial level, heparin is canceled. The platelet count usually begins to decrease on the 6-14th day of therapy, however, in patients with hypersensitivity, this may occur several hours after the start of treatment.
When using heparin, it is possible to change some indicators of laboratory blood tests: ESR, complement fixation tests, prothrombin time, T3 and T4 levels.
Careful medical supervision is required when using heparin in pregnant women. Women who were treated with heparin during pregnancy are absolutely contraindicated for epidural anesthesia during the birth period.

Drug interactions Heparin sodium

With simultaneous use with acetysalicylic acid, coumarin derivatives, fibrinolytics, dipyridamole, dextran, penicillins in a high dose, the risk of bleeding increases. Co-administration with NSAIDs potentiates the action of heparin. Parenteral administration of nitroglycerin weakens the effect of heparin. Solution of heparin sodium should not be mixed in the same syringe or dropper with solutions of any other medicines.

Overdose of the drug Heparin sodium, symptoms and treatment

With the development of life-threatening bleeding, protamine sulfate is used as an antidote for heparin (1 mg of protamine sulfate neutralizes the effect of 100 IU of heparin). Within 90 minutes after the on / in the use of heparin, 50% of the calculated dose of protamine should be administered; 25% of the dose - in the next 3 hours.

List of pharmacies where you can buy Heparin sodium:

• St. Petersburg

Heparin sodium (in Latin - Heparin sodium) is a substance that is characterized by anticoagulant properties. This means that thanks to it, the intensity of blood clots is reduced, because. blood viscosity decreases. It is used as the main active ingredient in various types of drugs.

There is a drug of the same name.

Its distinguishing features:

• one-component composition;
• a large number of release forms (solid, liquid structure);
• high efficiency.

The product has many trade names: Heparin-sodium Brown, Heparin-Richter, Heparin sodium salt, etc.

Composition and action

The main active ingredient is heparin. Its concentration varies depending on the form of release: 1000 IU (gel) to 5000 IU (solution).

Auxiliary components of the drug, characterized by a liquid structure:

• sodium chloride;
• benzyl alcohol;
• water d / i.

Other components in the composition of the gel-like substance:

• ethanol;
• carbomer;
• dimethyl sulfoxide;
• propylene glycol;
• diethanolamine;
• methyl and propylparaben;
• lavender oil and purified water.

The mechanism of action of drugs that affect erythropoiesis and blood coagulation

Release form

On sale you can find the drug in the form of a solution intended for injection. Other forms: gel, ointment.

The solution is available in a package containing 50 ampoules (5 ml each) and in 5 ml vials. This tool is intended for subcutaneous administration; can be used intravenously and intramuscularly.

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The ointment is offered in tubes of 25 g. The gel-like substance can be purchased in tubes of 30 and 50 g.

There are also vacuum tubes with heparin designed for blood sampling.

Mechanism of action of heparin sodium

The agent is characterized by anticoagulant action. Its distinguishing feature is the direct effect on the composition of the blood. This means that the substance reduces the intensity of blood clots. The principle of operation is based on the ability to influence the process of blood clotting. Means of direct action reduce the intensity of thrombin formation, which distinguishes them favorably from analogues of indirect action, tk. the latter are not as fast.

Other pharmacological properties:

• increased intensity of blood flow in the kidneys;
• increase in the resistance of cerebral vessels;
• hypolipidemic action;
• inhibition of aldosterone synthesis in the adrenal cortex;
• increased activity of parathyroid hormone;
• formation of ovarian response to hormonal stimuli;
• heparin increases the activity of brain tyrosine hydroxylase, pepsinogen, DNA polymerase;
• there is a decrease in myosin ATPase, pyruvate kinase, RNA polymerase, pepsin.

Blood clotting with heparin | Starsil Hemostat | Auroramed

Anticoagulants: drugs, mechanism of action and main indications

Pharmacodynamics

The anticoagulant effect is due to the binding of heparin to antithrombin III. As a result, a number of changes occur in the structure of its molecule, which leads to an acceleration of antithrombin III complexing. As a result of these changes, thrombin is blocked. In addition, under the influence of heparin, there is a decrease in the permeability of the walls of blood vessels, due to which microcirculation is restored, because. the likelihood of development of stagnant effects decreases.

Another function of the active substance is to reduce adhesion, and at the same time the aggregation of platelets, leukocytes, erythrocytes. With heparin therapy, the likelihood of atherosclerosis is reduced, because. there is a general improvement in the condition of the vessels. In addition, an antihistamine effect is provided, which is due to the binding of histamine, inhibition of the formation of immunoglobulin.

The agent under consideration affects the respiratory function: it reduces the activity of the surfactant in the lungs. It also prevents the development of thrombosis, myocardial infarction. The tool reduces the likelihood of complications and sudden death in patients who have recently had a heart attack. The drug in question is effective in the treatment of diseases and vascular pathologies: thromboembolism, embolism, thrombosis.

Pharmacokinetics

The substance is characterized by a high rate of action. With intravenous administration, the antithrombotic effect is visible instantly. If the solution is administered intramuscularly, the desired result is achieved in less than half an hour. With the subcutaneous method of delivery after the administration of the drug, a positive effect can be seen no earlier than 40-60 minutes later. The duration of the period during which the anticoagulant effect is exerted depends on the intensity of its distribution.

If the composition of the blood is changed (antithrombin III deficiency is noted), the effectiveness of the agent in question may decrease. The solution is distinguished by high bioavailability when administered intravenously, and when administered subcutaneously, on the contrary, it is low. The peak activity of the drug is reached after 2-4 hours. The half-life does not exceed 120 minutes.

