Heparin Injection

Heparin is used to:

• prevent blood clots from forming in people who have certain medical conditions or who are undergoing certain medical procedures.
• stop the growth of clots that have already formed in the blood vessels.
• prevent blood clots from forming in catheters (small plastic tubes through which medication can be administered or blood drawn).
• treat certain types of blood disorders.

Heparin is in a class of medications called anticoagulants ('blood thinners'). It works by decreasing the clotting ability of the blood.

Heparin comes as a solution (liquid) to be injected intravenously (into a vein) or deeply under the skin and as a dilute (less concentrated) solution to be injected into intravenous catheters. Heparin should not be injected into a muscle. Heparin is injected one to six times a day or a continuous injection into the vein. When heparin is used in intravenous catheters, it is used when the catheter is put in, and every time that blood is taken out of the catheter or medication is given through it.

Heparin may be given to you by a nurse or other healthcare provider, or you may be told to inject the medication by yourself at home. If you will be injecting heparin yourself, a healthcare provider will show you how to inject the medication. Ask your doctor, nurse, or pharmacist if you do not understand these directions or have any questions about where on your body you should inject heparin, how to give the injection, or how to dispose of used needles and syringes after you inject the medication.

Use heparin exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Heparin solution comes in different strengths, and using the wrong strength may cause serious problems. Before giving an injection of heparin, check the package label to make sure it is the strength of heparin solution that your doctor prescribed for you. If the strength of heparin is not correct do not use the heparin and call your doctor or pharmacist right away.

Your doctor may increase or decrease your dose during your heparin treatment. If you will be injecting heparin yourself, be sure you know how much medication you should use.

Heparin is also sometimes used to prevent pregnancy loss and other problems in pregnant women with certain medical conditions who had issues in past pregnancies. Talk to your doctor or pharmacist about the risks of using this medication to treat your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before receiving or using heparin,

• tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while using heparin. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• the following nonprescription products may interact with heparin: aspirin and nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or naproxen; nicotine; allergy medications (diphenhydramine, loratadine, fexofenadine, chlorpheniramine or cetirizine). Be sure to let your doctor and pharmacist know that you are taking these medications before you start using heparin. Do not start any of these medications while using heparin without discussing with your healthcare provider.
• tell your doctor if you have a low level of platelets (type of blood cells needed for normal clotting) in your blood and if you have heavy bleeding that cannot be stopped. Your doctor may tell you not to use heparin.
• tell your doctor if you are currently experiencing your menstrual period; if you have a fever or an infection; and if you have recently had a spinal tap (removal of a small amount of the fluid that bathes the spinal cord), spinal anesthesia (administration of pain medication in the area around the spine), surgery, especially involving the brain, spinal cord or eye, or a heart attack. Also tell your doctor if you have or have ever had a bleeding disorder such as hemophilia (condition in which the blood does not clot normally), antithrombin III deficiency (condition that causes blood clots to form), blood clots in the legs, lungs, or anywhere in the body, unusual bruising or purple spots under the skin, cancer, ulcers in the stomach or intestine, a tube that drains the stomach or intestine, high blood pressure, or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using heparin, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are using heparin.
• tell your doctor if you smoke or use tobacco products and if you stop smoking at any time during your treatment with heparin. Smoking may decrease the effectiveness of this medication.

Unless your doctor tells you otherwise, continue your normal diet.

If you will be injecting heparin yourself at home, talk to your doctor about what you should do if you forget to inject a dose.

Heparin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• redness, pain, bruising, or sores at the spot where heparin was injected
• hair loss

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• unusual bruising or bleeding
• vomit that is bloody or looks like coffee grounds, coughing up blood
• stool that contains bright red blood or is black and tarry
• blood in urine
• excessive tiredness
• nausea, vomiting
• chest pain, pressure, or squeezing discomfort
• discomfort in the arms, shoulder, jaw, neck, or back
• excessive sweating
• sudden severe headache
• lightheadedness or fainting
• sudden trouble walking
• sudden numbness or weakness of the face, arm or leg, especially on one side of the body, sudden confusion, or difficulty speaking or understanding speech, sudden loss of balance or coordination, difficulty seeing in one or both eyes
• purple or black skin discoloration, pain in the arms or legs
• itching and burning, especially on the bottoms of the feet
• chills, fever
• hives, rash
• wheezing, hoarseness
• shortness of breath
• difficulty breathing or swallowing
• painful erection that lasts for hours

Heparin may cause osteoporosis (condition in which the bones become weak and may break easily), especially with long term use. Talk to your doctor about the risks of using this medication.

Heparin may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you will be injecting heparin at home, your healthcare provider will tell you how to store the medication. Follow these directions carefully. Be sure to keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not freeze heparin.

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• nosebleed
• blood in urine
• black, tarry stools
• easy bruising, unusual bleeding
• red blood in stools
• vomit that is bloody or looks like coffee grounds

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to heparin. Your doctor may ask you to check your stool for blood using an at-home test.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are using heparin.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

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