Heparin, Injection

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KEY POINTS

• This medicine is given by injection to prevent or treat blood clots. It may be used to reduce the risk of heart attack or stroke.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause serious bleeding problems or other unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: anticoagulant (medicine that reduces the chance of blood clots forming)

Generic and brand names: heparin sodium, injection; Heparin Lock Flush

What is this medicine used for?

This medicine is given by injection to treat or prevent:

• Blood clots in arms or legs (deep vein thrombosis)
• Blood clots in the lungs (pulmonary embolism)
• Blood-clotting complications of surgery

It may be used to reduce the risk of heart attack or stroke.

Heparin Lock Flush is used to keep blood from clotting in IV catheters. This form of heparin is not used to treat or prevent blood clots in the body.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine, or to benzyl alcohol, sulfites, corn, beef, or pork products
• A stroke or transient ischemic attack (TIA)
• Asthma
• Bacterial endocarditis (heart infection)
• Bleeding problems or low platelet counts
• Brain, spinal, or eye surgery
• Eye problems due to diabetes
• Heparin-induced thrombocytopenia (HIT)
• Liver problems
• High blood pressure
• Stomach or intestinal problems such as ulcerative colitis, Crohn’s disease, heartburn, ulcers, or bleeding

Tell your provider if you have recently had a spinal tap, back surgery, spinal anesthesia, radiation treatment, or any kind of infection. Also tell your healthcare provider if you are taking any medicine that may increase the risk of bleeding, such as warfarin (Coumadin), aspirin, or non-steroidal anti-inflammatory drugs (NSAIDs).

Females: Also, tell your healthcare provider if you are currently on your period or have a history of heavy or unusual menstrual periods.

Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

This medicine may be given by IV (slow drip through a needle into a large vein). It may also be given as injections (shots) by your healthcare provider in the hospital.

Sometimes you can give yourself these shots or have someone at home give them to you. Check the label on the medicine for directions about your specific dose. Be sure you know when to use the medicine and how much medicine you should use. Carefully follow the instructions for using this medicine. If you are not sure how to use this medicine, ask your healthcare provider or pharmacist for help.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do, or if you miss a dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nosebleeds, severe bruising, black or tarry bowel movements, blood in the urine, vomiting or coughing up blood, bleeding that won’t stop.

What should I watch out for?

Bleeding is the most common side effect. You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests. Your healthcare provider will watch for side effects and be able to treat emergencies if they happen.

Rarely, this medicine may cause new blood clots while you are receiving this medicine or for several weeks after it is stopped. Tell your healthcare provider right away if you have chest pain; pain in your legs; trouble breathing or sudden cough; a sudden or severe headache; problems with vision, speech, or walking. Talk with your healthcare provider about this.

Do not drink alcohol or take aspirin while receiving this medicine without your healthcare provider’s approval. It may increase the risk of bleeding.

Use a soft brush to brush your teeth. Be careful while shaving, cutting fingernails or toenails, or when using sharp objects. Avoid sports and activities that may cause injuries. If you fall or are injured, contact your healthcare provider right away. Serious internal bleeding may happen without your knowing about it.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat); sudden weakness, numbness, or tingling, especially on one side of your body; sudden or severe headache; sudden trouble with vision, speech, balance, or walking.

Serious (Report these to your healthcare provider right away.): Unusual bruising or bleeding; dark red spots under your skin; vomiting blood or something that looks like coffee grounds; black, tarry bowel movements; red or brown urine; increased menstrual flow or vaginal bleeding; confusion; unusual tiredness or weakness; unexplained pain or swelling in chest, abdomen, joints, or muscles; pain, redness or swelling in your lower legs; yellowing of your skin or eyes; chest pain; shortness of breath; severe dizziness or fainting; discolored fingers or toes; skin sores; burning or itching on the soles of your feet.

Other: Pain or redness at the spot where shots are given.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Alcohol
• Antibiotics such as demeclocycline, doxycycline (Doryx, Monodox, Vibramycin), minocycline (Dynacin, Minocin, Solodyn), and tetracycline
• Antihistamines such as chlorpheniramine (Chlor-Trimeton) and diphenhydramine (Benadryl)
• Aspirin and other salicylates
• Cancer medicines such as dasatinib (Sprycel), ibritumomab (Zevalin), ibrutinib (Imbruvica), and tositumomab (Bexxar)
• Deferasirox (Exjade, Jadenu)
• Digoxin (Lanoxin)
• Medicines to treat or prevent blood clots such as alteplase (Activase), apixaban (Eliquis), cilostazol (Pletal), clopidogrel (Plavix), dabigatran (Pradaxa), dalteparin (Fragmin), desirudin (Iprivask), dipyridamole (Persantine), enoxaparin (Lovenox), fondaparinux (Arixtra), prasugrel (Effient), reteplase (Retavase), rivaroxaban (Xarelto), tenecteplase (TNKase), ticagrelor (Brilinta), vorapaxar (Zontivity), and warfarin (Coumadin)
• Medicines to treat pulmonary hypertension such as iloprost (Ventavis) and treprostinil (Remodulin, Tyvaso)
• Natural remedies such as agrimony, alfalfa, anise, arnica, bilberry, black cohosh, bladderwrack, bromelain, cat's claw, dong quai, evening primrose oil, fenugreek, feverfew, fish oil, garlic, ginger, ginkgo biloba, ginseng, goldenseal, grape seed, green tea, horse chestnut, licorice, nettle, passion flower, pau d'arco, red clover, reishi, SAMe, St. John's wort, sweet clover, turmeric, and willow
• Nicotine replacement products such as Habitrol, NicoDerm, Nicorette, Nicotrol
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as celecoxib (Celebrex), diclofenac (Cambia, Voltaren, Zipsor), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Pentoxifylline
• SSRI antidepressants such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), and sertraline (Zoloft)
• Vitamin E

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.