Heparin - instructions for use, reviews, analogs and forms of release (ointment or gel Acrigel 1000 IU, injections in ampoules for injection in solution) of a drug for the treatment of hemorrhoids, varicosity in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Heparin. There are reviews of visitors to the site - consumers of this medication, as well as opinions of medical specialists on the use of Heparin in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Heparin in the presence of existing structural analogues.Use for the treatment of thrombophlebitis, hemorrhoids, varicose in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Heparin - an anticoagulant of direct action belongs to the group of medium-molecular heparins. In blood plasma activates antithrombin 3, accelerating its anticoagulant effect. It breaks the transition of prothrombin to thrombin, inhibits the activity of thrombin and activated factor 10, to some extent reduces the aggregation of platelets.

For unfractionated standard heparin, the ratio of antiplatelet activity (antifactor 10a) and anticoagulant activity (APTT) is 1: 1.

Increases renal blood flow; increases the resistance of blood vessels of the brain, reduces the activity of brain hyaluronidase, activates lipoprotein lipase and has lipid-lowering effect. Reduces the activity of the surfactant in the lungs, suppresses the excessive synthesis of aldosterone in the adrenal cortex, binds adrenaline, modulates the ovarian response to hormonal stimuli, and increases the activity of parathyroid hormone. As a result of the interaction with enzymes, it can increase the activity of brain tyrosine hydroxylase, pepsinogen, DNA polymerase and reduce the activity of myosin ATPase,pyruvate kinase, RNA polymerase, pepsin.

There is evidence of the presence of immunosuppressive activity in heparin.

In patients with IHD (in combination with ASA) reduces the risk of developing acute coronary thrombosis, myocardial infarction and sudden death. Reduces the frequency of recurrent myocardial infarction and mortality of patients with myocardial infarction. In high doses it is effective for pulmonary embolism and venous thrombosis, in small doses for prophylaxis of venous thromboembolism, incl. after surgical operations.

With intravenous administration, blood clotting slows down almost immediately, with intramuscular injection - after 15-30 minutes, with subcutaneous - after 20-60 minutes, after inhalation, the maximum effect - in a day; the duration of anticoagulant action, respectively - 4-5, 6, 8 hours and 1-2 weeks, the therapeutic effect - preventing thrombosis - persists significantly longer. Deficiency of antithrombin 3 in the plasma or in the place of thrombosis can reduce the antithrombotic effect of heparin.

With external application has a local antithrombotic, antiexudative, moderate anti-inflammatory effect. It blocks the formation of thrombin, inhibits the activity of hyaluronidase, activates the fibrinolytic properties of the blood.Penetrating through the skin, heparin reduces the inflammatory process and has an antithrombotic effect, improves microcirculation and activates tissue metabolism, thereby accelerating the processes of resorption of hematomas and blood clots and reducing swelling of tissues.

Composition

Heparin sodium + excipients (injections).

Heparin sodium + Benzocaine + Benzyl nicotinate + auxiliary substances (heparin ointment).

Heparin sodium 1000 IU + auxiliary substances (gel Akrihin 1000).

Other forms, such as tablets, do not exist.

Pharmacokinetics

Heparin poorly penetrates the placenta due to its high molecular weight. It is not excreted in breast milk.

Indications

Prevention and therapy:

• deep vein thrombosis;
• thromboembolism of the pulmonary artery (including in diseases of peripheral veins);
• coronary artery thrombosis;
• thrombophlebitis;
• unstable angina;
• acute myocardial infarction;
• atrial fibrillation (including those accompanied by embolism);
• DIC-syndrome;
• prevention and therapy of microthrombogenesis and microcirculation disorders;
• thrombosis of the renal veins;
• hemolyticcouremic syndrome;
• mitral heart disease (prevention of thrombosis);
• bacterial endocarditis;
• glomerulonephritis;
• lupus nephritis;
• prevention of blood coagulation during operations using extracorporeal circulatory methods;
• preparation of non-stopping blood samples for laboratory purposes and blood transfusion
• prevention and treatment of thrombophlebitis of superficial veins;
• postinjection and postinfusion phlebitis;
• external hemorrhoids;
• inflammation of the puerperium hemorrhoids;
• trophic ulcers of the lower leg;
• elephantiasis;
• superficial periphlebitis;
• lymphangitis;
• superficial mastitis;
• localized infiltrates and edema;
• injuries and bruises without compromising the integrity of the skin (including muscle tissue, tendons, joints);
• subcutaneous hematoma.

Forms of release

Ointment for external use.

Solution for intravenous and subcutaneous injection (injections in ampoules for injection).

Gel for external use.

