"Heparin": instructions for use, analogues and reviews

"Heparin" is an anticoagulant that has a direct effect. Included in the group of medium molecular heparins.

According to the instructions for use, "Heparin" is produced by the manufacturer in three pharmacological forms:

1. Ointment for external use.
2. Gel for external use.
3. Solution for administration subcutaneously or intravenously.

The solution intended for injection contains sodium heparin, the concentration of which is 5 thousand units per 1 ml. The preparation also uses auxiliary components: water for injection, sodium chloride, benzyl alcohol.

One gram of gel contains 1 thousand units of heparin sodium. As auxiliary ingredients are used: purified water, lavender oil, methyl paraben, propyl paraben, diethanolamine, propylene glycol, dimethyl sulfoxide, carbomer, ethanol 96%.

Pharmacological effects

Instructions for use with Heparin indicate that the drug belongs to the pharmacological group of anticoagulants.

“Heparin” in the form of a gel refers to funds aimed at treating CVS pathologies. “Heparin” in the form of a solution refers to drugs that affect the blood and blood formation process.

Sodium heparin, which is part of Heparin, is able to exert an antithrombotic effect, slow down the adhesion and aggregation of red blood cells, platelets and white blood cells, reduce wall spasms and vascular permeability, and help normalize collateral circulation.

Pharacodynamics and pharmacokinetics

The action of "Heparin" is based on the binding of the cofactor to AT III. The use of high concentrations of "Heparin" allows you to suppress the activity of thrombin.

“Heparin” is not a fibrinolytic, that is, it does not dissolve blood clots, but it is able to stop their growth and reduce their size.

External heparin preparations have a local anti-inflammatory, antithrombotic and anti-exudative effect.

It activates the fibrinolytic properties of blood, is able to inhibit the activity of hyaluronidase, block thrombin. The patient using heparin ointments and gels improves microcirculation, activation of tissue metabolism is observed. As a result, there is an acceleration of the resorption of hematomas and blood clots, a decrease in tissue swelling. Instructions for use with the gel "Heparin 1000?" contains such information.

The absorption of the drug when used is apparently insignificant. The maximum concentration with subcutaneous administration is observed after 5 hours, about 95% of the substance binds to plasma proteins. The vascular bed "Heparin" does not leave.

Penetration into breast milk and through the placental barrier is absent. Metabolized "Heparin" in the tissues of the liver. The substance is characterized by rapid biological inactivation and short duration of action, since the antiheparin factor is involved in its biotransformation.

"Heparin" is displayed from half an hour to an hour. Excretion occurs through the kidneys. If high doses are used, up to 50% of the active substance is excreted unchanged. It is important to consider that "Heparin" is not excreted from the blood during hemodialysis.

This confirms the instructions for use for the heparin preparation.

Indications

Gel "Heparin" is indicated for use with the purpose of therapy and prevention:

1. Phlebitis, which occurs after injection or infusion.
2. Thrombophlebitis of superficial veins.
3. Subcutaneous hematomas.
4. Superficial mastitis.
5. Elephant news.
6. Superficial periphlebitis.
7. Lymphangitis.
8. Injuries and swelling of tendons, veins, joints, muscles.
9. Localized infiltrates.

So it is said in the instructions for use of the heparin gel.

In the form of a solution for injection, the drug is indicated for use in patients who have:

1. Deep vein thrombosis.
2. Thrombosis of myocardial arteries.
3. Renal vein thrombosis.
4. Tela.
5. Thrombophlebitis.
6. Atrial fibrillation, accompanied by embolization.
7. Unstable angina pectoris.
8. DIC syndrome.
9. Acute myocardial infarction.
10. Mitral heart disease.
11. Bacterial endocarditis.
12. Hemolytic-uremic syndrome.
13. Lupus nephritis.
14. Glomerulonephritis.
15. Microthrombosis, microcirculatory disorders (both therapy and prevention).

Heparin can also be recommended as a prophylactic in surgical interventions using extracorporeal blood circulation methods, with cytapheresis, peritoneal dialysis, hemodialysis, forced diuresis, venous catheter lavage, hemosorption.

Instructions for use for injections "Heparin" reports that if the drug is administered to the patient intravenously, then the coagulation slows down almost instantly. If the drug is administered under the skin, the effect is observed after half an hour. When inhaled, the effect appears after a day.

Contraindications

The use of heparin-based gels and ointments is contraindicated if the patient has an increased sensitivity to the components of the drug, diseases accompanied by ulcerative necrotic processes, injuries accompanied by a violation of the integrity of the skin.

In accordance with the instructions for use with Heparin ointment, the drug should be used with caution, if there is a tendency to bleeding, thrombocytopenia is diagnosed.

