Heparin, Injection HEP-a-rin

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. It may also be prescribed for other conditions as determined by your healthcare provider.

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.

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, to benzyl alcohol, or to beef or pork products
• a hemorrhagic stroke
• bacterial endocarditis (heart infection)
• bleeding problems or low platelet counts
• colitis
• eye problems due to diabetes
• liver problems
• high blood pressure
• ulcers

Tell your provider if you have recently had surgery, radiation treatment, or any kind of infection.

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 (steady drip 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. The shots should not be given into a muscle, but under the skin. Check the label on the medicine for directions about your specific dose. Be sure you know how and when to have shots and how much medicine to use.

Use sterile, disposable syringes and needles. Use each syringe and needle only once and dispose of them safely, following your healthcare provider's instructions. Carefully read and follow the directions that come in the package of medicine for preparing the shots. Wash your hands before using this medicine. Follow these steps to give yourself the shots:

1. Your healthcare provider will tell you where you can give yourself the shots (abdomen, thigh, upper arm, or other sites). If you are giving the shot in your abdomen, choose a site at least 2 inches away from belly button. Each day, choose a different spot for the shot to lessen irritation.
2. Use an alcohol swab to clean the skin where you will give yourself the shot.
3. Gently pinch up the skin and insert the needle into the skin at a 45° angle. After you insert the needle completely, release your grasp of the skin.
4. Inject all of the solution by gently and steadily pushing down the plunger.
5. After you have given yourself the shot, withdraw the needle and syringe and press an alcohol swab on the spot where the shot was given. To avoid bruising, do not rub the skin where the shot is given.
6. Discard the syringe, needle, and drug vial. Use the syringes and needles ONLY ONCE. Throw them away after use. Put used needles in rigid puncture-resistant containers with lids or caps, such as heavy plastic bleach bottles with screw caps. DO NOT throw needles directly into garbage cans or dumpsters.

If you are not sure of how to give yourself the shots, 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 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.

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 occur without your knowing about it.

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).

Serious (report these to your healthcare provider right away): Unusual bleeding or bruising; vomiting blood or something that looks like coffee grounds; black, tarry stools; red or brown urine; increased menstrual flow or vaginal bleeding; severe headache, dizziness, or weakness; unexplained pain or swelling in chest, abdomen, joints, or muscles; leg numbness or weakness; yellowish eyes or skin.

Other: Bleeding gums, nosebleed, heavy menstrual bleeding, heavy bleeding from a cut, 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:

• aspirin and other salicylates
• medicine that reduces the chance of blood clots forming such as clopidogrel (Plavix), dabigatran (Pradaxa), dalteparin (Fragmin), desirudin (Iprivask), dipyridamole (Aggrenox), enoxaparin (Lovenox), fondaparinux (Arixtra), prasugrel (Effient), rivaroxaban (Xarelto), ticagrelor (Brilinta), and warfarin (Coumadin)
• natural remedies such as agrimony, alfalfa, arnica, black cohosh, cat's claw, dong quai, evening primrose oil, fenugreek, feverfew, garlic, ginger, ginkgo biloba, ginseng, goldenseal horse chestnut, licorice, nettle, passion flower, pau d'arco, red clover, St. John's wort, sweet clover, and willow
• nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Voltaren, Cataflam), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen, ketorolac (Toradol), nabumetone (Relafen), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)

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.

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.