Heparin Leo Dosage/Direction for Use

Dosage: Haemodialysis: 7,500-12,500 i.u. (without preservative) is normally required per dialysis.
Intravenous administration: 5,000-10,000 i.u. every four hours either by bolus injection or continuous infusion in Sodium Chloride Injection or Dextrose Injection. However, the dose should be monitored with coagulation tests performed just before each administration and varied according to individual response.
The clotting time should be 2-3 times the control value.
Subcutaneous administration (Therapeutic dosage): Subcutaneous administration of 10,000 i.u. may be given every 8 hours after an initial intravenous bolus injection of 5,000 i.u.
Low-dose heparin prophylaxis: 5,000 i.u. in 0.2 ml s.c. should be given two to six hours pre-operatively and every 8-12 hours post-operatively for 10-14 days, or until the patient is mobile, which ever is the longer.
Myocardial infarction: 5,000 i.u. s.c. every twelve hours beginning during the twelve hours following the first sign of myocardial infarction.
Open heart surgery: Operations of less than two hours, 120 i.u./kg/hour. For operations of longer duration, one and a half times this dose should be given. For each 450 ml of blood used, 2,000 i.u. are needed.
Treatment periods vary from 10-14 days in peri-operative prophylaxis to as much as six weeks in the treatment of established thrombosis.
It is anticipated that heparin will have disappeared from the blood-stream 4 hours after intravenous injection of 5,000 i.u. and 6-8 hours after 10,000 i.u. and 15,000 i.u. of i.v. heparin, respectively.
In situations needing large amounts of heparin, as in cardio-pulmonary bypass, preservative-free heparin should be used. If this is unavailable and preserved heparin has to be used, then the most concentrated heparin solution (25,000 IU/ml) should be chosen to minimise the quantity of preservative administered.
Dosage in the elderly: Elderly women have a greater tendency to bleed and it may be necessary to reduce the dose according to coagulation tests, but dosage alterations are unlikely for prophylaxis.
Administration: Heparin is usually administered by intravenous or subcutaneous injection.
The intramuscular route cannot be recommended because of the high incidence of haematoma.
The increase in clotting time provided by heparin becomes apparent immediately after administration and lasts for 4 to 6 hours after intravenous injection and for about eight hours after subcutaneous injection.