Heparin Hanlim

Heparin Na.

Pharmacology: Action on Blood Coagulation: Small amounts of heparin in combination with antithrombin III (heparin cofactor) can inhibit thrombosis by inactivating activated factor X and inhibiting the conversion of prothrombin to thrombin. Once active thrombosis has developed, larger amounts of heparin can inhibit further coagulation by inactivating thrombin and preventing the conversion of fibrinogen to fibrin.
Heparin and Lipoprotein Lipase: In vivo heparin clears liperemic plasma by stimulating the release and activation of lipoprotein lipase which hydrolyzes triglycerides to free fatty acid and glycerol. This effect may occur following dose of heparin that are smaller than those required to produce anticoagulant effects. Bound hyperlipemia has been reported following a period of heparin-induced plasma clearing.

Prophylaxis and treatment of venous thrombosis therapy and its extension; pulmonary embolism in atrial fibrillation with embolization. Prevention of postoperative deep venous thrombosis and pulmonary embolism in patients undergoing major abdominothoracic surgery; clotting in arterial and cardiac surgery; peripheral arterial embolism. Diagnosis and treatment of acute and chronic consumptvie coagulopathies. Prophylaxis of cerebral thrombosis by cerebral hemorrhage.
An anticoagulant in blood transfusions, extracorporeal circulation, dialysis procedures and in blood samples for laboratory purposes. Atherosclerosis (with acute myocardial infarction).

Intraveneous injection or mixing with perfusion solution is used for extracorporeal circulation. Hypersensitivity should be checked before administration for large individual difference and maintenance dose should be fixed by checking coagulation time after each injection during the early stages of treatment. After usual use, maintain whole blood coagulation time as over 15-20 min but fix administration dose according to method and purpose of administration.
Extracorporeal Circulation (Blood Dialysis, Heart-Lung Machinery): Blood Dialysis: General Heparination: Before dialysis, 1000-5000 units should be injected after each dialysis, 1000-1500 units/hr continuously or intermittently should be injected.
Local Heparination: 1500-2500 units/hr should be adminsitered continuously and the action of heparin should be neutralized with protamine sulfate for intracorporeal perfusion.
Blood Perfusion by Heart-Lung Machine: Administer 150-300 units/kg and may add in accord to the need of the elongation of extracorporeal circulatory time. Neutralize action of heparin with protamine sulfate after extracorporeal circulation.
Continuous Intraveneous Therapy: Mix 1000-3000 units with 5% dextrose injection, normal saline or Ringer's solution. Inject about at a rate of 30 drops/min and infuse at the rate of 20 drops/min when the whole blood coagulation time is elevated 2-3 times the control value.
Intermittent Intraveneous Therapy: Initial Dose: 10,000 units followed by 5000-10,000 units every 4-6 hrs.
Subcutaneous Therapy: Intial Dose: 10,000-20,000 units in a concentrated solution injected SC of 8000-10,000 units in a concentrated solution every 8 hrs or 15,000-20,000 units in a concentrated solution every 12 hrs.
Anticoagulation in Blood Transfusion and Blood Samples: When heparin is used as an in vitro anticoagulant in blood transfusions, 400-500 units of heparin is usually added to 100 mL of whole blood. When heparin is used as an in vitro anticoagulant for blood samples 100 units is added to each 20-30 mL of whole blood.

Hypersensitivity to heparin or to any of the components of Heparin Hanlim.
Patients with unsuitable blood coagulation time in suitable blood coagulation tests eg, Lee White whole coagulation test, the activated partial thromboplastin time (aPTT); uncontrollable active bleeding state.
Use in children: Neonates and immature infants for Heparin Hanlim contains benzyl alcohol as preservative.

Heparin Hanlim should be used under physician's observation as this is a potent drug.

An overly prolonged clotting time or minor bleeding during therapy can usually be controlled by withdrawing Heparin Hanlim. Periodic platelet counts, hematocrits and tests for occult blood in stool are recommended during the entire course heparin therapy. Bleeding control as bleeding test should be checked. If the administration be discontinued abruptly, blood clotting may occur. Heparin Hanlim should be administered very slowly. If blood clot occurs, the action of Heparin Hanlim may be reduced. When clinical circumstances require the reversal of heparinization, protamine sulfate (1% solution) will neutralize heparin sodium. The number of thrombocyte should be monitored during the entire course of heparin therapy. The administration should be promptly discontinued if patient develops = new thrombosis in association with thrombocytopenia.
Patients Who Have Increased Danger of Hemorrhage: Cardiovascular: Subacute bacterial endocarditis, severe hypertension, arthereosclerosis, increased permeability of peripheral vessel.
Hematologic: Hemophilia, thrombocytopenia, jaundice, purpura, weakness of peripheral vessel.
Gastrointestinal: Ulcerative lesion, colitis, swelling of intestine, gastrointestinal diverticulitis.
Gynecologic: Abortion, premature birth, menstruation, postpartum hemorrhage.
Other: Operation, postoperation, urinary tract hemorrhage, hemoptysis, severe diabetes mellitus.
Patients with impaired renal dysfunction; hemorrhage after use of Heparin Hanlim; consumption coagulopathy. Catarrh-inserted patients.
Use in pregnancy: Administer with caution in pregnant women in late trimester.
Use in children: Neonates, immature infants for this drug contains benzyl alcohol as preservative.

Use in pregnancy: Administer with caution in pregnant women in late trimester.

Hypersensitivty: Pruritus, urticaria, fever, chills, rhinitis, asthma and lachrymation.
Blood: Thrombocytopenia, rarely arterial or venous thrombosis may be caused immunologically. Rhinorrhage, acute reversible platelet thrombosis may rarely occur.
Skin: Alopecia areata, leucoderma, local painful hematoma by SC or IM injection.
Liver: Elevation in degree of glutamic oxaloacetic transaminase and glutamic pyruvic transaminase.
Other: Suppression of renal reaction, rebound hyperlipidemia, osteoporosis due to long-term administration.

Anticoagulants, salicylic acid derivatives, anti-inflammatory enzymes or dipyridamole potentiate the effect of heparin; antihistamines, ascorbic acid, cardiotonic glycosides, tetracycline or phenothiazine derivative antagonize the effect of heparin.
Incompatibilities: Amikacin sulfate, amiodarone HCl, chlorpromazine HCl, diazepam, doxorubicin, droperidol, erythromycin, fentanyl citrate and droperidol (innovar), gentamicin sulfate, haloperidol lactate, kanamycin sulfate, meperidine HCl, methicillin sodium, methotrineprazine, netilmicin sulfate, pentazocine lactate, promethazine HCl, streptomycin sulfate, tobramycin sulfate, triflupromazine and vancomycin HCl.

Store at room temperature.

Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)

B01AB01 - heparin ; Belongs to the class of heparin group. Used in the treatment of thrombosis.

POM