Hepagusan Special Precautions

Inj: Heparin sodium injection is not given intramuscularly.
Sodium heparin is used very carefully in patients with ulcerative lesions, menstruation or hemostatic liver disease that is disrupted.
If the coagulation test is too long or bleeding occurs, then heparin sodium should be stopped.
Heparin sodium must be used cautiously in the patients who will undergo surgery, elderly and pregnant wom­en.
Thrombocytopenia is reported in some patients who receive Heparin. Thrombocytopenia mild degree­ severe must be closely monitored.
If Benzyl alcohol is administered in amounts of 100 mmol which significantly exceed those required for preser­vative purposes (0.1 mmol/mL), haemolysis rate, oxygen transport capacity of the erythrocytes as well as res­piratory rate may be adversely affected. Patients suffering from cardiac arrhythmia may be at risk when given Benzyl alcohol in substantially higher doses (8-16 mg per kg BW) than those which may possibly be administered in the course of Heparin therapy in maxi­mal therapeutic doses. For clinical studies on cAMP regulated cell activity it is recommended to use Benzyl alcohol-free Heparin. In case of need, icteric premature and neonate infants should preferably be given Heparin without preservative.
Extra precaution must be exercised when treating old age patient and pregnant women with Heparin. And the same precaution must also be exercised at post-ope­rative treatment and to hypersensitive patients.
Anticoagulant therapy: If heavy bleeding occurs during Heparin therapy pos­sible surgical intervention to stop the bleeding may have to be considered. Otherwise the Heparin dose is to be reduced depending on the extent of bleeding, and in case of need. Heparin therapy may even have to be discontinued or the Heparin action inhibited protamine. To neutralize 5,000 I.U. of heparin about 50 mg of Pro­tamine Hydrochloride or Sulphate are necessary. Be­cause of the possible risk of deep muscle haematoma intramuscular injections should be avoided during Hepa­rin therapy. The same applies also to organ punctures and angiographic procedures. Prevailing thrombopenia may lead Heparin accumulation. Compatibility studies carried out with Heparin Sodium Injection 5,000 I.U./mL have shown compatibility with carrier i.v. Fluids like Sterofundin, Sodium Chloride inj. 0.9%. Dextrose inj. 5% and 10%. These compatibility studies were based on physico-chemical criteria after 24 hours observation period. As matter of principle admixture to any of these carrier solutions should be done shortly prior to starting the infusion.
Topical Gel: Do not applied to mucous membranes or open wounds.