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When heparin sodium is administered in therapeutic amounts, its dosage should be regulated by frequent blood coagulation tests. If the coagulation test is unduly prolonged or if haemorrhage occurs heparin sodium should be discontinued promptly (See Overdosage).
Some of the condition in which increased danger of haemorrhage exists are as follows: Cardiovascular: Subacute bacterial endocarditis; arterial sclerosis: increased capillary permeability during and immediately following (a) spinal tap or spinal anaesthesia or (b) major surgery, especially involving the brain, spinal cord or eye.
Haematologic: Conditions associated with increased bleeding tendencies, such as haemophilia, some purpuras, and thrombocytopenia.
Gastrointestinal inaccessible ulcerative lesions and continuous tube drainage of the stomach or small intestine.
Heparin may prolong the one-stage prothrombin time. Therefore, when heparin sodium is given with dicumarol of warfarin sodium, a period of at least five hours after the last intravenous dose or 24 hours after the last subcutaneous dose should elapse before blood is drawn if a valid prothrombin time is to obtained.
As this preparation contains benzyl alcohol, its use should be avoided in children under 2 years of age.
Not to be used in neonates.
