View source for Unfractionated heparin

==General==
*Type: [[Anticoagulant]]
*Dosage Forms: IV, SC
*Common Trade Names: Heparin

==Adult Dosing==
===Thromboembolism===
*Bolus: 80 units/kg IV x 1 (MAX: 5,000 units)
*Then drip: 18 units/kg/h IV (MAX: 1,000 units/h)
*Adjust dose to target aPTT levels based on nomogram

===Acute Coronary Syndrome===
*Bolus: 50 units/kg IV x 1 (MAX: 5,000 units)
*Then drip: 12 units/kg/h IV (MAX: 1,000 units/h)
*Adjust dose to target aPTT levels based on nomogram

==Pediatric Dosing==
*IV infusion
**Initial loading dose 75 units/kg given over 10 minutes
**Initial maintenance dose 20 units/kg/hour and adjest per local policy

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*[[Lactation risk categories|Lactation risk]]: Infant risk minimal
*Renal Dosing
**No adjustment
*Hepatic Dosing
**No adjustment

==Contraindications==
*Allergy to class/drug
*33% of patients develop some form of bleeding complication; 2-6% develop major bleeding
*[[HIT (Heparin-Induced Thrombocytopenia)]]

===Risk Factors for Major Bleeding Complication===
*Recent surgery or trauma
*Renal failure
*Alcoholism
*Malignancy
*Liver failure
*Concurrent use of warfarin, fibrinolytics, steroids, or antiplatelet drugs

==Adverse Reactions==
===Serious===
*Major bleeding
*Thrombocytopenia

===Common===
*Injection site reaction<ref>Warnock LB, Huang D. Heparin. [Updated 2022 Jul 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538247/</ref>
*Hyperkalemia
*Alopecia
*Osteoporosis

==Pharmacology==
*Half-life: 1.5 hrs
*Metabolism: Hepatic
*Excretion: Urine
*Mechanism of Action:
**Binds to and activates antithrombin which in turns inactivates factor Xa and thrombin
*Anticoagulation effect lasts up to 3hr after stopping infusion
*Must give IV (not subq) for acute thromboembolic disease
**Unpredictable anticoagulation effect
**Must monitor with PTT; therapeutic range is 1.5-2.5x normal value


==Indications by Condition==
''The following table is automatically generated from disease/condition pages across WikEM.''

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 |?Has Dose=Dose
 |?Has Context=Context
 |?Has Route=Route
 |?Has Population=Population
 |format=table
 |headers=plain
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==See Also==
*[[Unfractionated heparin reversal]]
*[[Coagulopathy (main)]]
*[[Low molecular weight heparin]]

==References==
<references/>

[[Category:Pharmacology]]