The drug in the form of a solution should not be used for:

1. Hypersensitivity.
2. Diseases accompanied by bleeding, for example, with vasculitis, hemophilia.
3. Bleeding.
4. Aortic dissection, intracranial aneurysm.
5. Antiphospholipid syndrome.
6. TBI.
7. Hemorrhagic stroke.
8. Uncontrolled hypertension.
9. Cirrhosis of the liver, which is accompanied by pathological changes in the esophageal veins.
10. A threatening miscarriage.
11. Menses.
12. Childbirth, recent birth.
13. Breastfeeding.
14. Erosive and ulcerative lesions of the stomach, intestinal tract.
15. Recently transferred operations on the brain, liver, biliary tract, prostate gland, brain.
16. Condition after lumbar puncture.

Particular caution is recommended when injecting the drug to those patients who suffer from polyvalent allergies, bronchial asthma, diabetes mellitus, arterial hypertension, active tuberculosis, endocarditis, pericarditis, liver failure, chronic renal failure. As well as patients before dental procedures or radiation therapy, patients over 60 years old and women who use IUDs.

Side effects

In accordance with the instructions for use with Heparin, external use of sodium heparin can provoke side effects such as hyperemia and allergic reactions.

Against the background of the introduction of the solution, you may experience:

1. Bronchospasm, collapse, itching of the skin, urticaria, anaphylactic shock, rhinitis, fever in the soles, drug fever.
2. Vomiting and nausea, a clear decrease in appetite, headaches and dizziness, diarrhea.
3. Thrombocytopenia (manifested in 6% of patients). In rare cases, death occurs. Heparin-induced thrombocytopenia can be accompanied by myocardial infarction, stroke, gangrene, skin necrosis, arterial thrombosis. The introduction of "Heparin" should be discontinued immediately if the patient has a decrease in platelet levels about half of their original number.
4. Bleeding and irritation, ulceration and pain, hyperemia and hematomas in the place where heparin is administered.
5. Bleeding. The most typical bleeding with the use of Heparin solution is bleeding from the gastrointestinal tract and urinary tract, in areas under pressure, from surgical wounds and from the injection site. Hemorrhages in the internal organs are not excluded - in the adrenal glands, in the corpus luteum, in retroperitoneal space.

If Heparin is used for a long period of time, soft tissue calcification, alopecia, osteoporosis may develop. There are also spontaneous fractures, an increase in the activity of liver enzymes.

Method of use and dosage

“Heparin” in the form of a solution can be used for continuous infusions, regular injections into a vein, and subcutaneous injections.

In order to prevent sodium, heparin should be administered subcutaneously every 8-12 hours in an amount of 5 thousand units per day. Prevention of thrombosis involves subcutaneous administration of 1 ml of the solution twice a day.

For the purpose of therapy, “Heparin” is infused into a vein. Use a dosage of 15 IU / kg / h. Thus, an adult with an average body weight is shown to administer 1,000 units of heparin per hour.

If you want to get a quick anticoagulant effect, the patient must inject 1 ml of the drug into the vein. In the absence of the possibility of introducing the drug into a vein, it is administered under the skin in an amount of 2 ml four times a day.

The maximum allowable dose of Heparin per day is not more than 80 thousand units. The indicated dosage can be used no more than 10 days. An increase in the duration of the administration course is permissible only in exceptional cases.

Children are shown a drip of the drug into a vein. The dosage is selected individually based on the patient's age: 1-3 months. - 800 units per kg, 4-12 months. - 700 units per kg, from 6 years - 500 units per kg per day.

Ointment and gel

“Heparin” in the form of an ointment or gel is used exclusively externally. It should be applied up to three times a day to the affected area. A single dose is a column of gel 3-10 cm in length. If a patient has rectal vein thrombosis, the gel should be used rectally. To do this, special cotton pads are impregnated with gel, applied to inflamed nodes, fixed with a band-aid or bandage. In the anus enter tampons previously impregnated with a gel. The course of treatment in this case is mainly 4 days. So it is said in the instructions for use for heparin ointment.

Shin ulcer therapy involves careful application of the gel to the skin around the ulcer. Moreover, the frequency of use is twice or thrice during the day. Therapy should be continued until the inflammatory phenomena disappear. The standard course duration is 3-7 days. The course can be extended on the recommendation of the attending physician.

This tells us the instructions for use with the Heparin gel.

Alternative heparin-based ointments and gels are used similarly.

In order to treat hemorrhoids (external or internal), eczema in the anus, thrombophlebitis of the veins of the anus, cracks, special candles can be used, for example, “Hepatrombin G”.

It is important to note that “Heparin” has only three pharmacological forms: solution, ointment, gel. Moreover, the gel is more saturated with the active substance and is better absorbed into the skin.

This is confirmed by the instructions for use. Heparin tablets are not produced. This is due to the fact that sodium heparin from the gastrointestinal tract is practically not absorbed.