Indications for use

• pulmonary embolism;
• thrombosis of blood vessels;
• heart surgery, which is accompanied by a high likelihood of complications;
• thrombophlebitis;
• myocardial infarction (in the acute phase);
• angina;
• arrhythmia;
• glomerulonephritis;
• lupus;
• prevention of venous thromboembolism.

Heparin sodium for hemorrhoids

Given that the agent in question is effective in various pathologies of the veins, including venous insufficiency, thrombosis, etc., it is recommended to use it when nodes and bumps appear on the sphincter and rectal mucosa. The drug has a moderate analgesic effect, helps to reduce swelling. By reducing blood viscosity and inhibiting the process of thrombosis, the likelihood of congestive effects is eliminated, which is often the cause of the formation of nodes and bumps in the perianal region.

With more often use and. However, these drugs are effective in nodes of 2-3 degrees. In more severe cases (), heparin can only be used as an auxiliary measure. Often with intense symptoms, this drug does not provide the desired result.

Chronic

In this case, the signs of the disease are less pronounced. For this reason, the dosage may be reduced.

With an exacerbation

The frequency of use of the product, as well as the amount of active substance, increases.

The use of heparin sodium

The highest dosages for myocardial infarction: the initial amount of the drug varies from 15,000 to 20,000 IU. After that, treatment continues for another 5-6 days; the daily dosage is up to 40 IU (it should be divided into several doses with a break of at least 4 hours).

If pulmonary thrombosis is diagnosed, 40,000-60,000 IU are prescribed (administration method - drip). This amount should be delivered to the circulatory system within 4-6 hours. After that, a daily dose of at least 40,000 IU is prescribed.

In order to prevent thromboembolism, 5000 IU is used subcutaneously 1-2 times a day. Heparin therapy requires monitoring of blood clotting. This is done 1 time every 2 days; after elimination of acute symptoms - 1 time every 3 days.

Topical preparations are used externally. The gel and ointment are applied to the skin in a thin layer. The frequency of use is determined on an individual basis.

Contraindications

The drug is not prescribed in some cases:

• negative individual reaction to the components;
• diathesis with the patient's tendency to hemorrhage;
• susceptibility to bleeding;
• thrombocytopenia;
• high degree of vascular permeability;
• ulcerative formations in the gastrointestinal tract (intestines, stomach);
• polyps;
• malignant neoplasms;
• varicose veins of the esophagus;
• hypertension that is difficult to control;
• recent operations on the organs of vision, heart, spine;
• injuries, especially craniocerebral;
• dysfunction of the liver and kidneys.

Side effects

During therapy with the agent in question, the likelihood of the following negative effects is high;

• dizziness and headaches;
• bleeding in the digestive tract, from the urinary tract, hemorrhage in the ovaries;
• loss of appetite;
• change in the structure of the stool (diarrhea);
• nausea, against which vomiting may occur;
• anaphylactic reactions; as a manifestation of allergies, there is also a rash, redness.

With prolonged use of the drug, pain occurs at the injection site, hematoma. Sometimes alopecia, soft tissue calcification develops.

Overdose

If the drug is used in excess, the risk of bleeding increases. Therapeutic measures are selected taking into account its intensity. For example, with mild bleeding, you only need to interrupt the course of therapy. As a result, the symptoms will disappear. With more significant blood loss, the introduction of protamine sulfate is required. Its task is to neutralize the action of heparin. The dose of this compound is determined taking into account the rate of heparin excretion. The later this substance is applied (since the introduction of heparin), the less its amount should be.

special instructions

Caution should be exercised in patients who are diagnosed with an allergy to several types of allergens at the same time. It is also necessary to undergo heparin treatment under the supervision of a physician in patients with diabetes mellitus, hypertension, tuberculosis in the active phase, hepatic and renal dysfunction and when using extrauterine contraceptives.

Do not administer other drugs intramuscularly if heparin is used concomitantly.

An agent characterized by a liquid structure must be diluted with saline.

If severe thrombocytopenia develops while taking heparin, the course of treatment is stopped.

During pregnancy and lactation

It is permissible to use the agent in question, however, a course of therapy should be taken under the supervision of a specialist. Heparin is prescribed for vital indications.

Application in childhood

The drug is used to treat children from 3 years, but care should be taken when doing so. It should be borne in mind that there is no data on how heparin acts on the children's body. The appointment is made only on strict indications.

Medicines containing

The substance in question is used in the manufacture of such drugs:

• Heparin-Richter;
• Heparibene sodium;
• Nigepan (details);
• Heparin gel 1000 IU;
• Thrombophobic;
• Hepatrombin;
• Heparin ointment.

These drugs have a different structure: candles, gel, ointment.

drug interaction

Under the influence of acetylsalicylic acid, the level of effectiveness of the agent in question increases significantly. A similar result is provided by the drugs Dextran, Ibuprofen, Dipyridamole, Indomethacin. As a result, the likelihood of bleeding increases.

The action of heparin is weakened under the influence of antihistamines, tetracyclines, nicotine, cardiac glycosides.

If you use the agent in question together with anticoagulants of a different principle of action (indirect), the half-life of metabolites will increase.

Heparin is often used simultaneously with allantoin, benzocaine, dexpanthenol.

Analogues

As analogues, the above-mentioned agents containing heparin are used. In this case, sometimes it is necessary to recalculate the dosage if the concentration of the active substance is higher or lower. However, it is permissible to use tools that differ in composition, but have a similar principle of action:

• Troxerutin;
• Dexpanthenol.

Terms and conditions of storage

It is forbidden to use the drug after 2 years from the date of production. Recommended storage conditions: temperature within +25°С.

Terms of dispensing from pharmacies

The solution can be purchased with a prescription. Gel - without a prescription.

Price

The cost varies significantly. Pricing is affected by the form of release. You can buy the tool at a price of 60-520 rubles.