Heparin is an anticoagulant available with a prescription only. It is used for the prevention and treatment of blood clot disorders. Heparin does not dissolve blood clots, but prevents them becoming larger and causing complications such as heart attack or stroke. It may also be used before open heart surgery, bypass surgery, kidney dialysis and blood transfusions to prevent clot formation. Your physician can determine the dose for proper effectiveness.
Metabolism
Metabolism describes how a medication is broken down in the body and the remaining products are referred to as metabolites. Heparin is metabolized primarily by the liver and partially metabolized by the reticuloendothelial system. The reticuloendothelial system is a major part of the immune system composed of phagocytes, which are cells that engulf harmful substances, including bacteria and viruses. The medication is engulfed by the phagocytes and released from the body. There are no active metabolites for heparin so there no effects seen from these substances.
Liver Dysfunction
Patients who have liver dysfunction are able to take heparin. The dose of heparin does not need to be adjusted in patients who have liver disease. Elderly patients, or those over 60 years of age, may have higher levels of the medication in their bodies and an increased response. This can result in an increased risk of bleeding. The dose of the medication is based on bleeding time of the individual and is adjusted according to response.
Drug Interactions
Medications that increase bleeding time should not be given with heparin. These include aspirin, nonsteroidal anti-inflammatory drugs, dextran, clopidrogel, tetracycline, quinine, nicotine and blood thinners such as warfarin. Using heparin along one of these medications may result in hemorrhage. Heparin levels may decrease when used with high doses of nitroglycerin. This can lead to a decreased response to heparin and put you at risk of developing a clot. If the addition of a new medication is necessary, your physician can lower or raise the dose as needed.
Herbal Interactions
Herbal products are considered natural, but they may affect other medications you use. Herbal medications that increase the effect of heparin and can increase bleeding time include cat's claw, dong quai, evening primrose, feverfew, red clover, horse chestnut, garlic, green tea, ginseng and ginkgo biloba, according to the "Drug Information Handbook." Always tell your physician of all the herbal and over-the-counter medications you use to ensure that no interactions exist.
References
- Encyclopaedia Britannica: Reticuloendothelial System
- "Drug Information Handbook"; Charles F. Lacy, Lora L. Armstrong, et al.; 2009
- MayoClinic.com: Heparin
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