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Heparin

Last reviewed on RxList: 1/13/2017
Heparin Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

Last reviewed on RxList 9/16/2016

Heparin (heparin sodium injectable) is a heterogeneous group of straight-chain anionic mucopolysaccharides, called glycosaminoglycans that have anticoagulant properties used to help prevent clot formation (for example, venous thrombosis, pulmonary embolisms, coagulopathies and coronary artery clots). Heparin is available as generic heparin and under other generic brand names. Common side effects of Heparin are:

  • easy bleeding and bruising;
  • pain, redness, warmth, irritation, or skin changes where the medicine was injected;
  • itching of your feet; or
  • bluish-colored skin.

Thrombocytopenia, heparin-induced thrombocytopenia (HIT) and heparin-induced thrombocytopenia and thrombosis (HITT) are serious side effects of heparin.

Heparin is available in vials at strengths of 1000, 5000, 10,000 and 20,000 units per ml. Dosage depends on the coagulation problem; many initial doses start with 5000 units IV, but this can change depending on the problem; guidelines for dosages are available. If benzyl alcohol is listed as a preservative for the Heparin preparation, do not use in neonates and infants or nursing mothers. If preparations without benzyl alcohol are used in pediatric patients, the initial dose is usually 50 units per Kg but a pediatric specialist should be consulted. Heparin may interact with aspirin or other NSAIDs (nonsteroidal anti-inflammatory drugs), other blood thinners, digoxin, dipyridamole, hydroxychloroquine, indomethacin, nicotine (cigarettes, gum, lozenges, or skin patches), nitroglycerin, antibiotics, and cold, allergy, or sleep medications. Tell your doctor all medications and supplements you use. Tell your doctor if you are pregnant or plan to become pregnant while using Heparin. It is unknown if heparin will harm a fetus. Consult your doctor before breastfeeding.

Our Heparin Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Heparin Consumer Information

Heparin can cause you to have bleeding episodes while you are using it and for several weeks after you stop. Call your doctor at once if you have easy bruising or unusual bleeding, such as a nosebleed, blood in your urine or stools, black or tarry stools, or any bleeding that will not stop.

Get emergency medical help if you have any of these signs of an allergic reaction: nausea, vomiting, sweating, hives, itching, trouble breathing, swelling of your face, lips, tongue, or throat, or feeling like you might pass out..

Some people receiving a heparin injection have had a reaction to the infusion (when the medicine is injected into the vein). Tell your caregiver right away if you feel nauseated, light-headed, sweaty, or short of breath during or after a heparin injection.

Stop using heparin and call your doctor at once if you have any of these serious side effects:

  • sudden numbness or weakness, especially on one side of the body;
  • sudden severe headache, confusion, problems with vision, speech, or balance;
  • chest pain, sudden cough, wheezing, rapid breathing, fast heart rate;
  • pain, swelling, warmth, or redness in one or both legs;
  • trouble breathing;
  • (in an infant) extreme drowsiness, weakness, or gasping for breath; or
  • fever, chills, runny nose, or watery eyes.

Less serious side effects may include:

  • mild pain, redness, warmth, or skin changes where the medicine was injected;
  • mild itching of your feet; or
  • bluish-colored skin.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Heparin (Heparin)

Heparin Professional Information

SIDE EFFECTS

Hemorrhage

Hemorrhage is the chief complication that may result from heparin therapy (see WARNINGS). An overly prolonged clotting time or minor bleeding during therapy can usually be controlled by withdrawing the drug (see OVERDOSAGE). It should be appreciated that gastrointestinal or urinary tract bleeding during anticoagulant therapy may indicate the presence of an underlying occult lesion. Bleeding can occur at any site but certain specific hemorrhagic complications may be difficult to detect:

  1. Adrenal hemorrhage, with resultant acute adrenal insufficiency, has occurred during anticoagulant therapy. Therefore, such treatment should be discontinued in patients who develop signs and symptoms of acute adrenal hemorrhage and insufficiency. Initiation of corrective therapy should not depend on laboratory confirmation of the diagnosis since any delay in an acute situation may result in the patient's death.
  2. Ovarian (corpus luteum) hemorrhage developed in a number of women of reproductive age receiving short- or long-term anticoagulant therapy. This complication if unrecognized may be fatal.
  3. Retroperitoneal hemorrhage.

Hypersensitivity

Generalized hypersensitivity reactions have been reported with chills, fever, and urticaria as the most usual manifestations, and asthma, rhinitis, lacrimation, headache, nausea and vomiting and anaphylactoid reactions, including shock, occurring more rarely. Itching and burning, especially on the plantar site of the feet may occur.

Thrombocytopenia has been reported to occur in patients receiving heparin with a reported incidence of 0 to 30%. While often mild and of no obvious clinical significance, such thrombocytopenia can be accompanied by severe thromboembolic complications such as skin necrosis, gangrene of the extremities that may lead to amputation, myocardial infarction, pulmonary embolism, stroke and possibly death. (See WARNINGS and PRECAUTIONS.)

Certain episodes of painful, ischemic and cyanosed limbs have in the past been attributed to allergic vasospastic reactions. Whether these are in fact identical to the thrombocytopenia associated complications remains to be determined.

Miscellaneous

Osteoporosis following long-term administration of high doses of heparin, cutaneous necrosis after systemic administration, suppression of aldosterone synthesis, delayed transient alopecia, priapism and rebound hyperlipemia on discontinuation of heparin sodium have also been reported.

Significant elevations of aminotransferase (SGOT [S-AST] and SGPT [S-ALT]) levels have occurred in a high percentage of patients (and healthy subjects) who have received heparin.

Read the entire FDA prescribing information for Heparin (Heparin)

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© Heparin Patient Information is supplied by Cerner Multum, Inc. and Heparin Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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