Instructions for use and dosage

Ampoules

Intravenous (infusion or injection) or subcutaneously (the famous injections into the abdominal region), the initial dose is intravenously (injectively) 5000 IU, supporting: continuous intravenous infusion of 1000-2000 IU / h (20,000-40000 IU / day), previously diluting in 1000 ml of isotonic solution of NaCl; regular intravenous injections - 5000-10000 IU every 4-6 hours; subcutaneously (deep) - 15000-20000 IU every 12 hours or 8000-10000 IU every 8 hours.

Ointment

Apply externally. The ointment is applied a thin layer on the affected area (at the rate of 0.5-1 g (2-4 cm of ointment) per site 3-5 cm in diameter) and carefully rub the ointment into the skin. Ointment is applied 2-3 times a day daily until the disappearance of inflammatory phenomena, on average 3 to 7 days. The possibility of a longer treatment is determined by the doctor.

When thrombosis of external hemorrhoids, the ointment is applied to a coarse or linen pad, which is applied directly to the thrombosed units and fixed. Ointment should be used daily, until the symptoms disappear, on average from 3 to 14 days, with the same purpose you can use a tampon soaked in heparin ointment, which is injected into the anus.

Side effect

• bleeding of the gastrointestinal tract and urinary tract;
• bleeding at the injection site, in areas subject to pressure, from surgical wounds;
• hemorrhage in the organs;
• hematuria;
• thrombocytopenia;
• nausea, vomiting;
• decreased appetite;
• diarrhea;
• hyperemia of the skin;
• drug fever;
• hives;
• rhinitis;
• skin itching and sensation of heat in the soles;
• bronchospasm;
• collapse;
• anaphylactic shock;
• thrombocytopenia (can be severe up to a lethal outcome) with subsequent developmentnecrosis of the skin, arterial thrombosis, accompanied by the development of gangrene, myocardial infarction, stroke;
• osteoporosis;
• spontaneous fractures;
• soft tissue calcification;
• irritation, pain, hyperemia, hematoma and ulceration at the site of administration;
• transient alopecia;
• hypoaldosteronism.

Contraindications

• bleeding;
• diseases accompanied by violation of blood coagulation;
• suspicion of intracranial hemorrhage;
• cerebral aneurysm;
• hemorrhagic stroke;
• exfoliating aortic aneurysm;
• antiphospholipid syndrome;
• malignant hypertension;
• subacute bacterial endocarditis;
• erosive and ulcerative lesions of the gastrointestinal tract;
• severe lesions of the liver parenchyma;
• cirrhosis of the liver with varicose veins of the esophagus;
• malignant neoplasms in the liver;
• shock states;
• recent surgical interventions on the eyes, brain, prostate, liver and biliary tract;
• condition after spinal cord puncture;
• menstruation;
• threatening miscarriage;
• childbirth (including recent ones);
• hypersensitivity to heparin.

Application in pregnancy and lactation

The use during pregnancy is possible only on strict indications, under careful medical supervision.

Possible application in the lactation period (breastfeeding) according to the indications.

special instructions

Use with caution in patients suffering from polyvalent allergy (including bronchial asthma), with arterial hypertension, dental manipulations, diabetes, endocarditis, pericarditis, with an intrauterine contraceptive, with active tuberculosis, radiation therapy, liver failure, chronic renal failure, in elderly patients (over 60 years, especially women).

Intramuscular administration of heparin is not recommended because of the possibility of hematoma development, as well as the introduction of other drugs in the background of heparin treatment.

With caution apply externally with bleeding and conditions of increased bleeding, thrombocytopenia.

During treatment with heparin, blood coagulation monitoring is necessary.

To dilute heparin use only physiological solution.

With the development of severe thrombocytopenia (a decrease in the number of platelets by 2 times from the initial number or below 100,000 / μL), it is necessary to stop the use of heparin urgently.

The risk of bleeding can be minimized by careful assessment of contraindications, regular laboratory control of blood coagulation and adequate dosing.

Ointment or gel is not applied to open wounds, mucous membranes, do not apply for ulcerative necrotic processes.

Drug Interactions

The anticoagulant effect of heparin is enhanced by the simultaneous use of anticoagulants, antiaggregants and non-steroidal anti-inflammatory drugs (NSAIDs).

Ergot alkaloids, thyroxine, tetracycline, antihistamines, and nicotine reduce the effect of heparin.

Analogues of the drug Heparin

Structural analogs for the active substance:

• Viatrom;
• Heparin Lechiva;
• Heparin sodium;
• Heparin Sandoz;
• Heparin Acrigel 1000;
• Heparin sodium Brown;
• Heparin Richter;
• Heparin Ferein;
• Heparin sodium salt;
• Heparin injection for 5000 units / mL;
• Lavenum;
• Lyoton 1000;
• Trombleuss;
• Thrombophobia.

Similar medicines:

Other medicines: