Diparin

• Prophylaxis and treatment of venous thromboembolism and pulmonary embolism
• Atrial fibrillation with embolization
• Acute and chronic consumptive coagulopathies (disseminated intravascular coagulation)
• Prevention of clotting in arterial and cardiac surgery
• Prophylaxis and treatment of peripheral arterial embolism
• Anticoagulant use in blood transfusions, extracorporeal circulation, dialysis procedures and catheter patency

Heparin inhibits reactions that lead to the clotting of blood and the formation of fibrin clots both in vitro and in vivo. Heparin acts at multiple sites in the normal coagulation system. Small amounts of heparin in combination with Antithrombin III (heparin cofactor) can inhibit thrombosis by inactivating activated Factor X and inhibiting the conversion of prothrombin to thrombin. Once active thrombosis has developed, larger amounts of heparin can inhibit further coagulation by inactivating thrombin and preventing conversion of fibrinogen to fibrin.

Therapeutic Anticoagulant Effect (Full-Dose Heparin):

Deep Subcutaneous (Intrafat) Injection:

• Initial Dose: 333 units/kg
• Every 12 hours: 250 units/kg

Intermittent Intravenous Injection:

• Initial Dose: 10,000 units
• Every 4-6 hours: 5,000-10,000 units

Continuous Intravenous Infusion:

• Initial Dose: 5,000 units (IV injection)
• Continuous: 20,000-40,000 units/24 hours

Heart and Blood Vessel Surgery:

• ≥ 150 units/kg

Catheter Patency Maintenance:

• 2 units/mL (infusion rate 3 mL/hour)

* Use as directed by the registered physician

Common Side Effects (>10%):

• Heparin-induced thrombocytopenia (10-30%)

Other Side Effects:

• Mild pain at injection site, hematoma, hemorrhage, local irritation, erythema
• Increased liver aminotransferase
• Anaphylaxis
• Immune hypersensitivity reaction
• Osteoporosis (long-term, high-dose use)

Serious (Potentially Fatal): HIT with or without thrombosis; bleeding

Use in Pregnancy: Pregnancy Category C. Heparin does not cross the placental barrier. Use only if clearly needed.

Precautions:

• Notify doctor if you see blood in urine or stool or any unusual bleeding
• Inform doctor if you experience rash, itching, swelling of face, tongue and throat
• Regular platelet counts, hematocrits and stool occult blood tests are recommended
• Caution in active bleeding, thrombocytopenia, peptic ulcer, cerebrovascular disorders, severe hypertension

Overdose: Bleeding is the chief sign. Protamine sulfate (1% solution) by slow infusion will neutralize heparin. Each mg of protamine sulfate neutralizes approximately 100 BP heparin units.

Storage: Do not store above 30°C. Keep away from light and out of reach of children.