Multiparin
Generic Name
Heparin Sodium
Manufacturer
Multiple Pharmaceutical Companies
Country
Globally manufactured
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| multiparin 25000 iu injection | ৳ 554.00 | N/A |
Description
Overview of the medicine
Heparin is a fast-acting anticoagulant used to prevent and treat various thromboembolic disorders, including deep vein thrombosis (DVT) and pulmonary embolism (PE). It works by enhancing the activity of antithrombin III, an enzyme that inactivates several clotting factors.
Uses & Indications
Dosage
Adults
Dosage is highly individualized based on indication, patient weight, and activated partial thromboplastin time (aPTT). Typical therapeutic IV dose: Initial bolus of 5,000 units, followed by a continuous infusion of 1,000-2,000 units/hour. Subcutaneous prophylactic dose: 5,000 units every 8-12 hours.
Elderly
May require lower doses and more frequent aPTT monitoring due to increased sensitivity and risk of bleeding. Close observation is necessary.
Renal_impairment
Use with caution. Half-life may be prolonged, requiring dose adjustment and careful monitoring of aPTT and renal function.
How to Take
Administer by continuous intravenous infusion or deep subcutaneous injection. Intramuscular administration is contraindicated due to the risk of hematoma formation.
Mechanism of Action
Heparin binds to and activates antithrombin III (ATIII), which then inactivates thrombin (Factor IIa) and Factor Xa, preventing the formation of fibrin clots. It also inhibits other clotting factors to a lesser extent.
Pharmacokinetics
Onset
Intravenous: Immediate; Subcutaneous: 20-60 minutes.
Excretion
Primarily renal excretion of unchanged drug and metabolites.
Half life
1-2 hours (dose-dependent), prolonged in renal or hepatic impairment.
Absorption
Poorly absorbed orally; administered intravenously or subcutaneously. Subcutaneous absorption is variable.
Metabolism
Partially metabolized in the liver by heparinase and by the reticuloendothelial system.
Side Effects
Contraindications
- Active bleeding or bleeding disorders (e.g., hemophilia)
- History of Heparin-Induced Thrombocytopenia (HIT)
- Severe thrombocytopenia
- Recent severe trauma or surgery (especially brain, spinal cord, eye)
- Severe uncontrolled hypertension
- Bacterial endocarditis
Drug Interactions
NSAIDs (e.g., Aspirin, Ibuprofen)
Increased risk of bleeding due to additive antiplatelet effects.
Oral anticoagulants (e.g., Warfarin)
Increased bleeding risk, requires careful monitoring when transitioning.
Antiplatelet agents (e.g., Clopidogrel)
Increased bleeding risk.
Storage
Store at controlled room temperature (20-25°C), excursions permitted to 15-30°C. Do not freeze.
Overdose
Overdose can lead to severe bleeding. The anticoagulant effects of heparin can be neutralized by protamine sulfate, which acts as a specific antidote. Dosage of protamine sulfate depends on the amount of heparin administered and the time elapsed.
Pregnancy & Lactation
Pregnancy Category C. Heparin does not cross the placenta and is considered relatively safe for use during pregnancy when clinically indicated and closely monitored. It does not pass into breast milk in significant amounts, so it is generally considered safe during lactation.
Side Effects
Contraindications
- Active bleeding or bleeding disorders (e.g., hemophilia)
- History of Heparin-Induced Thrombocytopenia (HIT)
- Severe thrombocytopenia
- Recent severe trauma or surgery (especially brain, spinal cord, eye)
- Severe uncontrolled hypertension
- Bacterial endocarditis
Drug Interactions
NSAIDs (e.g., Aspirin, Ibuprofen)
Increased risk of bleeding due to additive antiplatelet effects.
Oral anticoagulants (e.g., Warfarin)
Increased bleeding risk, requires careful monitoring when transitioning.
Antiplatelet agents (e.g., Clopidogrel)
Increased bleeding risk.
Storage
Store at controlled room temperature (20-25°C), excursions permitted to 15-30°C. Do not freeze.
Overdose
Overdose can lead to severe bleeding. The anticoagulant effects of heparin can be neutralized by protamine sulfate, which acts as a specific antidote. Dosage of protamine sulfate depends on the amount of heparin administered and the time elapsed.
Pregnancy & Lactation
Pregnancy Category C. Heparin does not cross the placenta and is considered relatively safe for use during pregnancy when clinically indicated and closely monitored. It does not pass into breast milk in significant amounts, so it is generally considered safe during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years, check specific product labeling.
Availability
Hospitals and specialized pharmacies
Approval Status
Approved for widespread clinical use since the 1930s
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Heparin has been extensively studied in numerous clinical trials over several decades, establishing its efficacy and safety profile in various thrombotic conditions.
Lab Monitoring
- Activated Partial Thromboplastin Time (aPTT) to monitor therapeutic effect
- Platelet count (before treatment and regularly during treatment to monitor for HIT)
- Hemoglobin and hematocrit to monitor for bleeding
- Renal and liver function tests
Doctor Notes
- Strict monitoring of aPTT is crucial for safe and effective heparin therapy. Adjust infusion rate to maintain desired aPTT range.
- Monitor platelet count regularly to detect heparin-induced thrombocytopenia (HIT). Discontinue heparin if HIT is suspected or confirmed.
- Assess patient for active bleeding or increased bleeding risk before and during therapy.
Patient Guidelines
- Report any signs of unusual bleeding or bruising immediately to your doctor or nurse.
- Do not take aspirin, NSAIDs, or any other blood thinners without consulting your healthcare provider.
- Avoid activities that may increase your risk of injury or bleeding.
Missed Dose Advice
If a dose is missed, administer it as soon as you remember if it's not too close to the next scheduled dose. Otherwise, skip the missed dose and continue with your regular dosing schedule. Do not double dose.
Driving Precautions
Heparin is not known to impair the ability to drive or operate machinery. However, patients should be aware of potential side effects like dizziness and proceed with caution.
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