Drug reference

Heparin (unfractionated)

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 165, 166

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Treatment of mild to moderate pulmonary embolism | Treatment of unstable angina | Treatment of acute peripheral arterial occlusion ▶INITIALLY BY INTRAVENOUS INJECTION ▶Adult: Loading dose 5000 units, alternatively (by intravenous injection) loading dose 75 units/kg, followed by (by continuous intravenous infusion) 18 units/kg/hour, laboratory monitoring essential— preferably on a daily basis, and dose adjusted accordingly Treatment of severe pulmonary embolism ▶INITIALLY BY INTRAVENOUS INJECTION ▶Adult: Loading dose 10 000 units, followed by (by continuous intravenous infusion) 18 units/kg/hour, laboratory monitoring essential—preferably on a daily basis, and dose adjusted accordingly Treatment of deep-vein thrombosis ▶INITIALLY BY INTRAVENOUS INJECTION ▶Adult: Loading dose 5000 units, alternatively (by intravenous injection) loading dose 75 units/kg, followed by (by continuous intravenous infusion) 18 units/kg/hour, alternatively (by subcutaneous injection) 15 000 units every 12 hours, laboratory monitoring essential—preferably on a daily basis, and dose adjusted accordingly Thromboprophylaxis in medical patients ▶BY SUBCUTANEOUS INJECTION ▶Adult: 5000 units every 8–12 hours Thrombophylaxis in surgical patients ▶BY SUBCUTANEOUS INJECTION ▶Adult: 5000 units for 1 dose, to be taken 2 hours before surgery, then 5000 units every 8–12 hours Thromboprophylaxis during pregnancy ▶BY SUBCUTANEOUS INJECTION ▶Adult: 5000–10 000 units every 12 hours, to be administered with monitoring, Important: prevention of prosthetic heart-valve thrombosis in pregnancy calls for specialist management Haemodialysis ▶INITIALLY BY INTRAVENOUS INJECTION ▶Adult: Initially 1000–5000 units, followed by (by continuous intravenous infusion) 250–1000 units/hour Prevention of clotting in extracorporeal circuits ▶TO THE DEVICE AS A FLUSH continued → ▶Adult: (consult product literature) To maintain patency of catheters, cannulas, other indwelling intravenous infusion devices ▶TO THE DEVICE AS A FLUSH ▶Adult: 10–200 units, to be ﬂushed through every Cardiovascular system 4–8 hours, not for therapeutic use

PDF pages 165, 166

Prescribing And Dispensing Information

Doses listed take into account the guidelines of the British Society for Haematology.

PDF page 166

Safety

Interactions

→Appendix 1: heparin (unfractionated)

PDF page 166

Side Effects

Adrenal insufﬁciency. hypokalaemia. rebound hyperlipidaemia

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Pregnancy

Does not cross the placenta; maternal osteoporosis reported after prolonged use; multidose vials may contain benzyl alcohol—some manufacturers advise avoid.

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Breast Feeding

Not excreted into milk due to high molecular weight.

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Hepatic Impairment

Manufacturer advises caution; consider avoiding in severe impairment (increased risk of bleeding complications). Dose adjustments Manufacturer advises consider dose reduction if used in severe impairment.

PDF page 166

Renal Impairment

Dose adjustments Risk of bleeding increased in severe impairment—dose may need to be reduced.

PDF page 166

Dose and formulations

Directions For Administration

For intravenous infusion, give continuously in Glucose 5% or Sodium chloride 0.9%; administration with a motorised pump is advisable.

