Analogs

Heparin – Indar, Heparin – Biolik, Heparin – Novofarm, Fragmin, Clexane, Novoparin, Flenoks, Fraksiparin, Wessel Due F, Tsibor, Pentosan polysulfate SR 54, Angioflyuks, Atenativ 500 Mo, Enoxaparin – Farmeks, Heparin Sandoz, Heparin – Farmeks.

pharmachologic effect

When administered parenterally, it inhibits blood coagulation. The effect of the drug manifests itself immediately after administration and lasts for 2-3 hours. 

Indications for use

Systemic use – treatment of thrombophlebitis, phlebitis and thromboembolism; early therapy of myocardial infarction; prevention of venous thrombosis and thromboembolism of the branches of the pulmonary artery in the postoperative period and with prolonged immobilization; cardiac catheterization; 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.  

Local application – varicose veins, phlebothrombosis, thrombophlebitis, superficial periphlebitis, phlebitis after intravenous injections, hemorrhoidal vein thrombosis, varicose ulcers of the extremities, postoperative varicose phlebitis, complications after removal of the saphenous veins of the lower extremities, bruises, infiltrates, local limited edema hematomas, injuries to muscles, tendons and joints.  

Method of administration and dosage

Solution.   The dose is set taking into account the coagulogram parameters, the nature of the disease, age, body weight and sensitivity of the patient.

For the prevention of thromboembolism   during surgical treatment, 5,000–7500 IU of heparin are injected s / c 2 hours before the operation. 

In case of myocardial infarction,   inject s / c 7,500 IU 2-3 times a day or 12,000-12,500 IU 2 times a day.

For venous and arterial thrombosis and thromboembolism,   intravenous injection is administered. Adults are first prescribed an IV stream of 5000-10,000 IU, then through a perfuser 25,000-40,000 IU per day; children are initially injected with 50 IU / kg i.v. in a stream, then through a perfuser 20 IU / kg in 1 hour. 

Gel, ointment or cream   is applied in a thin layer, rubbing gently into the affected skin, 2-3 times a day. In case of thrombosis of hemorrhoidal veins, it is used either under a bandage (in the case of extraanal nodes), or injected into the rectum on a tampon. Depending on the nature of the disease, the course of treatment is 1-3 weeks.

Do not apply to open wounds, mucous membranes, area of ​​purulent process.

Spray . 3-4 sprays are carried out 3 times a day. Apply only over the affected area; excess liquid should be gently rubbed until completely absorbed.

Side effects

Allergic reactions, bleeding under the skin and in mucous membranes, bleeding from wounds, the urinary tract, genitals, gastrointestinal – intestinal bleeding, thrombocytopenia, increased activity of transaminases in blood plasma, is extremely rare – transient alopecia, gipoaldosteronizm. 

Contraindications

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

Overdose

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