Unfractionated Heparin (IV)

SCOPE LIMIT - READ FIRST: this page is categorised ACS / PE / Thrombus, but the fetched SPC (Heparin (Mucous) Injection BP 1,000 IU) covers only the treatment or prevention of thrombo-embolic disorders and prevention of clotting during haemodialysis. It contains NO acute coronary syndrome or PCI regimen - no weight-based procedural bolus, no ACT target, no ACS-specific infusion rate. The dose above is the labelled thrombo-embolic treatment regimen (applicable to the PE / thrombus part of this page); any ACS/PCI regimen must be sourced separately from cardiology guidance or the local anticoagulation protocol - clinician to source. Subcutaneous alternative for treatment (different dose, different route): initial 250 IU/kg bodyweight, then every 12 hours, individually adjusted according to coagulation tests. Prophylaxis is by subcutaneous injection only: major elective surgery 5,000 IU 2 hours pre-operatively then every 8-12 hours post-operatively for 10-14 days or until the patient is ambulant, whichever is longer; following myocardial infarction 5,000 IU twice daily for 10 days or until the patient is mobile (VTE prophylaxis post-MI, NOT ACS anticoagulation); other patients 5,000 IU every 8-12 hours. These standard prophylactic regimens do not require routine control. Prevention of clotting during haemodialysis (adults): initial bolus 1,000-5,000 IU followed by continuous intravenous infusion 1,000-2,000 IU per hour, adjusted to maintain clotting time above 40 minutes (the comparator symbol is degraded in the fetched text - verify against the SPC). CHILDREN: standard treatment dosages should be given initially, then subsequent dosages and/or dosage intervals individually adjusted according to changes in thrombin clotting time, whole blood clotting time and/or APTT - no separate paediatric IU/kg figure is stated, hence paedDose is null; this formulation contains benzyl alcohol and must not be given to premature babies or neonates. ELDERLY: lower treatment dosages may be required, but standard treatment dosages should be given initially and then individually adjusted according to coagulation tests. PREGNANCY: this formulation contains benzyl alcohol which may cross the placenta, so it should be avoided in pregnancy; if considered essential, give standard treatment dosages initially by continuous intravenous infusion, or every 12 hours by subcutaneous injection - intermittent intravenous injections are not advised. MONITORING: platelet count should be measured before starting treatment and periodically thereafter because of the risk of immune-mediated heparin-induced thrombocytopenia (type II).