Overdose

Overdose with parenteral use is manifested by bleeding of varying severity. If a little bleeding occurs during treatment with Heparin, it will be enough to cancel the drug. With extensive bleeding, neutralization of heparin in the blood is required. To do this, the patient is prescribed protamine sulfate in a dosage of 1 mg for every 100 units of heparin sodium.

It is important to consider that Heparin is excreted rapidly. This means that half an hour after the last dose of the drug, a twice-reduced dose of protamine sulfate should be administered, its maximum dose is not more than 50 mg.

Hemodialysis does not contribute to the elimination of heparin.

Cases of overdose when using gels and ointments with heparin are currently not described. An overdose in this case is considered unlikely, since the drug has a low systemic absorption. If you use heparin ointments for a long time, extensive hemorrhagic complications can occur.

Therapy of an overdose of external drugs based on heparin involves the complete discontinuation of the drug. If necessary, use a heparin antagonist - 1% protamine sulfate solution. Instructions for use with Heparin 1000? must be thoroughly studied before use.

Interaction with other medical devices

The effect of "Heparin" is enhanced by parallel therapy with drugs that reduce platelet aggregation, for example with ASA, dipyridamole, NSAIDs, antibiotics that reduce the synthesis of vitamin K, indirect anticoagulants, agents that block tubular secretion.

The effect of Heparin is reduced if used simultaneously with cardiac glycosides, ergot alkaloids, phenothiazines, antihistamines, nicotine, ethacrylic acid, nicotinic acid, intravenous nitroglycerin, ACTH, tetracyclines, alkaline amino acids and polypeptides, t,.

Do not mix Heparin with other medicines in the same syringe.

The anticoagulant effect of local heparin preparations is enhanced if used in combination with anticoagulants, NSAIDs, antiplatelet agents. Antihistamines, nicotine, thyroxine, tetracycline reduce the effectiveness of heparin drugs. This information also contains instructions for use.

Analogs of "Heparin"

The main analogues of “Heparin” in the form of a gel include the following agents: “Trombless”, “Laventum”, “Lyoton 1000”, “Heparin-Akrigel 1000”.

The generic injectable forms are Heparin-Sandoz, Heparin J, Heparin-Ferein.

The Wessel Duet F, Angioflux, Piyavit tablets, as well as the Enixum, Fraxiparin, Anfibra, Fluxum, Wessel Due F, Antithrombin III tablets have a similar mechanism of action. "Hemapaxan", "Angioflux."

It is important to remember that any replacement of a therapeutic drug should be done only after consulting a specialist.

Use of Heparin by pregnant and lactating women

There are no contraindications to the administration of Heparin solution to pregnant women. However, its use during lactation is best avoided. The active substance is not able to penetrate into breast milk, but prolonged use of the drug by lactating women can provoke the rapid development of osteoporosis and damage to the spine.

A doctor who can take into account the ratio of probable risk and benefit should decide on the advisability of using the drug.

Data on the use of heparin gels by pregnant and lactating women are not available.

More about analogues

According to the instructions for use "Heparin Akrigel 1000?" is an anticoagulant with a direct effect. Against the background of taking the drug, antithrombin III activation in the blood plasma is observed and its anticoagulant effect is accelerated. The drug disrupts the transformation of prothrombin into thrombin, the activity of the latter is inhibited. This is also indicated in the instructions for use with Heparin Akrigel. In addition, the platelet aggregation is reduced to some extent.

Indications and contraindications for the drug are similar to the analogue.

According to the instructions for use, "Heparin Akrikhin 1000?" also applies to direct anticoagulants, has anti-inflammatory, antiproliferative, decongestant and analgesic effects. Platelet aggregation is reduced, the transition of prothrombin to thrombin is prevented. The activity of the latter is inhibited. It is indicated for thrombophlebitis of superficial veins; localized infiltrates and swelling of soft tissues, injuries of tendons and joints, bruises of soft tissues and joints.

Instructions for use "Heparin Akrikhin" is almost identical to other similar means.

Cost

Currently, the average cost of “Heparin” in the form of a gel varies at the level of 280 rubles, and in the form of an injection solution - at the level of 480 rubles. It depends on the region and the pharmacy network.

Reviews about "Heparin"

“Heparin” is a very well-studied, clinically tested, often used and effective antithrombotic drug, its mechanism of action is based on the suppression of thrombin activity, which catalyzes a number of reactions that occur in the hemostasis system. Among them is the biotransformation of fibrinogen to fibrin.

Most often there are reviews about "Heparin" in the form of a gel and ointment. Patients note its high effectiveness against hemorrhoids, thrombophlebitis, bruises and localized infiltrates. Side effects occur quite rarely if you adhere to the doctor’s recommendations and the rules specified in the instructions for use with Heparin. Reviews on this subject are available.