Prevention of clotting during haemodialysis
Adult: Initially, 1,000-5,000 units given as a bolus inj followed by continuous infusion of 1,000-2,000 units/hour, adjust dose as needed. Dosage recommendations may vary between countries (refer to specific country guidelines).
Intravenous
Thrombosis
Neonate: Initially, 75 units/kg over 10 minutes, followed by 28 units/kg/hour as a continuous infusion. Doses are adjusted to maintain an anti-Xa activity of 0.35-0.7 units/mL or aPTT range that correlates to this anti-Xa range or a protamine titration range of 0.2-0.4 units/mL.
Intravenous
Peripheral arterial embolism, Pulmonary embolism, Venous thromboembolism
Adult: Initially, 75-80 units/kg or 5,000 units (10,000 units for severe pulmonary embolism) given via bolus inj, followed by continuous infusion of 18 units/kg/hour or 1,000-2,000 units/hour. Alternatively: Continuous infusion: Initially, 5,000 units via bolus inj, followed by continuous infusion of 20,000-40,000 units over 24 hours. Intermittent inj: Initially, 10,000 units followed by 5,000-10,000 units 4-6 hourly. Dosage is individualised and adjusted according to response. Dose and treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
Elderly: Dosage adjustment may be needed.
Child: >1 year Initially, 75-100 units/kg via bolus inj over 10 minutes, followed by 18-20 units/kg/hour. Dosage is individualised and adjusted according to response. Dose and treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
Elderly: Dosage adjustment may be needed.
Child: >1 year Initially, 75-100 units/kg via bolus inj over 10 minutes, followed by 18-20 units/kg/hour. Dosage is individualised and adjusted according to response. Dose and treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
Intravenous
Maintaining patency of central venous access device
Neonate: 0.5 units/kg/hour via continuous infusion. Recommendations may vary among countries (refer to specific country guidelines).
Parenteral
Maintaining patency of indwelling intravenous line
Adult: As heparin flush solution: 10-200 units administered into the catheter/cannula 4-8 hourly or as necessary. Recommendations may vary among countries and individual products (refer to specific product guidelines).
Subcutaneous
Pulmonary embolism, Venous thromboembolism
Adult: Initially, 333 units/kg, followed by 250 units/kg (10,000-20,000 units) 12 hourly or 8,000-10,000 units 8 hourly. Alternatively, 10,000-20,000 units for 1 dose (proceeded by 5,000 units IV loading dose), followed by 8,000-10,000 units 8 hourly or 15,000-20,000 units 12 hourly.
Elderly: Dosage adjustment may be needed.
Elderly: Dosage adjustment may be needed.
Subcutaneous
Prophylaxis of postoperative venous thromboembolism
Adult: 5,000 units given 2 hours before surgery, then 8-12 hourly for 7 days or until the patient is ambulant.