PDF page 166

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: solution for injection, solution for infusion Solution for injection EXCIPIENTS: May contain Benzyl alcohol ▶Heparin (unfractionated) (Non-proprietary) Heparin sodium 1000 unit per 1 ml Heparin sodium 1,000units/1ml solution for injection ampoules | 10 ampoule P £14.85 DT = £14.85 Heparin sodium 5,000units/5ml solution for injection vials | 10 vial P £16.50–£37.41 DT = £16.50 Heparin sodium 20,000units/20ml solution for injection ampoules | 10 ampoule P £70.88 DT = £70.88 Heparin sodium 5,000units/5ml solution for injection ampoules | 10 ampoule P £37.47 DT = £37.47 Heparin sodium 10,000units/10ml solution for injection ampoules | 10 ampoule P £64.59 DT = £64.59 Heparin sodium 5000 unit per 1 ml Heparin sodium 5,000units/1ml solution for injection ampoules | 10 ampoule P £29.04 DT = £29.04 Heparin sodium 25,000units/5ml solution for injection vials | 10 vial P £45.00–£84.60 DT = £45.00 Heparin sodium 25,000units/5ml solution for injection ampoules | 10 ampoule P £75.78 DT = £75.78 Heparin calcium 25000 unit per 1 ml Heparin calcium 5,000units/0.2ml solution for injection ampoules | 10 ampoule P £44.70 DT = £44.70 Heparin sodium 25000 unit per 1 ml Heparin sodium 25,000units/1ml solution for injection ampoules | 10 ampoule P £76.95 DT = £76.95 Heparin sodium 5,000units/0.2ml solution for injection ampoules | 10 ampoule P £37.35 DT = £37.35 Intravenous flush EXCIPIENTS: May contain Benzyl alcohol ▶Heparin (unfractionated) (Non-proprietary) Heparin sodium 10 unit per 1 ml Heparin sodium 50units/5ml patency solution ampoules | 10 ampoule P £14.96 DT = £14.96 Heparin sodium 50units/5ml I.V. flush solution ampoules | 10 ampoule P £14.96 DT = £14.96 Heparin sodium 100 unit per 1 ml Heparin sodium 200units/2ml I.V. flush solution ampoules | 10 ampoule P £15.68 DT = £15.68 Heparin sodium 200units/2ml patency solution ampoules | 10 ampoule P £15.68 DT = £15.68 Infusion ▶Heparin (unfractionated) (Non-proprietary) Heparin sodium 2 unit per 1 ml Heparin sodium 1,000units/500ml infusion Viaflex bags | 1 bag P s Heparin sodium 2,000units/1litre infusion Viaflex bags | 1 bag P s Heparin sodium 5 unit per 1 ml Heparin sodium 5,000units/1litre infusion Viaflex bags | 1 bag P s eiiii F 140

PDF page 166

Dose text by age group

Adult

Loading dose 5000 units, alternatively (by

First-line fragment. Read the complete Indications and Dose section above.

PDF page 165

Adult

Loading dose 10 000 units, followed by (by

First-line fragment. Read the complete Indications and Dose section above.

PDF page 165

Adult

Loading dose 5000 units, alternatively (by

First-line fragment. Read the complete Indications and Dose section above.

PDF page 165

Adult

5000 units every 8–12 hours

First-line fragment. Read the complete Indications and Dose section above.

PDF page 165

Adult

5000 units for 1 dose, to be taken 2 hours before

First-line fragment. Read the complete Indications and Dose section above.

PDF page 165

Adult

5000–10 000 units every 12 hours, to be

First-line fragment. Read the complete Indications and Dose section above.

PDF page 165

Adult

Initially 1000–5000 units, followed by (by

First-line fragment. Read the complete Indications and Dose section above.

PDF page 165

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 165

Adult

10–200 units, to be ﬂushed through every

First-line fragment. Read the complete Indications and Dose section above.

PDF page 166

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Heparin (unfractionated)

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 165, 166

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF pages 165, 166

Prescribing And Dispensing Information

Doses listed take into account the guidelines of the British Society for Haematology.

PDF page 166

Safety

Interactions

→Appendix 1: heparin (unfractionated)

PDF page 166

Side Effects

Adrenal insufﬁciency. hypokalaemia. rebound hyperlipidaemia

PDF page 166

Pregnancy

Does not cross the placenta; maternal osteoporosis reported after prolonged use; multidose vials may contain benzyl alcohol—some manufacturers advise avoid.

PDF page 166

Breast Feeding

Not excreted into milk due to high molecular weight.

PDF page 166

Hepatic Impairment

PDF page 166

Renal Impairment

Dose adjustments Risk of bleeding increased in severe impairment—dose may need to be reduced.

PDF page 166

Dose and formulations

Directions For Administration

For intravenous infusion, give continuously in Glucose 5% or Sodium chloride 0.9%; administration with a motorised pump is advisable.

PDF page 166

Medicinal Forms

PDF page 166

Dose text by age group

Adult

Loading dose 5000 units, alternatively (by

First-line fragment. Read the complete Indications and Dose section above.

PDF page 165

Adult

Loading dose 10 000 units, followed by (by

First-line fragment. Read the complete Indications and Dose section above.

PDF page 165

Adult

Loading dose 5000 units, alternatively (by

First-line fragment. Read the complete Indications and Dose section above.

PDF page 165

Adult

5000 units every 8–12 hours

First-line fragment. Read the complete Indications and Dose section above.

PDF page 165

Adult

5000 units for 1 dose, to be taken 2 hours before

First-line fragment. Read the complete Indications and Dose section above.

PDF page 165

Adult

5000–10 000 units every 12 hours, to be

First-line fragment. Read the complete Indications and Dose section above.

PDF page 165

Adult

Initially 1000–5000 units, followed by (by

First-line fragment. Read the complete Indications and Dose section above.

PDF page 165

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 165

Adult

10–200 units, to be ﬂushed through every

First-line fragment. Read the complete Indications and Dose section above.

PDF page 166

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.